Best route into the ER

dthfytr, ADN, LPN, RN, EMT-B, EMT-I · Jul 28, 2010

I strongly recomend a year working on the med surg floor before working in the ER. I've seen too many new grads, good nurses all, find the ER too hard a place to start. Think about getting your drivers license and going directly to the Indy 500. Don't kill yourself, nursing school is hard enough, but the EMT course or better yet the TNCC teaches great basic assesment skills. In any case, good luck, fair winds and following seas. As always, your mileage may vary.

pharmgirl · Jul 28, 2010

I agree with dthfytr, get a solid year of med surg under your belt. It really helps, trust me. I am a new grad in the ER. I graduated from a bridge program and got my LPN last May and RN this May. During my LPN year I worked on a med surg floor and it has come in very handy. There is a lot of autonomy in the ER which I'm trying to get used to. I am so glad I had that year, not only to "practice" skills but to also gain some confidence.

You could also try to get a job in an ER as an ER tech. It would give you a feel for the ER and also get your foot in the door. Secondly, if you have the option to precept in Emergency, jump on it, once you get there, work your butt off and prove yourself. Believe me, managers watch students and consider them for future employment. The hospital I precepted with called me when they had an opening available and offered me the job. That's how I got in.

Good luck with NS but please know, its time consuming and difficult. Try not to overwhelm yourself, at least for the first semester until you know your workload.

Sarah010101 · Jul 28, 2010

I recently had the same question, since now that i have finished my second year I am able to become an employed student nurse (ESN). I was told that wherever you choose to do your ESN (if you are doing it) that is most likely the place where they will try and hire you. Hence, if i do my ESN for the remainder of my nursing school in the ED, I will most likely get hired. However i just finished a medical rotation and i LOVED it... surgical is next semester, but we have been told that one year of med-surg to consolidate those skills is a great idea, PLUS the experience that comes along with it!

Good luck in nursing school, it is definetly an experience of a life time :)

NoPrisoners · Jul 28, 2010

Thanks for the replies! I'll definitely look into med-surge for the experience but would I tell the interviewer that my end goal is ER or keep that to myself? I'd love to be an ER Tech but I never see them advertised in my area so I don't know what qualifications are needed here. Do I need to be an EMT-B or would being an NA and getting a BLS be enough to get a foot in the door while I'm a student? I'm tempted to go ahead with the EMT-B either way. I think it's something I'd really enjoy and it couldn't hurt to volunteer with my local rescue squad. I don't know if we have ESNs here but I'll check into that too.

Med surge scares me a little because I hear more threats to quit from med-surge new grads than ER new grads. Maybe the ER new grads are too exhausted to complain? I worked as an NA in PCU for 8 months and it was great experience, but not where I want to be in the long run.

Thanks for all the tips and thanks for being out there in the trenches day after day! You guys are the reason my dad, my brother and myself are all alive!

emtb2rn, BSN, RN, EMT-B · Jul 28, 2010

You can go right into the er as a new grad. My manager actually likes to hire new grads because as she says "we don't have to break you of any bad habits". Plus new grads are cheaper....

The critical thing is to have a solid orientation, minimum 3 months, that includes classroom as well as "live" precepting. You need to have preceptors who want to teach as well as a top down support system. That and an understanding that as a new grad, you don't know what you don't know, will set the stage for a successful beginning as an er rn.

As for emt, if all you have is the certification but no actual riding experience, it won't count for much. The er tech route is much better. As a side note, the majority of our new grads are former techs. They know us and we know them.

Go to your local er, talk the manager. You might be surprised at what can happen.

Good luck, have fun.

vhern246 · Jul 28, 2010

Is it better to start in Icu? At a local hospital, they have an MICU new grad position open. could this experience also help in the ER?

Fribblet · Jul 28, 2010

If you know you want ER, then go for it right out of school. Don't listen to people who tell you you need med-surg experience. You don't.

The knowledge you learn on a floor is only minimally useful, and odds are, you'll be utterly miserable.

I went straight into a trauma center as a new grad. I have excelled, and I cannot see myself doing anything different.

Go for it.

happy2learn · Jul 28, 2010

You could always volunteer in the ED! That would help get your foot in the door. Or at least make important connections.

DC Collins, ASN · Jul 30, 2010

I hate to be the stick in the mud, but I have to disagree with those who suggest med/surg first. M/S and ED are two *very* different worlds. If you are *sure* the ED is what you want, then it is easier to learn it without going to any other unit first. If you start elsewhere, there are habits that have to be trained out of you (very *good* habits for those departments - not disparaging them).

Hopefully whatever school you attend has as its last quarter/semester some sort of preceptorship where you can choose the department in which you spend your clinical hours. If you do well during that cycle, they will want to hire you, as you are a known quantity.

DC :)

hiddencatRN, BSN, RN · Jul 30, 2010

I'm graduating in September (this September, YAY!) and if I can get a job in an ED I will take it. I've been able to do a couple of clinical days in two different EDs and have loved the pace and excitement (even with fairly non-flashy things like migraines and nausea). Obviously, the economy being what it is right now, I'll take what I can find and make the best of it (get ACLS, PALS, TNCC, etc) but I see it more as a concession to the job market.

ImThatGuy, BSN, RN · Aug 2, 2010

EMT is by no means a hard class, and at the time we only needed 24 hours in the ER and four "emergency" ambulance runs all of which we did when it suited our personal schedules.

Just to give you an idea of how doable it all is...

When I was in college I attended a university by day taking 15-18 credit hours for the fall, spring, and subsequent fall semesters with two courses the summer between there, and most of those were science classes. In addition to that, on Monday and Thursday nights I drove a half hour to a community college and took 14, 15, and 8 credit hours of paramedic classes for the fall, spring, and fall. I can't remember what went on that summer. I never had any trouble studying for it all. My university classes were only one Mondays, Wednesdays, and Fridays so I used the Tuesdays and Thursdays to go to clinicals as needed. We had 600 hours of clinicals to do back then. I don't know what's required now. Neither school knew that I was enrolled in the other. When I was taking graduate courses (04-05), I recall the advisor having trouble figuring out how the timetable worked, lol.

Anyway, it's doable. There wasn't anything hard about it, but I mostly only skim read text books. Your results may vary. University GPA was 3.45 which I was content with, and the paramedic GPA was 4.0. I had plenty of free time and sack time too.

Note, I've never taken any nurse classes but will this fall. I still think you can do it though.