Best way to get a position in the ER?

neneRN, BSN, RN · May 5, 2007

Get a job in your ER as a tech...almost all of ours are nursing students and they usually end up staying when they graduate. You get to learn the paperwork and flow of the dept. so that when you graduate you are already comfortable with those aspects and can focus more on the actual nursing care when you go through your RN orientation. Also, you get to know staff and docs you'll be working with and be able to know who your resource people are going to be when you need help. There are always a couple of nurses who will go out of their way to make sure you get to see interesting cases/procedures, etc. especially if they know you're a nursing student.

CainRN · May 5, 2007

Yeah, I hope to get on as an aide after I get certified. My local ER doesn't use techs. But, I think they also train us in EKG, splinting, etc., so I guess it would be about the same as a tech. The problem with that is I live in a pretty rural area. The current ER I volunteer in is decent sized (12 bed plus hallways), but nothing compared to a level one center. I'm concerned that the experience will not be considered "intense" enough for post grad employment.

CrufflerJJ, BSN, RN, EMT-P · May 5, 2007

I would like to work in either ER or critical care when I graduate with the eventual goal being to work in flight nursing.
Also, does anyone have any suggestions of things I could do now while in school to better prepare myself for my current career goals? I currently voulnteer at my local ER and am taking a CNA class in June. Also, I am a CPR instructor for the Red Cross. I've considered getting certified as an EMT, but I'm not really sure if the time spent on it would be worth it.

Depending on where you want to "fly", each area might have different prerequisites. Here in the Dayton, OH area, the ScareFlight nurses are RN and EMT-Paramedics. Experience as an EMT would certainly help you in the ER (patient contact in trauma situations), and would help building patient assessment skills. Field exposure would also give you the experiences in scene size-up, scene safety, extrication, and all that good stuff.

I would NOT recommend that you go for your paramedic certification while doing nursing school. You'd be looking at ~5 quarters of heavy classwork & clinical hours, which would not be fun while doing nursing school. EMT would be much shorter class time, but you'd still gain the patient contact and field experience.

Once you get your RN, some areas offer a "bridge" course from RN-->EMT-P that only take ~2 quarters of part-time coursework. Those programs build on your already strong RN patient assessment skills, and add the skill set you'll need to function in the field.

"Real world" field experience, as EMT or EMT-P would certainly help you as a flight nurse. It's a whole different world "out there". It's you, your fellow squad members (or flight crew personnel), and your patient. Your patient isn't arranged nicely for you on a bed in a well lit ER. You'll have folks upside down, in ditches, pinned in cars, all that good stuff. I would think that field experience before you become a nurse would be invaluable.

mom2michael, MSN, RN, NP · May 7, 2007

Yeah, I hope to get on as an aide after I get certified. My local ER doesn't use techs. But, I think they also train us in EKG, splinting, etc., so I guess it would be about the same as a tech. The problem with that is I live in a pretty rural area. The current ER I volunteer in is decent sized (12 bed plus hallways), but nothing compared to a level one center. I'm concerned that the experience will not be considered "intense" enough for post grad employment.

Don't sell the rural facility short - small ER's in rural areas can be very intense at times.

I'm responsible for whatever walks thru that door, the good, the bad, the ugly. We aren't seperated out into cardiac, trauma and general rooms, our rooms are a free for all - whatever fits in that room, fits and EVERYONE helps out - we are not assigned rooms.

For example yesterday I had in room 1 a head cold for 2 days, in Room 2 I had an AMI, in Room 3 I had a broken femur, in Room 4 I had an open compound fracture, in Room 6 I had a rectal bleed and in my Pedi Room I had a child with a head lac who needed head CT's and sutures. There was just 2 of us and the doc with all of this.

We also don't have fast track rooms, so as a new grad, I'm not shoved into the fast track room and I am instead shoved right into the middle of the action about 99.9% of the time. A little overwhelming at times, very intense most of the time.

You rely on your gut, your co-workers and your docs to stablize whatever walks thru that door until you can find resources to get that person even more stable. We have to make very quick decisions because the closest trauma center is 55 miles by ground, 15 mins by flight. We are always fighting that golden hour rule where I work.

We also don't have the ability to close down d/t lack of beds, we have to take patients and can not divert. We can have them stacked in the hallways at times.

My experience in a small ER, I believe is extremly "intense".

OK, off my soap box about rural nursing.....back to your original questions - get tons of hands on, field experience. I took an EMT class before I went to NS and it helped me tons in the ER. Get a job as a aide, tech or whatever they call it in your ER that way you learn the paperwork, the flow, etc...which will make you more marketable when you graduate. For our flight crews they want 5-8 years of ER and ICU experience and whole bunch of certifications before they'll look at you.

And, we've had several of our RN's go on to become flight RN's, so the rural nursing thing has never held them back.