BSN Preceptorships - Does ER level matter?

emtb2rn, BSN, RN, EMT-B · Mar 7, 2012

i'm not sure i understand what you mean by "

i was placed in a smaller town that is a level 3 er...and one that pretty much nothing goes to."

as far as i know (and i'm sure someone will correct me if i'm wrong), "level" refers to trauma and trauma only. i work in a little ole 50 bed er in a community hospital in nj and while we don't get the ejected during the rollover multi-system traumas, i'd have to say that all the mi's, cva's & septic workups we do would like to think they're above "pretty much nothing".

with respect to your actual question, i think any experience is better than none. embrace everything as a learning experience.

good luck.

DebanamRN, MSN, RN · Mar 7, 2012

I work in an 18 bed ER in NJ and we see some wild stuff. Go in with a great attitude and soak up all you can. You will probably be surprised what goes on in there.

JustinAllen · Mar 7, 2012

emt2brn, you are correct, the level system does refer to trauma classification. I only used it to showcase the difference between not being placed in a Level 1 facility and a facility that has no level. And as a former Paramedic I really do understand that the trauma is cool, but the medical involves more thinking at times. However the acuity level would have been much different at the Level 1 trauma center, and it is in that area that I will not get the experience that I was looking for.

But I also agree with you...any experience is better than none :) I just hate to think that's all I get to hang my hat on.

JustinAllen · Mar 7, 2012

Thank you DebanamRN!

whichone'spink, BSN, RN · Mar 7, 2012

I will be finishing my practicum at a Level IV trauma ER. If this ER gets a serious trauma case, the patient is quickly shipped off to the Level II ER at their sister facility. But I also work in this same ER, and I know that plenty of sick patients come through. It'll be good experience, even if you don't get the bad trauma cases.

EDRN10 · Mar 8, 2012

I think you will do fine and gain a lot of valuable experience. Do not get hung up on the trauma level rankings. I work in a ER that is not a trauma center and we see tons of trauma's. You have to realize that any traumatic injuries that occur and people just come in through the lobby you will see which will be more than you think. Also if a pt is severely injured and not stable enough to transfer to a higher trauma center and your ER is the closest they will come to you. You will do a lot of work to quickly stabilize the pt for transfer to a higher level facility. Even in a trauma center most of your patients are not going to be trauma patients. With all that being said every ER is different but all have the opportunity to see any thing from a stubbed toe to a major traumatic injury.

JustinAllen · Mar 8, 2012

Thanks everyone for your comment. I think I have "ER Snobbery" lol. My years as a Paramedic has been in a large urban city and I think I still tend to look at things that way.

I have a job interview next week at a Level 1 Trauma Center ER and I will ask them what would they like me to "learn" from this preceptorship...if they give me a few things then that will help me out a lot...if they say that what I would learn there would not transfer well...then my anxiety starts all over again :)

DebanamRN, MSN, RN · Mar 8, 2012

What you learn will transfer well, because its the basics. Trauma is all fine and good, but you gotta recognize that MI, CVA, septic, etc. patient. Even in our tiny ER we do trauma, because we are on the Jersey Shore and they often come to us. I've transferred out lots of trauma patients. We stabilize them and get them on the rig or chopper. It can be more interesting because if they come to us they aren't considered so sick. We get lots of surprises - brain bleeds, cervical spine fractures, all kinds of stuff. We don't even have a cath lab and they get helicoptered out pretty quick with MIs. I'm like an EMTALA queen - watch out, I get those forms filled out, report called, and the pt packaged to go pretty quick. Your paramedic experience is invaluable, but now you get to expand your scope as an RN. Good luck!

sserrn, BSN · Mar 8, 2012

I did my nursing school preceptorship in an 8-bed level 5 trauma center . And I loved it. wanted to work there when I graduated, but the mgr at the time would not hire new grads. I now work FT at a Level 3 trauma center near Memphis. It is one of the busiest ERs in the midsouth. I now also work prn in the 8-bed ER where I did my first preceptorship...and let me tell you--I have seen a lot of stuff (including traumatic injuries) that I haven't seen at my 35-bed ER. you will get good experience anywhere, honestly.

JustinAllen · Mar 9, 2012

Thanks again for the new comments...I am a bit over my initial feelings...but will report back on Monday after my interview.

the1anonlycarol · Mar 12, 2012

My accelerated nursing school program in Mass also had an internship... it was something like 300 hours. I asked to be placed in an ED in my home state (one state over - CT - ; ~ 1.5 hour drive). They agreed and got me into a Level 2 on the shoreline. I did not apply there, but instead applied to two Level 1s and got offers at both. I had about a year of experience as a tech in the ED (w/ EMT certification) at a different hospital that I don't even think has a trauma level. It will look great that you have those other certifications, we typically put our new grads through ACLS, PALS, and TNCC. And with your Paramedic history...it seems like you have more experience than our new grads do so I don't see why you would trouble getting into where you want to go! In your interviews (when you get to that point), talk about how this preceptorship at the Level 3 helped to build your nursing skills and lay a solid foundation for performing assessments. We spend so much time teaching basic nursing stuff to our new grads that if you can incorporate that into your interviews (to show that you used this experience to prepare you for a Level 1) then you should be golden. Feel free to message me if I can help at all. :)