Calling all once-upon-a-time ER new grads!

[MissBrittanyRN]

You never know what might walk through the door when you are working in the emergency department. How did you learn so much, and feel prepared before your shift? When you specialize, OB for example, you know obstetrical emergencies very well. However, in the emergency department, did you feel like you had to learn the pathophysiology, interventions, assessments, and every aspect of every disease? Or was your orientation more focused on stabilization? I am concerned that I will encounter a disease that may be fairly common, but I remember nothing about from nursing school, and never experienced in clinical. Of course everyone experiences something new at some point, but how did you prepare, and what did your orientation focus on? Do you ever have a patient with medical histories consiting of (for example) chronic GI or endocrine diseases that you know you learned and tested on in nursing school, and then forgot all about? Thanks in advance for your responses!

[Lunah, MSN, RN]

This is my bible: http://www.amazon.com/gp/product/0323055850/

I had an excellent ED nursing fellowship through my employer last year, and we did a lot of reading from Sheehy's, as well as online ENA orientation modules that followed Sheehy's and were FABULOUS.

You really do have to be a jack-of-all-trades, so to speak, because just as you said, you have no clue what's going to come in. If you don't know about a disease process or particular illness, you can bet one of your coworkers (docs, RNs, etc.) can probably tell you about it. Find your coworker who is the "wealth of knowledge." Get comfy with Google -- I still have to look up some of the more obscure stuff on the fly, but I've learned a lot in the ED. I've found that once I've seen a patient with XYZ disease, I remember it forever.

I went from being an ED tech for nearly 4 years to being an ED RN last summer, and I've been a paramedic since 2003, so my transition was a little different. But I'll never stop learning -- I learn something new with each shift, it seems.

Good luck!!

[MissBrittanyRN]

Thank you for lunah!

[emtb2rn, BSN, RN, EMT-B]

Agree with Lunah. The learning never stops. There's always something new or different. Keep asking questions. My orientation was also ENA based and that gave me a solid foundation that I keep building upon. Nursing school only gives a basic platform, it's truly the OTJ where you learn how to actually be an RN. I find a year out, I'm much more cognizant of the big picture with my pt's as opposed to simply carrying out individual tasks/orders.

Have fun.

[MissBrittanyRN]

I have an interview at an urgent care center, and although I don't want to get ahead of myself, they are not brand new, but a fairly new business. Of course I will ask lots of questions during my interview and request a shadow day, if they want to offer me a position, but I am concerned that they are not familiar with a new grad's training needs. I am very eager to learn, and I am more than willing to keep myself informed with reading material, continuing ed, etc. , but as far as orientation goes, will they expect that I only need to learn what everyone needs to when they first start (their rules, processes, etc?) Although I have done assessments and such in clinicals, I wonder if my preceptor will be there to give me feedback, implement interventions with me that I have not done in clinical, etc.

I will stop rambling as I don't want to ruin this thread with my pitty party lol, but I would love any suggestions that anyone wants to give about whatever I can do (if I get the job, and the orientation is not great) to learn so much. It's not an ER, it's a free-standing urgent clinic, but from my understanding they get a lot of variety through that door, including some people that should have gone straight to the ED.