Discouraged 1st year ER/ ED nurse

Editorial Team / Moderator · Apr 10, 2016

Instead of how we feel, let's talk about you. What did you think you would love about the ER? How is your setting not meeting your expectations? What is it that you dislike? Is there a part of it you do like? Do you feel confident and competent in your role, or are you still adjusting?

pthelper777, BSN, RN · Apr 10, 2016

I feel overwhemed. I love when I'm chugging along & I'm productive & efficient. I don't like feeling as I don't know what to do with a patient...if I'm not sure what to do. Usually when Im over my head.

Thank you for asking me what i don't like. I want to love what i do!

Editorial Team / Moderator · Apr 10, 2016

I feel overwhemed. I love when I'm chugging along & I'm productive & efficient. I don't like feeling as I don't know what to do with a patient...if I'm not sure what to do. Usually when Im over my head.
Thank you for asking me what i don't like. I want to love what i do!

When you don't feel like you know what to do, do you have a mentor/coworker that you can bounce things off of? Maybe a clinical educator? With each new patient encounter, there is the opportunity to learn. We all have those days when we feel like we're drowning, and that is the worst! I make sure I help other nurses out when I have a minute, and they are quick to return the favor when I am struggling with competing priorities.

pthelper777, BSN, RN · Apr 10, 2016

I love the aspect of learning with every patient, every experience. Im on nightshift & live the nurses I work with but d/t loss og quite a few experienced night nurse a lot of times its new grads I'm with at night & I feel as though there's not enough experienced nurses to ask for advice but if they're there I will definitely ask them. Thank you!

pthelper777, BSN, RN · Apr 10, 2016

*love

AZQuik · Apr 10, 2016

I love the aspect of learning with every patient, every experience. Im on nightshift & live the nurses I work with but d/t loss og quite a few experienced night nurse a lot of times its new grads I'm with at night & I feel as though there's not enough experienced nurses to ask for advice but if they're there I will definitely ask them. Thank you!

I usually find a few docs I can bounce things off as well. Many people enjoy showing of their knowledge. Docs are no different. I also study cases that stumped us. Humans are dynamic creatures which will kill themselves trying to survive. Comorbidities and compensation can take what should be a straight forward case to some crazy mystery waiting to be solved.

Maevish, ASN, RN · Apr 11, 2016

Having a lot of new grads on one shift can be really tough. That's when, if your hospital uses travelers, they can come in REALLY handy because (once they've found their legs on the floor) they've probably seen more that most people there and worked more places. If you haven't been there longer than a year I'd say to give it a bit more time and utilize your educators if you can. If you have a very nice manager, you can try him/her, but I did that once as a new grad (I was unaware of what clinical educators were actually for and worked nights so I rarely saw them) and she took it as me saying I didn't like my job, not that I wanted more education. She was a rotten manager though, so hopefully that won't be a problem for you.

I know I don't like ER, but I never wanted to do it either. It doesn't sound like the staff are a problem (besides the lack on seasoned nurses) so that's a plus and it's normal to feel this way multiple times when you're new. ER is tough so it will take some getting used to, but if it's a place you really want to work, I'm sure it will come to you eventually. I know the feeling and it passed :)

xo

MedicFireRN · Apr 11, 2016

When you don't feel like you know what to do, do you have a mentor/coworker that you can bounce things off of? Maybe a clinical educator? With each new patient encounter, there is the opportunity to learn. We all have those days when we feel like we're drowning, and that is the worst! I make sure I help other nurses out when I have a minute, and they are quick to return the favor when I am struggling with competing priorities.

This is gold. I read that you are on nights and you feel like most of the people you're working with now are new grads. What about your charge nurse? Also, what about an evening shift or even a day shift nurse? Is the person who oriented you still there (assuming you got along and respect their nursing judgment)? I love my preceptor and even though I'm going to nights and she's a day shift person, she's someone I can ask advice from even if it's when she's coming and I'm going. I'm also big on asking the docs. They appreciate us like we appreciate them (or at least ours do!). I'd much rather be a bother than continue to feel like I don't know what or why I'm doing something.

Also, don't forget about your clinical resources. If your questions are about meds, you can always call pharmacy. We also have clinical info imbedded into the chart (like the ability to pull up med info from the MAR, along w/ educational info for the patient). Find out if you have something like that. I have found that its often faster to call pharmacy and ask then it is to dig into reference books.

bgxyrnf, MSN, RN · Apr 25, 2016

The first year is tough... really tough, especially if you're not busy enough to see repetition of cases. The second year starts to get easier and by the third year you've really hit your stride. (These scales are dependent on the individual and the average census/acuity/turnover.)

Why I like the ED over the floor and the ICU: Chaos can be stimulating, sometimes you get patients who aren't stable enough to transport to the ICU, less rigid charting, lots of practice with psychomotor skills, broad range of patients from infants to centenarians, neuro, cardiac, GI, trauma, nephro, ob... a little bit of everything (and a lot of some things). In the ED we've had patients put on ECMO, thorocotomies, massive transfusions, EVDs, burns, dialysis, real psych, even cutting a kid out of a coding mom... everything... variety is the spice of life and the ED offers it in spades... and a camaraderie born of working together under duress.

Some people don't dig the ED... in fact, most don't... and the turnover is pretty high. That said, I'd give yourself a couple or three years to really figure it out for yourself before you contemplate making a change. I've seen a number of people leave and then come back.