Does your ED/ER hire new grads? (and related ?s)

Heather, R.N. · Jan 12, 2008

I just started an ER internship, but I've been a nurse for a year and a half. My hospital only hired 2 interns out of 20 applicants. The other intern is a new grad. January/June are typical start dates for most internships. But, my med-surg internship in 2006 started in October for me. Orientation is usually 12 weeks, but can be longer if you need it. We need ACLS, but some facilities require PALS also. I think we're a level III center, but we are a "foremost" cardiac ER.

nursingisworkRN · Jan 12, 2008

To answer your question:

1. Yes

2. Year round, depending on dates of new grad orientations which are every 8-12 weeks. All new grads will start in new grad orientation, the ED has I believe 4-6 months of training for new grads, 10 weeks for experienced nurses.

3. I have not heard of more than two new grads hired at the same time, but it is totally dependent on department needs, available preceptors, and length of orientation.

4. New grads are required to have ACLS, PALS, and dysrhythmias. Experienced nurses get TNCC, ENPC, and any other recerts. I have 11 weeks of orientation, with TNCC and ENPC, and still need PALS. I already had ACLS and dysrhythmias/12 lead interpretation, so that helped.

5. We are a level 2 trauma center (no affiliation to university)

Personally, I was not prepared as a new grad to work in the ED. My year and a half of telemetry was invaluable experience, but I do tend to think that experience is experience and you have to get it some where. Best of luck!

luckylucyrn · Jan 12, 2008

1. Yes, we have a nurse intern program and a lot of new grads are hired from that program.

2. They don't really have a "schedule", they are Intern 2's until they pass their boards and then they can start official orientation. But from the time they graduate until they are done with orientation, they work with their preceptors. There is a big interview time near the end of each semester where the soon-to-be grads do all their interviews and then it is announced who is hired, usually about a month before graduation.

3. It all depends on the number of spots the ER has available at the time. New grads are hired at graduation while experienced nurses are hired anytime. So sometimes there are more spots than others. There were 4 new grads hired when I graduated and 4 this year, it fluctuates. There are 2 of us 4 grads left in my group, the others moved out of state and are still currently working in ERs.

4. Orientation for new grads is typically 12-16 weeks after passing boards, depending on the needs of the new nurse. Almost all of our new grad hires have spent a lot of time as interns in the ER prior to graduation and already have a good feel for the "flow", so new grads that come from the ER usually don't require as much time. We get ACLS and PALS, and we also have to take EKG courses, and a Critical Care course. Other certifications will be paid for by the hospital but aren't required.

5. We don't even get a level. We are a large facility but have limited Trauma. We have a large patient volume and can do minor trauma (and the occasional major trauma that is accepted by our docs that is usually advertised by EMS as not being as bad as it really is) but we are mostly cardiac.

Trauma Columnist · Jan 12, 2008

I worked in a level one trauma center for 10 years. Yes, we hired new grads, orientation was 12-16 weeks and we used the ENA references which provided a solid didactic basis.

mom2michael, MSN, RN, NP · Jan 12, 2008

I'll answer your questions based on our sister facility which is a 900 bed Level II trauma center rather than where I actually work, which is an outlying facility.

1. Yes...oodles of them and they hire into any department.

2. New grads are hired in Dec/May each year. Say you graduate in May, you'll be hired in March or April. The end of May/1st of June you'll start general orientation and computer classes, which are a week long. The 2nd week you'll take an NCLEX prep class. The 3rd week you'll take more computer classes and classes designed to help you transition from student to RN. 4th week, more classes. They want you to have your NCLEX done and out of the way by the end of your 4th week. Normally, not an issue because it's acutally been 6-7 weeks since graduation. They push hard for you to finish your NCLEX before the 4th week because you transition into your department orientation week 5 and they really want you to concentrate on that. Does it always happen, no....but that's what they strive for.

3. At my trauma conference yesterday they said 28 new grads were taken into the ER this last round (Dec). They said that was a small amount hired. I guess they normally hire more????

4. 4 weeks of general/new grad orienation. Unit specific is anywhere from 8 weeks (M/S) to 22 weeks (L&D). ER averages around 16-18 weeks they say. ER requires ACLS, PALS, NRP, TNCC, ENPC. Then some additional computer modules that are unit specific and are required by the end of the 1st year.

5. The facility I'm talking about is a level II. Where I actually work, we are not a trauma center.

Where I live, the nursing shortage is very real and if you breathe, you'll get hired pretty much anywhere you desire. Does that mean a good solid orientation???? No. I will say though, I was pretty impressed with my sister facilities orientation. I didn't have ANYTHING like that when I started in ER a year ago.

And, I will say, most of the trauma centers in this area are similiar in nature to this one in regards to orientation. The only difference is my sister facility really focuses on retention of new grads more than most....thus the 4 weeks or orientation when you 1st get hired.

ERnewbieRN, BSN, RN · Jan 13, 2008

I entered ER as a new grad in June 2007, but I think the only reason I got the job is because I did an internship during the summer of 2006 in that ER and they already knew me. Most hospitals in my area (southern NH) don't hire new grads into specialty areas because there isn't as much of a shortage around here.

They don't hire on a "schedule" per se, but you start whenever the next hospital-wide orientation is scheduled.

Hospital-wide orientation was 5 days, and my orientation period with one set preceptor was about 12 weeks, but could have been extended if I had wanted. I probably could've used another couple of weeks, but I really couldn't take working 11a-11p anymore :) I work 7p-7a now, 11p-7a e/o weekend.

My hospital is a level 2 trauma center... the ER is only 20 beds and the hospital itself is really tiny, but we're equipped to at least stabilize big things and send em out to be admitted elsewhere.

CraigBSN02 · Jan 13, 2008

I graduate in May and hope to work in an ER. From my understanding it is quite possible to find jobs in the ER as a new grad.
Out of curiousity, I have a few questions:
1. Does your hospital hire new grads?

Yes, they have internships and externships.

2. If so, do they hire on a scheduled basis- i.e. January start and June start? Or do they hire and start year round?

Usually coincides with school graduations, but ideally they'll start a new grad training class whenever they're enough people.

3. How many new grads do you typically get per hiring round?

I think it's pretty heavily skewed towards newbies, though I don't know what the numbers are.

4. How long is the orientation, and what classes/certifications are involved?

I think about 18 months: 6 months minimum for classes and orientation and a contract year for the remainder with financial penalties if you quit early. Classes cover the gamut: ER, OR, ICU, the floors, and even newborns. However it's all from a unit perspective (ie: how does this affect you in the ER).

5. Which level trauma center is your hospital?

Level 1, sees 100,000+ visits per year, about 2500 of those real trauma.

Thanks for any responses! I'm just trying to get a better idea of what to expect, and what my odds are.....

Keep plugging away, be proactive, smart and driven and you'll get whatever position you want. It's still a buyers market out there for nurses.

-Craig

RN, BSN, and others.:hrnsmlys:

MikeyBSN · Jan 15, 2008

I graduate in May and hope to work in an ER. From my understanding it is quite possible to find jobs in the ER as a new grad.
Out of curiousity, I have a few questions:
1. Does your hospital hire new grads?
2. If so, do they hire on a scheduled basis- i.e. January start and June start? Or do they hire and start year round?
3. How many new grads do you typically get per hiring round?
4. How long is the orientation, and what classes/certifications are involved?
5. Which level trauma center is your hospital?
Thanks for any responses! I'm just trying to get a better idea of what to expect, and what my odds are.....

Hospitals in my area seem to waiver back and forth on the new grad question. Some hospitals will take them, others won't take them one year but then change their mind the next. I entered the ER as a new grad and my hospital still hires them.

1. Yes, I started with several new grads and I'm one of the only ones who stayed.

2. There is no real schedule for hiring, we hire based on need. However, we do have a program for new grads that starts in the winter and fall of each year, depending on intrest.

3. There is no set number, but I started with 6 other new grads.

4. My orientation was pretty extensive. I started before I got my license; I was in a classroom setting. We had to learn basic hospital policy along with the other new grads, but our classroom orientation extended longer than the other grads'. After basic orientation, we had to learn critical care, including CVP monitoring and EKG analysis. Our facility requires BLS, ACLS, TNCC, ENPC, PALS and encourages CEN.

5. We are a level 2 trauma center.

Gwailo · Jan 15, 2008

My ED actively recruits new grads from the local university. We have recently begun a new initiative called the "trauma day" where fourth year students are given a TNCC type presentation and then given 3 or 4 different scenarios where ED RN's play injured patients (with the back boards, collars, blood and guts!) The students seem to really like the day and many of them apply to do their pre-grad in our ED. We hire new grads on an on-going basis and they are given extensive classroom and on-the-job training with a mentor for about 3 months or so. (the mentorship is very flexible). I was hired about three years ago right from school and was offered a job while I was doing my pre-grad. If you want emerg then don't stop until you get it. It is incredibly rewarding and exciting. The learning curve is a steep one and its not for the lazy or faint of heart. Good luck, there are tons of opportunities out there right now for emerg nursing, even for new grads.

ErNrsLynzzie · Jan 15, 2008

1. Yes - they do. More so on the floors but we do hire in the ER too. They place preference on those who've worked as a Student Nurse Associate (aka PCA, Nurses's Aid) in the ER already.

2. They prefer new grads June and January only, but make some rare exceptions.

3. This year there were 6 of us.

4. 22 week orientation called Versant. It's a Pediatric Nursing Residency program (i work at a Children's Hospital). PALS and ENPC are required within one year and ACLS and TNCC are optional.

5. Level 1 Pediatric Trauma Center

it's rough as a new grad in the er - having worked for 6 months prior as a Student Nurse Associate was amazing help! I had my IV and procedure skills down pat and just worked on my med and RN skills. Best of Luck!

SDS_RN, RN · Jan 16, 2008

Our facility requires at least 1 year experience before hiring new grads into specialty areas. We are a level III facility and my orientation was 6 weeks but could have been longer if I had asked. We also rotate to Same Day Services and I had 6 days orientation up there but was surg nurse before so that was easy. We are required to have ACLS and TNCC w/in 6mo to 1 year of hire, PALS is not required but is encouraged. I'm prepping right now for my ACLS and then TNCC in March. Good luck to you in the ER it is a great place to learn.