ED preceptors - who are the best?

[Footballnut]

I am wondering what qualities your favorite ED preceptors had. What helped you learn the most and be the most ready for the job? What kind of things would have been helpful if you had known to ask? Be as specific as you can. I would love to know. I can find plenty of rants on this subject but few positive hints. Also it would be helpful to know if you were a new grad or a transfer from another floor and how much experience you had before you started ED.

[WonderRN]

I am a new grad in the ER with 7mos experience- 3 mos of which have been on my own. I work in a community hospital in a city- we do not do trauma except the walk-in traumas, we have quite a large poor-underserved population with many comorbidities. We see a sick bunch.

I graduated from a one year accelerated program at a very good school. I did not do ER before graduating, but worked 4 years as a tech in an urgent care (drawing blood, wound care, casts, EKGs, VS)- the UC saw ESI level 4 and 5 kind of stuff, some ESI level 3, with the once a week real deal unstable angina, CVA symptoms, trauma, burn, respiratory distress that walked through the door and had to be transferred. (Saw some pretty cool stuff in my time there, but knew nothing more about how to care for them besides their initial stabilization)

Top quality in ED preceptor:

1) PATIENCE- let me do it! Take the time to stay with me and help me. Please recruit help from other coworkers/charge RN on my/our behalf if this means we'll be caught up for a while in a pt room and be away from our other patients, so they can help watch those folks. I need to learn how to do it the right way.

My best preceptors helped me with the

1) Critical thinking process- before going into this room "ok, we know this is a belly pain, young female- that's all we know right now.. We need to know where it is, pain quality, radiation, when it started.... n/v/d? fever? urinary symptoms? blood in urine or stool? LMP? etc..... We need to place an IV that is at least 20G, above the wrist so that the doc can do an abdominal CT if necessary"

3) Debriefing- especially with codes, pt going to ICU- there is soooo much going on so quickly with these pts, helps me with the critical thinking process

"ok, why did we use calcium chloride? why do we think her pressure was so low? what are the side effects of that levo drip? What are the steps we did in that rapid sequence intubation?"

4) Help me learn how to prioritize and multi-task!!!- so hard for the new grad

Good question, by the way. I'm guessing you are a preceptor?

[Footballnut]

Thanks WonderRN! Yes, I am a preceptor. I coordinate the precepting and education for our ED. I am always looking for ways to learn more. Thank you for helping me.