Originally posted by kaycee
...I do think though that a basic arrythmia course should be offered by your hospital as part of your Er orientation. If they don't look around and see if you can sign up for one. ACLS is great but it's more helpful if you already know the basics. As Rick said things are not always the same clinically as they are in a book so you will learn as you go along.
Yes, to the arrythmia class. When cardiacs do weird things, you've got to know your basics and the hallmarks of each arrythmia. Abberancy can change rules. Take a TNCC prep class after about 6 months to a year.
Look, listen, and ask questions. Don't be afraid to ask questions. Don't do things you aren't comfortable doing. Everyone is busy and they won't always greet your questions, but ask them anyhow. Listen to your gut. Remember, 70% of the dx is in the history, so listen to histories, that is listen to what your clients tell you. Desensitize yourself to asking sex questions, but don't get insensitive. That is, you do have to ask teen girls with belly pain if they are having sex, but don't do it in front of their mom or their friends. Listening to histories is important in trauma too since it often will tip you off to serious trauma when the patient might not look that bad.
There are many good books out there, but I thought _Sheehy's Emergency Nursing: Prin and Practice_ is a good overview. Nursing assessment
is the ED is a different critter because you sometimes do it pretty focused and short and other times you have to know when to broaden it out. I think the favorite gem I remember from this book that I saw nurses fluff off repeatedly is, in eye injury, visual acuity is the vital sign of the eye.
I like Rick's advice too. ED is a long and steep learning curve. Expect to go home feeling stupid sometimes more than you want to. But be sure to give yourself credit for what you're learning and doing better.