Need advice - new to ER, major anxiety

  1. Hello everyone!

    I just transferred to ER after spending 2 years on a very difficult med-surg unit. I have some great experience as a floor nurse, I handle well all kinds of stress, people and emergent situations.
    For some reason I feel EXTREMELY insecure about going to work in ED, I feel like I will not know what to do and will fail. I don't know if all of this is brought on by leaving comfort zone and meeting new people.

    I have no real reason to feel this way, although sometimes I do make really stupid choices when the obvious is right in front of me. In med-surg, I felt very confident and my patients were very well take care of.
    There was not one incident when I missed something or when my patient ended up going to the unit because I did not do something for that patient.
    I was a resource for others for telemetry, IV therapy and emergencies, did charge nursing on weekends on a 46 bed unit with 4 stepdown beds.

    Now I feel like I need to learn everything all over again in the ER.
    If anyone has any suggestions please tell me your thoughts.
    Thanks!!
    Nat
  2. Visit Anagray profile page

    About Anagray

    Joined: May '02; Posts: 338; Likes: 43
    RN; from US
    Specialty: 8 year(s) of experience in ER,med-surg, LTC, psych, dialysis

    15 Comments

  3. by   nuangel1
    just relax. you will be oriented .ask questions get informed .and everyone has a learning curve .give it time .we were all new to er once .you will use all the knowledge and skills learned in tele and learn more.good luck.
  4. by   bopps
    Relax. You really want to do this right? Then you can! Of course you aren't going to be comfy at first cause it's a whole new ballpark, but you can still get a homerun with some practice. Go get em tiger!
  5. by   Katnip
    You've got good, solid experience behind you and that will help enormously in an ER setting. Yes, it's different, but you'll do well I think.
  6. by   rachelaleanRN2B
    Relax, you can do it. I was an ER nurse for 2.5 years straight out of school in a level one trauma center. I cannot tell you how scared I was the first time I nurse one in trauma and then had to go to CT with the pt and surgeons BY MYSELF!!! OMG. You will learn what to do and what not to do. You'll learn protocols to do and then it will become second nature to you. You'll have the fluids and Zofran out before the doc even sees them just waiting for the go ahead. Always try to anticipate what the next step is going to be. Breath, relax, watch, ask lots of questions, and don't be afraid to say hey I don't know how to do that. In a good ER everyone works together, nurses and doctors. Good luck!!

    Rachel
  7. by   RNtigerEMT
    I too just started in the ED after 2 3/4 yrs on a difficult med surg floor, different hospital. I agree with everyone else, ask LOTS of questions, and don't be afraid to say I'm not familiar with that. I've been in the ED now for a little over a month, and am just starting to feel comfortable. Find a "go to" person, hopefully your preceptor/orientator, that you trust and can rely on. Unfortunately for me, and the rest of the staff, my orientation has not gone very smoothly, I have yet to be assigned one particular person to orient with. They wanted to take me out of orientation two weeks ago and I told them "no, I'm not ready". Now it feels like they are doubting my ability as a nurse all around, just because I'm smart enough to know my limitations. The ED is a whole new world for me, one that I love very much, but its been stressful. Good luck, take a deep breath, and don't let them make you doubt yourself. You'll do great once you get your feet under you. It may take a while, but go with the flow, and never be afraid to ask questions if you are having doubts.
  8. by   JBudd
    I did all sorts of medsurg floors for 16 years before coming to the ER. I went from the "senior know it all" to newbie in one fell swoop. Most folks around here say it takes about a year to feel really comfortable in the ER, it just creeps up on you until one day you realize you haven't been anxious about much lately. You have a head start with the tele experience. Its okay to be the newbie, what people resent is someone coming in and thinking ER is just the same as medsurg only faster. NOT! Its a whole different world of assessments, done on the run, and a terrific challenge. Nothing like the adrenaline rushes you get here! Take a deep breath, dive in and start swimming with the sharks, lol. :spin: Its been some of the most fun 10 years in nursing yet.
  9. by   hzrizen
    Quote from RNtigerEMT
    I too just started in the ED after 2 3/4 yrs on a difficult med surg floor, different hospital. I agree with everyone else, ask LOTS of questions, and don't be afraid to say I'm not familiar with that. I've been in the ED now for a little over a month, and am just starting to feel comfortable. Find a "go to" person, hopefully your preceptor/orientator, that you trust and can rely on. Unfortunately for me, and the rest of the staff, my orientation has not gone very smoothly, I have yet to be assigned one particular person to orient with. They wanted to take me out of orientation two weeks ago and I told them "no, I'm not ready". Now it feels like they are doubting my ability as a nurse all around, just because I'm smart enough to know my limitations. The ED is a whole new world for me, one that I love very much, but its been stressful. Good luck, take a deep breath, and don't let them make you doubt yourself. You'll do great once you get your feet under you. It may take a while, but go with the flow, and never be afraid to ask questions if you are having doubts.
    How long were you on orientation?
    D-
  10. by   AC439
    I also just came into ER from med/surg. Just finished my 5 weeks orientation. I'm getting comfortable in most areas except fast track, especially one nurse for 6 fast track beds without tech/CNA. Actually, I like ER in a way that the documentation is lesser and MDs works with nurses. You also have a bit more autonomy and being less bounded by policies. Most ER people works together as a team although some are not team players. But I'd never go back to med/surg.
  11. by   steelcityrn
    Good luck!
  12. by   teeituptom
    Most importantly, remember to breathe. Breathing is very good. Keeps you alive. If breathing properly, it will help you to stay relaxed.

    I also reccomend wearing magnets, very beneficial

    I also say find a way to relax that is non chemical in nature. I recommend Golf
  13. by   RNtigerEMT
    Quote from hzrizen
    How long were you on orientation?
    D-
    I had 3 days of general hospital orientation, started on the floor in ED March 15, 1 wk on days, 2 wks on midnights, and am starting my 4th wk on afternoons. So so far 7wks. They wanted to pull me out of orientation 3 wks ago, and I told them "no I'm not ready". Feel alot more comfortable now, have been pretty much doing my own thing for about the last wk and half.
  14. by   teeituptom
    Quote from RNtigerEMT
    I had 3 days of general hospital orientation, started on the floor in ED March 15, 1 wk on days, 2 wks on midnights, and am starting my 4th wk on afternoons. So so far 7wks. They wanted to pull me out of orientation 3 wks ago, and I told them "no I'm not ready". Feel alot more comfortable now, have been pretty much doing my own thing for about the last wk and half.
    7 wks orientation, OMG.
    Times have changed
    1 day orientation for me
    Saw my preceptor in the morning for 15 min. got a tour and quick intro ti paperwork. Saw her again 11 1/2 hrs later. She asked if I killed anybody. I said no. She said I passed orientation. And congratulations

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