New grad In ED

  1. Hello everyone!

    So I am a new graduate who just got hired in the ED at a level 1 trauma center. I will be working in fast track and another area of the ED with less critical patients, but I am still pretty nervous. Any advice for me? What to do/not to do during orientation?

    Oh and I will only be getting 80 hours of orientation along with ACLS certification and a 32 hour Dysrhythmias class.

    Thanks!!
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    About nursejess12

    Joined: Jan '12; Posts: 37; Likes: 14

    14 Comments

  3. by   RNCEN
    No advice for you, really....but 80 hours sounds awfully short. Have you worked in that ER (or any ER) as a tech? If so, it may be an easier transition. I'd say keep your eyes and ears open, and learn as much as you can. Good luck!!!
  4. by   nursejess12
    Hey no I havent worked as a tech before. Just a new grad with no experience. I am a little worried I am getting myself into more than I can handle, but I am just going to do my best and see how it goes!
  5. by   Esme12
    Congratulations on passing NCLEX and your new job!!!!!!!!

    80 hours....seem short. That is only 2 weeks. I hope you misunderstood for that would be unusual for a level one to even let an experienced nurse have less than that to get acclimated to the department. Urgent care is really like a walk in clinic, colds, coughs, lacerations, simple fractures. Ask questions pay attention.

    Now remember...no matter where you work. YOU WILL BE OVER WHELMED. You will feel that you aren't cut out for this job and will probably cry in your car in the way home...alot. YOU ARE NORMAL. It takes a minimum of a year to even think you might survive.

    You'll be fine....it's a huge learning curve....Good Luck. We're here!
  6. by   joanie2341
    I'm a new grad in a smaller community ER. I worked there as a tech for about 9 months prior to taking nclex. I had 10 weeks orientation.

    My suggestions: Get a small notepad with tabs for each letter (I use an address book with letter dividers) to take notes. Write down the alternate names of meds you can't remember so you're not wasting time at the pyxis.

    Familiarize yourself with your supplies in the omnicell (or wherever your chargeable materials are).

    Stay on good terms with the techs and ask them nicely for their help! Even though it's their job to help, some (not all!) have attitude problems. Use them when you need too, but don't assume they will always be there.

    And realize that you can't do everything at once! Just breathe and do your best! I have to remind myself that I'm only one person and I can't be starting an IV in one room and triaging in another room. Good teamwork in the ER is a must. And you must be willing to help too when a co-worker is drowning!

    I'm still a newbie and learning so much every day. But it gets a little easier every day! Congrats!
  7. by   TheSquire
    Yeah - 80hrs of orientation for a new grad with no prior ED nursing experience sounds like they're setting you up for failure. I'd go and speak with the unit's educator ASAP.

    I started as a new grad in a community hospital ED (no official trauma designation, but would probably be a Trauma 3 if they wanted to bother with it). I had a 12 week orientation, which was barely sufficient - I was still leaning on other nurses for a couple months after that (because Murphy's Law states that you'll see all the stuff you never saw during orientation when you no longer have a preceptor), but I was at least able to handle a usual load of patients at that point.
  8. by   LalaJJB
    Without experience, 80 hours doesn't seem like much... however, they may have seen something in you that made them think you could handle it. I know in my ED, our fastrack/urgent care area has 1 RN, 1 tech and 1 ARNP or PA-C working at any given time. Out of experience, I believe 80 hours of orientation is definitely do-able.

    If there's a skill you aren't familiar with (like splinting or wound dressing) the tech will most likely know how to take care of it...and depending on the techs attitude, you can ask them to teach you how to perform these skills.

    If there is a patient who's physical health has you confused, the PA's and NP's will be there to help.

    I always feel that in the fast track area the main role of the nurse is to assess the patient, decide if they're sick or not sick (which is done in triage already), communicate the problem to the provider... analyze the providers orders, question the orders if you disagree or need clarification on them.... carry out the orders... delegate the tech stuff to the techs.... understand the medications you are giving and what they do what they do.... decide if the treatments worked or not.... then ship them out.

    It's definitely overwhelming at first, but you WILL be good at it eventually... one day you will think "I got this!"... then the next day you will think "Omg, i cant do this! I dont know what i'm doing!"

    Just remember, it's difficult to harm someone in the fast track area, especially if they are attached to your main ED. If you are unsure of something, DONT GUESS! Ask someone...if they dont know the answer, then ask someone else.

    Also, like another poster said: keep a notebook.
  9. by   brainkandy87
    Only eighty hours orientation for a new grad in a level one trauma center? Props to you for not totally freaking out. I think I still might semi freak out NOW if I was told I'd only get eighty hours orientation at a level one trauma center. Best of luck! Be a sponge and absorb everything!
  10. by   KellzBellz
    Sweet Jesus.... I was literally saying, "I'm not cut out for this" while audibly sobbing in the car on the way home from yesterday. I just took my boards today, and I'm hoping that my head will spontaneously pop out of my butt once I get my results.
  11. by   Ernurse2012
    Reading this thread has me laughing and smiling. I just started in the ED after doing 8 months in tele. Everyday is a struggle n
    But I will not be defeated.
  12. by   MnemonicMonkey
    From what I've heard from a friend that just transferred to our ED and started in the annex, brush up on your pelvic exams. She says at least half of her patients get one. Also practice keeping a straight face when an MD pulls an object out of an orifice that you never thought would fit up there, much less need to be there.

    Psych skills are also a given...
  13. by   Crux1024
    I kinda have to repeat what everyone else said....80 hrs of orientation? You state fast track, but also the "less critical pts" which means you'll have typical ER pts that CAN go from healthy to near death rather quickly. I know that personally, I wouldnt have been ok with that short of an orientation time. Id speak with someone about the length of time. Never be afraid to ask questions and always cover your own butt. Good luck.
  14. by   brainkandy87
    Quote from MnemonicMonkey
    From what I've heard from a friend that just transferred to our ED and started in the annex, brush up on your pelvic exams. She says at least half of her patients get one. Also practice keeping a straight face when an MD pulls an object out of an orifice that you never thought would fit up there, much less need to be there.

    Psych skills are also a given...
    Even the men?

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