Starting out in ER?

  1. Does anyone think starting as a new nurse in the ER is a good idea?

    One of my final placements as a nursing student is in the ER and I LOVE it. Just unsure about where to apply when I'm done, I've heard conflicting things from nurses about starting in the ER.

    Thanks!
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    About YoursNursingly

    Joined: Jan '18; Posts: 17; Likes: 5
    Specialty: 1 year(s) of experience

    18 Comments

  3. by   akulahawkRN
    Starting out in the ED can be a great place to learn! I did and I've only worked in the ED and I wouldn't have it any other way right now. Here's the caveat to the whole thing and it can make you or break you as a new grad in the ED. When you're hired there, you will need a longer orientation that nurses that are transferring there from another department, floor, or unit. You will need to have an orientation that lasts at least 16 weeks and have continued support for the remainder of your first year. Otherwise the ED that hires you will not be doing you any favors and could very well be (inadvertently) setting you up for eventual failure.

    If you're able to get a year or so out on a Med/Tele floor, that would probably give you a decent foundation to work from and allow the orientation to the ED to be relatively short, like 8-ish weeks (maybe less) as you'll have to learn differences from doing ED nursing and doing floor nursing.
  4. by   Gary Mendoza
    I also started out in the ER and I think it's perfectly okay. They are going to teach you what you need and they will not let you go by yourself until you're safe. I'm not one of those that think you need to 'do your time' on a med-surg unit first. Do what feels right and work hard at it.
  5. by   ruby_jane
    [QUOTE=akulahawkRN;9711393]When you're hired there, you will need a longer orientation that nurses that are transferring there from another department, floor, or unit. You will need to have an orientation that lasts at least 16 weeks and have continued support for the remainder of your first year. Otherwise the ED that hires you will not be doing you any favors and could very well be (inadvertently) setting you up for eventual failure. [QUOTE]

    That. If you are welcomed and precepted well, you should do just fine. It takes about a year to feel like you've gotten you feet under you (and longer to feel competent). If you're given this opportunity and can safely take it, jump on it. People who love the ER really love it.

    Mr. Ruby Jane is a nurse who jumped into ER fresh out of nursing school and did very well. He worked for a smaller rural hospital and they had a lot of time to make sure he practiced safely. He never did learn to organizationally manage five or more patients for an extended period of time (and that limits him slightly) but his assessment skills are amazing.
  6. by   SpankedInPittsburgh
    Go for it!!! Where I work you had to do at least one year of floor nursing (a long time ago) before jumping to the ER or ICU. That philosophy has changed now as both those units have expressed a desire to hire newer nurses to break them in the way they want. I'm a simple charge nurse and such decisions are way over my head but I got no problem with it. Truthfully, looking back my year on the floor didn't give me much applicable knowledge to use in the ER. It sure wasn't worth the investment of a year. If that's where u wanna be and have the opportunity then take it!!! A warning though, in my experience the ER is a place that people fight like heck to get into and many quickly want to leave. Good Luck to You!!!
  7. by   YoursNursingly
    Quote from akulahawkRN
    Starting out in the ED can be a great place to learn! I did and I've only worked in the ED and I wouldn't have it any other way right now. Here's the caveat to the whole thing and it can make you or break you as a new grad in the ED. When you're hired there, you will need a longer orientation that nurses that are transferring there from another department, floor, or unit. You will need to have an orientation that lasts at least 16 weeks and have continued support for the remainder of your first year. Otherwise the ED that hires you will not be doing you any favors and could very well be (inadvertently) setting you up for eventual failure.

    If you're able to get a year or so out on a Med/Tele floor, that would probably give you a decent foundation to work from and allow the orientation to the ED to be relatively short, like 8-ish weeks (maybe less) as you'll have to learn differences from doing ED nursing and doing floor nursing.
    Thanks for the input! I'll look for an ED position thats willing to give me lots of training when I apply.

    I think that would make me the MOST comfortable. Thanks so much
  8. by   YoursNursingly
    Quote from SpankedInPittsburgh
    Go for it!!! Where I work you had to do at least one year of floor nursing (a long time ago) before jumping to the ER or ICU. That philosophy has changed now as both those units have expressed a desire to hire newer nurses to break them in the way they want. I'm a simple charge nurse and such decisions are way over my head but I got no problem with it. Truthfully, looking back my year on the floor didn't give me much applicable knowledge to use in the ER. It sure wasn't worth the investment of a year. If that's where u wanna be and have the opportunity then take it!!! A warning though, in my experience the ER is a place that people fight like heck to get into and many quickly want to leave. Good Luck to You!!!

    I realized that too! A lot of nurses that transferred to ED have told me they never did IV insertion on the floor, and never had a chance to do compressions on a patient while on the floor.

    But they gained all that experience IN the ED. Gives me some hope! Thanks
  9. by   canoehead
    I'm in the ER right now, I know for certain that I couldn't have done it straight out of school. After about 12 years of experience I floated to the ER, went home in tears and swore I'd never in life darken their doors again. But by 15 years experience and helping out in the ER when they were busy, and a FABULOUS ER nurse that took me under her wing, I was comfortable. I've been ER only for about 12-13 years, and wanted to say that if this doesn't work out on your first crack, that doesn't mean you can't do it. More experience, more maturity, education, and more variety will get you there.
  10. by   KeeperMom
    Do a search on this topic. It has been discussed A LOT around here for years.

    My personal opinion...It just depends. Depends on the person and the ER. Some ERs are definitely not new-grad friendly while smaller, lower acuity ERs might be perfectly fine.
  11. by   Forest2
    For some reason people seem to forget that nursing has specialties. Go right into ER and see how it goes. Med/surg will give you a good foundation but that doesn't mean you can't go to ER out of school. Just remember each nurse has a job to do and don't under appreciate floor work. You can't say what it is like until you have experienced it.
  12. by   HermioneG
    I'm a New Grad at a teaching hospital and level 1 trauma center. We are also cross trained in both the adult and pediatric ERs. I think that starting out in the ER is great, but you need to be in the right ER and you have to go in with the right mindset. The ER you start in should have a solid new grad program (from my experience and what I've read, about 4 months with consistent preceptors), and preferably be a hospital that has a culture that accepts new people/students/etc. If you can find a hospital and program like that, then you will find your transition so much easier.

    As far as the right mindset to thrive as a new nurse you need to be a self starter, be quick on your toes, and also be okay with man/womaning up and admitting when you need help or don't know your head from your tail. Some people might disagree with me, but I don't think that the ER is a good place to start if you insist on having a "fake it until you make it" attitude. Especially starting out, you need to be mature enough and wise enough to admit when you need help or are overwhelmed, since the flow of the unit and also patient status can change so rapidly in the ER.

    In short, if you're up for the challenge and find a place that is a good fit for you, do it!! Good luck with everything, and I hope to read about your success as an ER nurse in the future!
  13. by   Artsy_RN
    Yes go for it! I started as a new grad in the ER and did fine. And we're a very busy ER with high acuity critical patients. Most important thing is to ask questions if you don't know/ familiar with something and always prioritize based on unstable/stable patients. Love being an ER nurse and couldn't imagine myself anywhere else.
  14. by   ERNurse-FutureNP
    I think starting out in the ER is awesome. You get a lot of great experience. You honestly use all of your nursing skills and more when working in the ER. I have been in the ER for 3 years.
    I think finding jobs that take new grads in the ER may be a little difficult. Some ERs would like nurses to have at least 6 months of experience prior to going to the ER. When you do start out in the ER as a new grad you will have to go through a longer orientation.
    The only downside is how fast new grads are able to get organized and use to there environment. If you never worked in a hospital setting it may be harder to get use to. It is a fast pace environment. It requires you to think quickly and at times use some creative thinking. But you do have a longer orientation which would work out well. Some new nurses are actually able to get comfortable with a new environment quickly.

    Hope this helped!

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