Views on New Grads Entering the ER. - page 3

hi all... i am in my final semester on nursing school!! my graduation is august 10th! woohoo ... sorry i am so excited! i am doing a school project on new grads entering the er. i would like your... Read More

  1. by   pamc217
    Hi Erica
    thanks for asking this question, I am a new grad last may and am interviewing this week for jobs, 2 ER jobs one geri psych and one pedi office. Until I read your post, i was nervous about the ER job, but it is my first love. I have been an EMT for 5 yrs and just took an ACLS class, so I think I would be prepared, this hospital has a 6 month preceptor program and send you to take the other classes such as tnccp end encp classes, pals also. I know I can do it, and Im sure you can do. I also did a student nurse externship during school at a local ER for 3 months, loved it!!!!!
    thanks again!!!!
    love this web forum!!!
  2. by   RNcDreams
    Quote from Melissa94RN
    Personally, I think that a new grad could be fine in the ER with the proper training, but in my experience most of the hospitals in my area are terrible with orientation. The nurses end up trying to fend for themselves and it can be a disaster. I was thankful for my experience prior to entering the ER but again, I had little or no orientation, kind of on the job training. In the hospital that I presently work, they require 1 yr of floor nursing prior to ER. Someone stated in a prior post that it takes a couple of years to feel truly comfortable and I truly feel that is true. After 9 yrs in the ER, there are days when I learn something new or see something that I have never seen before. I think though that is why the ER is definitely for me as I keep learning everytime I step through the door.
    I am a new grad in a 30 bed ED, and this topic always gets me going. The ED is absolutely a place where an new grad can flourish, but ONLY if proper supervision/education is in place. I think that the mentality of "medsurg first" is antiquated for a few reasons. Mainly, the ED is a place where your mind works differently, and you have your hands on twice as many people so your assessment skills can really grow with the right guidance--working in medsurg means you can be great with assessments, but you have to adjust to just doing focused assessments and managing a very high turnover rate. You get the tele experience during the preceptorship, where you have opportunities to work inconjunction with a preceptor and actively learn what you are seeing, as opposed to repetition.

    My program is 6 months of precepting, 2 additional weeks precepting on off shifts, class time, med tests, ACLS, PALS, and discussions. It is a very well rounded and supportive program. I have had my moments where I feel out of control and almost unsafe, and others where I feel entirely in the right.

    My preceptor is always there to watch and ensure nothing is going off track, and in the meantime, it's my responsibility (and rightly so) to actively work at practicing assessments, reviewing appropriate documentation, and ALWAYS checking meds. I take one or two patients from her assignment, which she could manage alone, so there is room for discussion, review, and verification.

    ... I love it :spin:
  3. by   radbird
    Anyone recommend any ER internships for new grads?
  4. by   WDWpixieRN
    Quote from radbird
    Anyone recommend any ER internships for new grads?
    I just completed a summer internship at a local hospital here in the midwest. They apparently also do winter internships during that break.

    You must be within a year of graduation and go through an application/interview process. I found this one through a local hospital/career fair they did on our campus. I would suggest checking local hospital websites under "Nursing" or "Student Nursing" if those headings are there. If not, you can try calling the Nurse Recruiter on staff (most of our local hospitals have these) and I bet you'd find they'd at least be more than willing to tell you what options they DO have for you. They're usually very helpful to students!
  5. by   danielleRN76
    I think that new grads would be okay only if given a very, very exensive orientation. Some ED's have separate sections for acute and subacute in which case a new grad could move into critical situations over time. My ED is a pod system, with a mix of acute, subacute, peds and adult, so a new grad could get thrown a pt having a very critical issue and if the other staff was extremely busy, they may not get the help they would need. So I have mixed feelings. I was an LPN for 6 yrs before getting my RN, then worked on a tele unit for 2 1/2 yrs, the last yr as a charge nurse, then transferred to the ED, and I still have a lot of questions! It was actually hard to go from being one of the best nurses on a hard telemetry unit to being a novice all over again in the ED! (I think a big plus for ED is tele certification, ACLS, comfort with IV starts, stuff like that...)
  6. by   bigreddog1934
    well i guess i am the worst case senario on this topic. i am a new grad with no experience, outside of 15 years of carpentry, working on my third day in the er. i feel like i have a very good preceptor. i undertand her nickname is "the colonel" and she has been working er for 30 years.

    after two days i can say that i love the place, and my preceptor told me that i had passed a number of tests i wasnt aware were even occuring. even so, i am very green and have a world to learn. at the moment i am just working as hard as i can, being as helpful as possible, asking questions about the things i dont understand and carrying around a little notepad for things to review when i am off work.

    hopefully it will conitinue along these lines for my orientation.
  7. by   RN1263
    I'm a new grad and I started in the E.D. last week. I use to be an E.M.T. and had been an E.D. tech years ago. So, I thought it would work out......NOPE.

    I was thrown to the wolves on the first day......I quit after 4 days of hell. Simply, they needed an extra body in the E.D. and weren't interested with whether or not I was learning the flow of the E.D., if I knew how to operate equipment, ect., ect..
    Soooooo, the clincher for me.........they wanted to start giving me my "own" patients the following week.

    Not all "new grad" E.D. experiences have a happy ending......It didn't work out for me and now I'm without a job.
    Last edit by RN1263 on Jul 31, '07
  8. by   n2bation
    Hmm.. where are you located and what area are you from? I won't go as far as asking what ED you were working for.
  9. by   RN1263
    This was in northeast ohio....and three yrs ago. I'm doing home health nursing now, so maybe it just wasn't right for me. Like I said I was an ER Tech yrs before this and at that hospital they would never have treated a new nurse the way this place I spoke of treated me!
    good luck
  10. by   canoehead
    I'm working the ER now, and I know I could never have handled it safely as a new grad. You don't know how much you don't know. There is so much to learn you could easily spend a year on orientation- why not just do a year of nursing? ER tends to be fast paced with no nonsense type staff. If you are unsure of your skills or worth as a nurse you can be quickly bulldozed, even supportive staff can be pretty bold in a crisis. If you are exposed to an acutely ill patient you need to move with confidence, no time to look a lot of things up or talk it out. You are in the middle of everybody's worst day from the patient's perspective. It's very easy to get emotionally overwhelmed, and some time in nursing can give you some coping skills to deal with families and life/death issues. After the code you must pick up and get back to your other patients, and likely there's a lot to catch up on. Plus the G-D- paperwork postcode and afterdeath care is hard when you feel like a wet dishrag. It's a real reality shock when you first do it.

    So that's why I'd vote for some time elsewhere first. I'm not saying it can't be done, some very exceptional coworkers have done it and been great. I'm saying there is no way in hell I could have until I had at least 5 years under my belt. If someone out there chooses to give it a try, and doesn't make it, that doesn't mean they aren't an excellent nurse, they are just frigging human.
  11. by   RN1263
    Nicely put Canoehead....I totally agree with what you said!