What do ER Nurses look for in a PCT?

cousx2 · Oct 8, 2007

I am a recent grad who was an ER PCT prior to becoming an ER nurse so I can understand where you're coming from. As a PCT, I truly didn't realize just how busy the nurses are even though I was a nursing student myself. Your perspective will totally change when the patient belongs to you! As for what I like in a PCT now that I am nurse:

1) Take initiative. As a nurse, I appreciate a PCT who takes initiative and doesn't stand around waiting to be told what to do. If you don't know what you can do, take the initiative to ask. I LOVE it when a tech asks me, "Do you need help with anything?" I could just hug you.

2) Communicate. Let your nurse or MD know when you see a change in your patient for the worse. You went to take Mrs. Jones' vitals and her BP went from 128/84 to 72/40? Sats went from 98 to 86? Inquiring minds want to know. I've heard of some PCTs not sharing this sort of info, believe it or not.

2) Learn to prioritize. Don't stock rooms when patient needs are not being met. Remember the patient comes first. When Granny is sitting in her own urine soaked stretcher, stocking the tongue depressors can wait.

3) Do the most critical task and communicate. If you're on your way to get a urine sample for HCG for a stable healthy looking 20 yr and another nurse asks you to do an EKG for the code that just came through the door, hold off on the urine. (But don't forget to get to it later or let the nurse know why the urine wasn't collected.)

4) Document what you've done. I admit, as a PCT, I was not always the best at this, and I didn't understand how difficult I was making the nurses' life. I hope the karma gods forgive me.

5) Be willing to learn. If you're asked to do something you don't know how to do, don't say, "No, I don't know how to do it." Just say, "I have never done it before, but if you show me how, I can learn."

6) Don't let anyone bully you. You're the lowest on the totem pole and some people will try to make you feel worthless and make your job more difficult, which ultimately endangers the patient (monitor techs are famous for this, but doctors, PAs and nurses are guilty as well). Be assertive--not aggressive, and don't be afraid to use the chain of command.

If you have any questions, feel free to contact me. I hope this helps! Good luck!

BillEDRN · Oct 9, 2007

As a former ER tech and ER nurse, I agree with the above....good luck

cmo421 · Oct 9, 2007

I do not agree that u r the lowest on the totum pole. TEAM,means everyone is a necessary entity. RN's need ur help and assistance. Otherwise I agree with everything above. One other thing, please do not get lost,so many get lost. I do not know where or how but its like the ER UFO comes and takes them away for the longest time and they come back with amnesia!

cousx2 · Oct 9, 2007

Thanks for saying that cmo421--you're right. I should clarify that I personally don't think you or any PCT is the lowest on the "totem pole" either, not in the least. What I should have written is that unfortunately you are perceived as that by some insecure people on the patient care team because you are new and because of your title, and you have to be able to stand up for yourself if and when that happens because ultimately, it's the patient that suffers. I have to watch for that too--as a new nurse, I'm being felt out in the same way too. I don't think anyone outranks anyone, regardless of how many fancy initials you put behind your last name. I won't forget where I came from!

MrsGPR · Oct 9, 2007

This is great feedback! I would love to hear more!!!

And - truthfully - I will be the lowest man on the totem pole - at least for a week or so until they harvest another unsuspecting soul and throw them into the pit :devil: ... (been looking for a reason to use that icon)

Of course I don't intend to be a doormat either- but it has been my experience that sometimes when you first start out you have to "eat a little" and prove yourself (which sucks). I want to be prepared to do that, which is why I came to you all!! So far I have some wonderful advice to begin with like: take initiative, don't disappear, promptly report findings/observations, prioritize tasks etc...

Again, these are great and thanks to you all!!

Sooooo...overall, I am really excited about starting, however now I'm a little concerned about the 12 hr shifts ... :bugeyes:

Editorial Team / Moderator · Oct 9, 2007

Sooooo...overall, I am really excited about starting, however now I'm a little concerned about the 12 hr shifts ...

You'll get used to them! :) I was used to working long hours in my former job (graphic designer/desktop publisher) -- but those were sitting at a desk. My first week as a PCT (three 12s in a row) my feet were HURTING. The next week was much better, and the days didn't seem as long. One thing I learned -- invest in good shoes! I love my Klogs. I have a bunch of nursing-type shoes (I have a little shoe problem ... *ahem*), and out of all that I've tried, my Klogs are my go-to shoes for that fourth shift in a row.

MrsGPR · Oct 9, 2007

Lunah - You must be psychic...you read my mind!

How are Klog-type shoes in the arch support category?

I think I may have the beginnings of Plantar Fasciitis or something (those "nursing" shoes required for school are hard on the feet) - a super-duper arch support insert seems to be doing the trick for now but I don't anticipate that it will get better in light of my chosen career...*sigh*

Editorial Team / Moderator · Oct 10, 2007

They seem to have good arch support. :) I also have Quarks that I bought on Allheart.com -- http://www.allheart.com/nm233.html -- they are soooo comfortable. Supportive, squishy, and light! I also bought my favorite Klogs on the same site -- http://www.allheart.com/kllaguna.html -- they're a little heavier, but comfortable and supportive.

jojotoo, RN · Oct 14, 2007

I am a recent grad who was an ER PCT prior to becoming an ER nurse so I can understand where you're coming from. As a PCT, I truly didn't realize just how busy the nurses are even though I was a nursing student myself. Your perspective will totally change when the patient belongs to you! As for what I like in a PCT now that I am nurse:
1) Take initiative. As a nurse, I appreciate a PCT who takes initiative and doesn't stand around waiting to be told what to do. If you don't know what you can do, take the initiative to ask. I LOVE it when a tech asks me, "Do you need help with anything?" I could just hug you.
2) Communicate. Let your nurse or MD know when you see a change in your patient for the worse. You went to take Mrs. Jones' vitals and her BP went from 128/84 to 72/40? Sats went from 98 to 86? Inquiring minds want to know. I've heard of some PCTs not sharing this sort of info, believe it or not.
2) Learn to prioritize. Don't stock rooms when patient needs are not being met. Remember the patient comes first. When Granny is sitting in her own urine soaked stretcher, stocking the tongue depressors can wait.
3) Do the most critical task and communicate. If you're on your way to get a urine sample for HCG for a stable healthy looking 20 yr and another nurse asks you to do an EKG for the code that just came through the door, hold off on the urine. (But don't forget to get to it later or let the nurse know why the urine wasn't collected.)
4) Document what you've done. I admit, as a PCT, I was not always the best at this, and I didn't understand how difficult I was making the nurses' life. I hope the karma gods forgive me.
5) Be willing to learn. If you're asked to do something you don't know how to do, don't say, "No, I don't know how to do it." Just say, "I have never done it before, but if you show me how, I can learn."
6) Don't let anyone bully you. You're the lowest on the totem pole and some people will try to make you feel worthless and make your job more difficult, which ultimately endangers the patient (monitor techs are famous for this, but doctors, PAs and nurses are guilty as well). Be assertive--not aggressive, and don't be afraid to use the chain of command.
If you have any questions, feel free to contact me. I hope this helps! Good luck!

This is so well said! If you can keep these points in mind, everyone will be looking to sign up on the shifts YOU are working.

And cmo421 and cousx2 are right about you being an essential part of the team. A good tech (or clerical staff) can make or break a shift. Just as I have saved MD butts before, so has mine been saved by an observant tech.

MrsGPR · Oct 14, 2007

So would I be the BIGGEST poser if I brought/used my stethescope as a PCT?

Wouldn't it be better for apical heart rates and manual BPs? I am so used to practicing vital signs in the lab with it at school - I think I will feel like I am not getting accurate results otherwise.

Have any of you seen PCTs with them?

Editorial Team / Moderator · Oct 14, 2007

I'd check with the charge nurse -- explain that you're a nursing student who is eager to practice. As long as it doesn't take away from assigned patient care duties, I don't think they'll mind. I have mine with me on occasion for the same reason, but I make sure I'm not leaving work undone while I'm unofficially assessing people. :)