ER fear

[Fritz71]

I am a fairly new nurse (graduated in 2011 and started this job in Nov. 2013) who took a job in a rural area at a critical access hospital. The town has about 500 people and smaller towns surrounding. I work in Med/Surg and am also required to work ER as I am usually Charge and have one LPN or CNA to work with me. We may go for days with no one in the ER, then we may get 3 to 5 in one day. Often these ER cases are minor, someone may have a sprain or break, or pain or a cold, and I feel okay with these type of issues. What I am afraid of is REAL EMERGENCIES, you know like MI or Stroke or bad motor vehicle accident or gunshot. I, unfortunately, did not receive a lot of orientation because there is not enough money or staff available for such. We have a new (who's learning) Doctor here part time, 2 FNP's, and a Dr. that is kind of a jerk. Our EMT staff are great and readily available to help in ER, but also condescending and kind of treat me like I'm a fool.

My problem is, I feel like an idiot a lot of the time. I am also quite sure others think I am to some degree too. Every tiny fumble is relayed to my DON, also a provider here, who says I need to appear more confident and just do things. The thing is unless I do them consistently to become comfortable with these emergencies that come up, how will I know how to do them and become confident? She says I need to study, study, study, everything I can and pick every nurse's brain whenever I have an opportunity. I am willing to do this, but I don't always have an opportunity to talk to other RN's, and what I really need is some advice on WHAT to study and HOW to train myself to be a good/better ER nurse. Part of me wants to run screaming from this job :0

[LadyFree28, BSN, LPN, RN]

Look into self studying...look on the Emergency Nursing forum and look up what study guides the ER nurses there use.

Also sign up for the ENA; there may be additional study sources and CEUs that will help assist in at least learning what could possibly be presented to you at any time.

Best wishes.

[MoshRN]

You could take TNCC and also study the CEN (I think it is called). TNCC you do not have to have experience, but make sure you take the time to read the book before class. ACLS, PALS would help too if you do not have them.

[iceyv3]

It is unfortunate that you have been placed in such a predicament and I'm hoping that your employers have plans in place in case of 'real' emergencies.

Until you consistently see those issues you are worried about and get comfortable with them, you will continue to feel like a fish out if water. The only thing you can do something about now is how you show your discomfort! Read up so at least you have the theoretical knowledge and STOP acting like you are unsure even if you are.

When I graduated, I was placed in a similar position. I asked tons of question during orientation and right after that I was put as charge nurse with 1 tech on a unit with 10 acute psych patients. You bet I was scared but I was the only one who knew that. I read and when there were emergencies I called for help and did my best.

You either read up and ACT like you know what you are doing (safely) ask questions, or you RUN. If you feel and act so uncertain and you have no backup during an emergency, you could make a mistake that could cost you your license.