ER New Grad Hire questions

[SashaO]

I wanted to know why you were chosen out of all applicants as a new grad. in the ER. Did you have other certifications other than ACLS, BLS, or PALS? Such as NIHSS and EKG? Were you an ER Tech/EMT/Paramedic prior? Did you rotate there? Did you network with others for personal references. What was the interview like? How did you contact the Director of Nursing? I've contacted Human Resources for the DON of the ER for specific hospitals so I can email them and/or fax my resume to be considered for the positions but would like insight into qualifications that would stand out.

[dthfytr, ADN, LPN, RN, EMT-B, EMT-I]

Many new grads gravitate towards the ER. IMHO, thats like getting your drivers license and going right into the Indy 500. Some grads make it, but those who don't are devastated. I would encourage new grads to work on med surg for a year or more before going to the ER. Many basic skills have by then become automatic, and you can focus on the ER itself. To answer your question, I was a CPR and first aid instructor for 10 years, an EMT for about 5 years, and worked almost a year on med/surg before going to the ER. I still had a steep learning curve and it was several years before I was sure I'd made the right choice. As always, your mileage may vary. Good luck whatever you do.

[coolpeach]

I did my clinical there prior to graduation. I told them I was interested in an internship a couple of weeks before the end of the semester, but all of the spots had already been filled. I graduated and started looking for work. Then about a month later I got word that one of the nurses in the internship had fallen out for reasons unknown so a spot was open. I called my old preceptor, and the director. They told me to call HR first thing the next morning as it was already 8pm. I did, and they had me take an online personality test right then online at home, and then I had a phone interview the same day, and set up an in person interview for two days later. Because I had already worked with the panel that would normally sit in on the interview, and they had already recommended me it was just me, the director, and the educator. I got a call later in the afternoon with a job offer. I found out later there were over 300 applicants in the pool, but it was between me, and one other nurse. The reason I beat her out was that she had five children.

I agree with what the above poster said. I lasted about 4 months before moving on to med/surg. There were three interns including me. One dropped out about three weeks in, the other didn't pass NCLEX, and I left after four months. I almost quit nursing completely it was so horrible.

[pharmgirl]

Just like the above poster I did my precepting in ER the semester before I graduated. I worked my butt off and learned a ton!! The powers that be knew that I was interested in a position in the ER there but nothing was available. I kept my job on med surg and about a month after graduation I received a phone call from the manager that there was a position available. She stated that she knew I was willing to learn and not afraid of hard work. I had proven myself during my precepting.

I agree ER is tough. I worked a year med surg as an LPN and no way would I go back to med surg. I'm still learning and adjusting but I can say that I love it and cannot wait to become more comfortable. But my manager assures me this will take at minimum a year. Good Luck to you!!

[mikeicurn, ASN, RN]

I don't have a job in the ER, but am hoping for one. I precepted there this past winter/spring. When I graduated and passed my LPN boards I went back to my preceptor and ER manager and asked if I could volunteer there this summer to complete my 120 hours internship. I am just finishing that up, and am starting back to school to finish my RN next week. I have already talked to my instructors and program director and told them I wanted to precept in the ER (I didn't want to hear "so and so asked first", so I talked to them when I picked up my books before classes have even started, and have 4 RN's who have offered to precept me). The clinical nurse manager has said I would work out great in the ER, and they would hire me now if I were an RN (they no longer hire LPN's). I know I have a ton to learn before I would be comfortable there, but most of the nurses there have advised me to come straight to the ER. They feel the med/surg experience would not really be that helpful. So that is my plan. Good luck to you.

[emtb2rn, BSN, RN, EMT-B]

Long time EMT, applied to hospital that is my squad's primary destination. HR set up interview in ER. Interview was great. NM and ass't NM knew me and I knew them, along with most of the staff (at least on sight). Offered job on the spot. Accepted and very happy I did. Love being in the ER.

That said, techs and externs/interns have the best chance of getting hired. If you've worked there, they already know your personality and if you'll fit into the group.

Certifications without experience, imho, don't count for much. Plus, the hospital will send you for what you need. I also found the certs (iv, tele, acls, pals) were a great bonding experience with the other new grads.

I'll agree to disagree with the 1 year m/s prior to going to the ER. Follow your heart and go where you want to work.

Good luck.

[VICEDRN, BSN, RN]

I want to clarify something here: Not all ERs are the same. I am a new grad in an ER but its also a Level III. We see no virtually no traumas but still treat a variety of ER type complaints. I do not feel overwhelmed and I do think that when I am ready, I can "bump up" to the next level of acuity.

I would never take a job on med/surg. The ER can be overwhelming but I have loved every minute of it.

[Medic/Nurse, BSN, RN]

You will likely NEED to set yourself apart from the masses of new grad RN's that share the "ED as a dream job" goal.

I do not think there is ONE right way -

I think paramedics may have an easier time providing that they have been competent and respectful of the ED staff throughout their career. Also, most medics have some face time with most all the ED staff and through their regular work or shared courses (some even teach ACLS, etc) they become "known" (good or bad - just keep your "bridges" in good repair - :) )

Otherwise - I think ED "tech" - via nursing assistant/EMT-B/CNA roles - that get an opportunity to work in the ED during school, near ALWAYS get considered before the "unknowns". Again, do a great job, do your job (head down, don't be "too good" to help with anything, focus on the job at hand, don't get too wrapped up in "gonna be a nurse" or "when I'm a RN" - just bloom where you are) and do it well - and you WILL get the right kind or reputation and attention.

Although I think of MS as it's own speciality and do not see an absolute reason for that "1 year experience rule" prior to a nurse coming to the ED - not all that want to work ED (or other "high-demand" areas that new-grads seek to join) will be able to start in those spots. Regardless of where you start your nursing career - to ensure your success in any area - I think being known as a hard worker, willing to do more than what is expected and be a team player is ALWAYS the key to getting noticed. Even IF you are passed over for your "1st choice" and have to take an RN spot in another area - do not despair - WORK HARD, WORK SMART and you will get your chance to move to another area. The BEST thing about nursing -- options!

Opportunity favors the well-prepared!

CAUTIONARY TALE!!! I have seen many, that although a good fit "on paper", get passed over (or let go in orientation periods!) for a deficit in "interpersonal" skills - so, always be professional, be mature (no work related Facebook/Twittering/MySpacing, sharing TMI, having an inflated sense of entitlement and avoiding the less than "pleasant" tasks "cause I'm an RN now" - these can be deal killers even if you do get the chance to work in the ED) and adopt good work habits (on-time, well rested, prepared, be kind, be a team player, learn to communicate clearly and succinctly, avoid harping about your patient assignments - yep, I've seen NG's tantrum and more!!!! that they should get to triage, do the critical beds alone, get their turn at charge nurse, manage the pre-hospital in-coming communications - no kidding!!! ---- so avoid these "extreme" and often laughable behaviors!) and the ED may work out to be the dream you hoped for ----- there are scores of strange things that enter the doors - so having a mature, prepared, dependable and team-work driven staff is essential! Make it your job to be as good of a fit as possible.

There is no one right way. Even a detour will add to your nursing practice. Work hard - work smart, take classes if offered -- like ACLS, PALS, TNCC and then take them again if you don't use the skills on a regular basis (I think any new-grad RN should have to take ACLS and the like every year that they do critical care for the first 2-3 years - actually there should be an ACLS "novice provider", just like the "experienced provider" - I learned more from my second time - I was not as stressed and felt better about the "roles" involved and where I fit in - just an idea!) Classes and "certifications" aren't worth crap IF you do not use 'em or cannot fully USE them! IMHO.

Best advice - work hard, be ready and be persistent.

Good Luck!

Practice SAFE!!

[traumaRUs, MSN, APRN]

I moved to a new state (1996) and had two years of ICU experience so originally planned to go to the ICU. However, I just didn't care for the attitude of the nurse interviewing me and asked if they had other openings and they said, "yep". So, I interviewed in the ER (level one trauma center) and got and stayed 10 years and loved every minute of it.

Still miss it.

[iamnomad]

My story is a little bit odd. I did not apply for it. The facility I'm currently working at (long term care - LTC) is attached to a critical access hospital. The chief nursing officer is in charge of all the nursing activities both in the LTC and in the ED/Acute Care.

Every two months, our facility has this poster fair where everyone is required to attend. I was busy looking at the posters and answering the questions (I'm actually the last one to get through it because I had to work) when the chief nursing officer approached me and asked me if I want to work in the ED/Acute Care.

For someone who only got BLS/CPR, and without ACLS or PALS or TNCC, and with limited IV skills and EKG skills, it was a good learning opportunity so I said yes.

And just now, I got my TNCC certification. I will take ACLS and PALS next.

[ImThatGuy, BSN, RN]

I start a BSN (second degree for me) in a couple weeks and having worked as a paramedic and having worked as a cop for longer than that I can't imagine working in an enviroment other than the emergency department. I've never taken PALS, but I've got the other stuff. I figure if I can't get an ER job, or something similar to that, then I'll keep on doing what I'm doing full-time with maybe some PRN jobs here and there to justify having paid a little for the schooling.

The USPHS seems interesting, but mostly only because I like seeing places and I love a good crisis.