ER nurse- advice/ what do you wish you knew before starting?

Specialties Emergency

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I am a new grad RN starting in a great emergency department nurse residency program and so excited to be there. For other ED nurses- what do you wish you knew or what advice would you give a new grad? Thanks so much!

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Specializes in ED.

Try reading through the stickies at the top of this board. There is LOADS of good info there.

Grab a glass of wine one night and settle in for some good info.

m

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Know that you are very likely going to feel overwhelmed at times and feel like you know nothing. Most of us have been there and it's a good thing. Practitioners who don't know what they don't know can be dangerous.

Identify a mentor.

Ask questions.

If you get put down for not knowing, say, "Thank you", while thinking to yourself, "Yeah, like you started off knowing everything", then move on, finding someone who is willing to share their experience.

Know that somewhere along the line, you are going to make a mistake. Own up to it, knowing that it does not make you a bad nurse. (My first was giving an oddly timed antibiotic when it wasn't due - it was q18h, so it wasn't given daily. According to the nurse who caught it, you'd have thought I'd shot the pt in the head. Fortunately, I had a preceptor who was a little more realistic. We wrote it up, notified the doc, I forgave myself and we moved on).

Establish yourself as being competent (for your level of experience) and conscientious. Then let people know you want to learn and would love any chance to do so. Then hopefully, they'll come find you when a once-in-a-lifetime case rolls through the door.

Maintain a life outside of your job.

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Specializes in Cardiology, ER, Hospice, Pediatrics.

That my feet would HURT! Get some DR Scholls!

That people really can be mean --- do not take anything personally -- it will kill your soul.

How whiney people can be -- remember it is their journey in life, NOT YOURS!

How making a child breathe easier, being part of a team that saves someone's life, or being the last person there as a life ends is such a blessing. You will learn so much, have fun.

Humor is your best weapon against the harsh reality of life, cultivate it.

Jen

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Specializes in Flight, ER, Transport, ICU/Critical Care.

There are lots of good posts on here - good info.

How do you eat an elephant????

One bite at a time. No one ever that ever came BEFORE you knew everything - so remember that EVERYONE has a starting point.

So --- First, ask questions and DO NOT be shy to ask for help or admit that something is new. We all had a starting point.

Otherwise, Good time management is essential. Without it you WILL NOT make it. Just temper your enthusiam to met all of the "needs" of some patients - some "needs" will never and cannot be met in the ED - some will "need" to talk and talk and talk and it will usually come at a price for your other patients. I find that a lot of new grad or newer nurses fall to the "talkers" and it can eat up your night and rarely is it essential to their care. I'm not advising being abrupt - when you get the "talker" you will know - just have an exit strategy that does not make them feel slighted. "Let me get back with you - I'll check - you make a good point - thanks for sharing, I need to talk with the doctor - etc". Sometime you have to get a "rescue plan" from one of your co-workers.

Good shoes. Dansko's worked for me better than any athletic style - but get good shoes. Also note cards (colored ones worked best for me) and a good watch. Also, a pedometer proves just how much you walk and made me feel a bit better about feeling like I was getting my a$$ kicked sometimes.

Listen, ask questions - get help - look for learning options (IV starts and the like are numbers games - do more = get better, so start everyone you can and have time for).

Good Luck and CONGRATS on your new spot.

Practice SAFE!!

;)

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Specializes in Emergency.

Congrats!!! I work as an ER Tech and will graduate from nursing school in December (hoping to continue in the same ER as an RN).....I have to echo about the feet hurting :uhoh3:

Do not go to the ER with your feelings on your sleeve....Be confident but ready to ask questions and constantly listening!!! They don't want to hear how much you know and will waste little time and telling you so!

Always remember the patients are first....and learn to deal with each and every type. You will be faced with many personalities (I'm talking about patients and co-workers) but SAFE patient care is your bottom line.

You will have some amazing opportunities and, yes, you will be there for the end of some lives. I had a gentleman come into our ER at 0840 and expired by 1125. It was unexpected for his wife but I did my best to help the RN, who was taking care of him, and comfort his wife (to the best of my ability.) Approximately 20 minutes prior to the man's death I rubbed his forehead (he was on a vent) and assured him he was not alone.

You will do great and be ready to learn many many things! :up:

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Specializes in ER, Trauma.

I've 2 answers to your question. 1. Work in the ER as long as it's exciting. If it becomes just stressfull be kind to yourself and find something better. 2. I wish I knew that the hospital would treat me like their best friend as long as I busted my butt to do a good job, but when my back went away they couldn't get rid of me fast enough. Good luck in your career.

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A few quick tips, do everything you need to do for the patient, ie IV EKG, labs, fluid, assesment, foley whatever , in one trip and always think to cut your time in the room by a third. if you spend to much time in one room you will drown.

next, and some will dissagree, I dont feed my patients in the ER , if your hungry you shouldnt be there.

and third most of your patients do not need to be in the ER, they show up for alot of things that are not emergencies, toothache, uti, std, etc.etc focus on the sickest person first, then the bs ones.

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Specializes in Emergency Room.

THEIR emergency is not YOUR emergency

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How exhausting 12hour shifts would be.

How sexual assaults and children with criminal histories are more upsetting to me than codes and post-mortem care (I work in a peds ER).

How little weight I've lost despite feeling like I've run a marathon during my shift.

How, despite being a new grad, residents still seek/require my input on treatment. Sometimes it is scary to be the last line of defence when I know so little and sometimes it makes me feel appreciated and an integral part of the decision -making process.

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