ER Nurses: What did you do before the ER?

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Specializes in Ambulatory Case Management, Clinic, Psychiatry.

I am asking b/c I am considering pursuing ER nursing, but have a non-traditional background. I graduated from nursing school 5 years ago. I didn't have the best nursing school experience; I went to a community college ASN program that was very focused on churning out nurses, not so much on nursing as a profession or academics. I wasn't happy with the professors (a lot of them were negative: "you're not going to be able to find a job after you graduate and will probably be stuck in a nursing home") or a lot of the teaching (constantly having errors in tests, powerpoint presentations), and felt like our rotations were extremely task oriented, constantly running up and down the halls giving meds and doing backbreaking personal care, feeling like I was just following someone else's orders all the time-- I highly value autonomy and this did not seem like a good fit at all. During my second year I applied to go straight into a bachelor's programs for biology, but ended up majoring in psychology. I have been in psych nursing for the past 4 1/2 years, but have started to think about going back to medical nursing, as this would open up more doors, and I am feeling somewhat burnt of out psych.

I did an ER rotation in school and actually loved it, but what put me off was having to do med/surg first. I am wondering if ER programs ever take "new" ER nurses that aren't new grads and give them preceptorships. I would definitely take a refresher course first, as my IV skills are next to nil, and review a lot of med/surg and ER material. I think I would like the ER and could be good at it b/c I value autonomy/independence, work well with minimal supervision, have good problem solving skills, a TON of experience and skill handling "difficult" patients, like a busy fast paced environment, am very organized with good prioritization/time management skills, etc.

Any advice?? Sorry for the long post!!!

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Specializes in OB, ER.

You can do it for sure! I had one year of post partum then went to ER. I have no desire to ever do med surg. I did just fine. You will learn a lot on the job. We hire new grads even in our ER. Go for it! You will love it!

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bjaeram, what state are you in? I'm asking because I am a new RN grad and want to work in an Emergency room. I'm in the southeast.

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Specializes in being a Credible Source.

I didn't read your whole post but here are some general observations:

1) IV skills are not acquired through classes... they are acquired only through practice. Intellectually, it's not difficult. The challenge is in the motor skills

One piece of advice that I routinely give is to obtain some outdated angiocaths and manipulate them until you're very comfortable. The more that your mind can focus on the actual task rather than manipulating the equipment, the better off you'll be.

2) I came off the med-surg floor which was, I think, a decent way to prepare. I was at least comfortable assessing patients, touching them, dispensing meds, etc. That lowered the learning curve a bit - which was good since I was solo in the ER after orientation.

3) If you have a job, try to get to know the ER folks... offer to help with the mundane tasks and they may warm to you and give you opportunities to participate in more complex situations. Eventually, you may get the chance to orient there. That's basically what happened to me; an acquaintance got into the OR the same way.

4) Connect with the docs... more than in many other areas, the docs can make you or break you because you interact with them continuously and in real-time. Make sure you have your terminology down, speak up when appropriate, admit your mistakes, and ask questions... few docs pass on the chance to share their knowledge and you can learn a ton from an experienced ER doc.

5) Study your butt off right now... get a CEN book and start studying... you can learn much of the material without ever working in the ER... and then demonstrate your knowledge when you're helping out.

6) Be confident: The ER is not a place for timidness or passivity (though neither do cockiness nor aggressiveness work well, either).

7) Thank people when they take the time to offer suggestions or criticisms... develop a thick skin... don't be defensive... though if you're sure you're right, explain yourself... though back off if the other is not one who can listen (and the ER seems to have more than its share).

8) Know your meds and know your math!! I work in two little hospitals and I mix all my own meds, do all my own dilutions, etc - often with nobody to check (far from ideal but it's the reality of what I have to work with)...

9) Know your drug guide very well... I still look things up all the time... even when I'm "sure"... it's my way of "consulting" with someone else since I'm the only nurse.

Just random musings...

Take 'em or leave 'em

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Specializes in Peds ED, Peds Stem Cell Transplant, Peds.

​pediatric stem cell transplant step down cv surgery

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I got a B.A. from a large university, then went back to school and got my ADN from a community college. Same experience with clinicals, lots of monotonous labor that really didn't prepare me for the real world of nursing. However, I took the initiative to do my preceptorship in ER and absorb as much as I can. I started out on a step down unit, got to know the ER people well, and it was a really smooth transfer to the ER. Love my job more than anything. If you're a psych nurse, you shouldn't have a problem dealing with the various personalities that you'll experience in the ER. However, your biggest hurdle will probably be time management and prioritization, simply because it's such a different type of nursing from psych. However, if you have the motivation and determination, you'll be just fine. We actually just hired a nurse that has been a full time psych nurse for years with no ER experience. ER nurses come from all sorts of backgrounds. It's necessary. You see so many varieties of patients, sometimes you need to lean on that former OB nurse or former psych nurse or former yada yada yada.

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Specializes in being a Credible Source.
ER nurses come from all sorts of backgrounds. It's necessary. You see so many varieties of patients, sometimes you need to lean on that former OB nurse or former psych nurse or former yada yada yada.
The ER nurse wears 100 different hats from phlebotomist to psychologist to OB, infusion, or critical care nurse, sometimes switching roles every minute.

OP: Your job will be to explain to the ER manager how your unique set of clinical and life experiences and skills will be valuable asset to their operation. It will help you if you really 'get' what they're doing in their ER.

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Specializes in pediatrics, ED.

I was an accountant. I also did a stint as a dental assistant and Loan shark.

I went right into ER after nursing school so it's all the nursing I ever know.

But while I'm saving your butt I can do your taxes!

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

I was a high school student. I've been a nurse for 34 years in critical care and ED. I think you're lack of med surg skills will make it challenging but your psych skills will benefit you.

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Tele for 8 mths and now In the ER thankful that a big teaching hospital gave me a chance but boy everyday is a challenge!

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Specializes in ED.

I was a chef for 8 years before becoming a nurse. I graduated and went straight to the ED.

I told them I was very good under high-stress, fast paced environment, and great dealing with people. Doesn't hurt to tout your strong points.

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Specializes in EP/Cath Lab, E.R. I.C.U, and IVR.

I managed a cattle farm before, during and after school to then work in the E.D. Since then I have moved to the Cardiac Cath Lab.

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