Finally Got the Job I've always wanted and now i'm nervous

turnforthenurse, MSN, NP · May 14, 2015

What kind of ER is it? What levels of acuities do they see (if they utilize the 5 level ESI system)? Is it a trauma center? How long will your orientation be? Does the facility have a split adult ER and pedi ER? Anyone with peds experience going into the ER is a great asset. There are some books that I would recommend, tho:

Sheehy's Manual of Emergency Care (a wealth of information!)

ECG Workout - Jane Huff (goes over basic EKG stuff because you will be expected to recognize any life-threatening rhythms!)

12 Lead ECG for Acute and Critical Care Providers - Bob Page (this book is in depth and I would hold off on getting this one right away but still a great resource for 12-leads)

Fast Facts for the ER Nurse: Emergency Room Orientation in a Nutshell - jennifer Buettner RN CEN (this basically provides all of the info that is short, sweet & to the point!

Bobjohnny · May 14, 2015

Anyone with peds experience going into the ER is a great asset.

Massive understatement. Anyone with peds experience going to the ED isn't worth their weight in gold, they're worth their weight in platinum. The vast majority of ED nurses seem to have primarily adult pt. experience and are sometimes a little lost with kids.

As to the adult IVs, I find that as general rule of thumb they're easier than on kids. Obviously they aren't always, but generally. Most of the meds are the same, just as indicated different dosages.

MMDEC · May 14, 2015

What kind of ER is it? What levels of acuities do they see (if they utilize the 5 level ESI system)? Is it a trauma center? How long will your orientation be? Does the facility have a split adult ER and pedi ER? Anyone with peds experience going into the ER is a great asset. There are some books that I would recommend, tho:
Sheehy's Manual of Emergency Care (a wealth of information!)
ECG Workout - Jane Huff (goes over basic EKG stuff because you will be expected to recognize any life-threatening rhythms!)
12 Lead ECG for Acute and Critical Care Providers - Bob Page (this book is in depth and I would hold off on getting this one right away but still a great resource for 12-leads)
Fast Facts for the ER Nurse: Emergency Room Orientation in a Nutshell - jennifer Buettner RN CEN (this basically provides all of the info that is short, sweet & to the point!

It is not a trauma center (the other area hospital is) but there are a regional stroke center (which I find very interesting). They do not to alot of Peds because there is an area children's hospital, but they said they still get there fair share to stabilize and send out agan. Orientation will be 3-6 months depending on experience. Thanks for all the book reccomendations! I think I will be collecting and studying resources a lot!

AZQuik · May 15, 2015

Good peds nurses are at a premium where I work. I mean there are enough good ones, but not enough that can learn the dept flow instead of having to figure out how to get solid iv access "now" on a consistent basis. Our peds primary's are darn good. Our peds leaders are fabulous.

Almost to a T they all have great experience prior to the ED, and have the right "sas" for the Ed to deal with kids, RN's, MD's, charge, ems, parents, the list goes on.

Good luck, and enjoy the journey! At my hospital, the ED is kinda the "back door" to/of the hospital

BSN GCU 2014. ED Residency

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ScrappytheCoco · May 16, 2015

Don't let it slip that you came from NICU or your co-workers will have you doing all their pedi IVs! :)

rearviewmirror, BSN, RN · May 17, 2015

True true. We are level 1 but rarely get peds and neonates. Recently had activation on little kid and gosh wish we had experienced critical nurse from nicu. I came from floor and did fine, lots of learning but can't do nothing but ER. Love it! Good luck!

**NickiLaughs, ADN, BSN, RN** · May 20, 2015

Seriously you will be a huge asset to the department. I was adult ICU before and wish I had peds experience like you. Adults seriously are different and the same. You can look at an adult and just know when they are going to crump. Some will actually hold still when you start an IV. Most say they will and won't. My knee helps hold their arm in place usually and my left hand is on their forearm as well. With adults, you tend to have more time than a sick kid. They have more circulating volume. Kids are weight based, adults are standard one dose based.

most frequent meds I give:

zofran 4 mg

GI cocktails

pepcid

antibiotics

morphine 4 to 8 mg

beta blockers like metoprolol

cardiazem

the average ER patient is a clinic patient who couldn't get to a clinic now a days sadly. We do have emergencies, but many are not. They are just people who need some meds and advice on how do deal with a health condition. You may find yourself missing some acuity. I love it though.

MMDEC · May 26, 2015

Thanks for all the great info Everyone! I start mid-next month and we'll see how it goes :)

LadyFree28, BSN, LPN, RN · May 26, 2015

Congrats!!! :up:

medic9872 · May 26, 2015

I second the recommendation for the Bob Page book. It's a great book and very easy to understand. Good luck!