First Emergency RN Job After Graduation?!

[Stone Woodring, BSN]

I am a senior nursing student graduating in May 2020. I am working in a Level 1 trauma center this summer as an intern and I absolutely love the ER setting. I am 100% set on working in emergency medicine upon graduation.

I am curious as to what other experienced nurses opinions are on what kind of hospital nurses should start at after graduation. I know some of the pros and cons of teaching hospitals vs. non-teaching hospitals, but I want to know what others think. Should I start at a teaching hospital vs non-teaching hospital? Should I try to work at a level 1 trauma center vs. a level 2 or 3? Is a nurse residency program important or just a little more helpful?

Any other tips you have for going into emergency medicine directly out of college are greatly appreciated as well! Thanks!

[CalicoKitty, BSN, MSN, RN]

Many hospitals will hire new grads for ER positions. For first jobs, the biggest challenge is usually getting the first job. It may not even be ER, although you probably have a better chance due to your internship.

Find a job with a new-grad program and a good amount of orientation time. 3 months is common, some places perhaps 8 weeks. Nurse residency programs teach new grads how to be nurses. There is also the extra training to learn how to use equipment, how to run protocols, etc. Many new grads feel overwhelmed, even with these nursing orientations.

Things that are important to most people are commute time and money. If you live in an area, I'd suggest applying to all the jobs in the area. Take shadow days, see how you like each place.

Hope to stay at least 1-2 years, then finding new jobs will be easier and you'll have a better idea of what you like/dislike.

Good luck!

[Xance]

As a new grad I applied to 4 different hospitals in my area (large city) different positions at the ER and ICU in each one. I received 2 interviews followed by 2 job offers and I took the one I liked more. That was as a new grad, but it still took almost 2 months to get to that place even after I had my RN license in hand. The point I'm making is that you should apply the second you graduate the program. Many hospitals (depending on area) offer something called a 'critical care specialist'. From what I can gather it's a special position that mimics an ER tech's job description but is specifically made for GN before they get their licenses and they will be expected to move up to a unit RN afterwards. It allows time (usually 3 months) to get let the GN get their license and you even get paid slightly higher than tech wages to boot. I figure that is something also worth looking into and you can apply to those types of positions.

Alternatively you can simply go applying to tech positions now. Some states allow nursing students to work as a tech in hospitals without requiring a CNA or EMT-B certificate, and this will give you a backdoor into that hospital once you get your license. You could remind the ER at that hospital you work at for example that you are a nursing student and want to work in that unit. That's a prime example of networking and if your studies allow it, working part-time or full-time as a tech in a hospital allows excellent networking. Hospitals are keen to advance you to a unit RN once you get your license as you would be a known entity, and they are more apt to have someone working for them as an RN using that license instead of a tech who happens to have an RN license.

[PiperLambie, MSN, APRN]

I started in an ED with no prior intern/externships or medical experience, straight out of nursing school. The division of the company I work for has fully transitioned to the nurse residency model for new grads. I know there are some mixed reviews in general amongst my peers regarding residency, but I cannot recommend it enough. In my case, orientation was 13 weeks (as opposed to the 5-6 for an "experienced" nurse- even one with only six months before transferring to the ED). During this period there were days spent on the unit with my preceptor, as well as in-person and online didactics to supplement things. It was also a great time for the unit to get my ACLS and PALS taken care of with all the additional education time available.

As far as type of facility, if trauma is your thing then apply to the trauma center, but throw some eggs into other baskets as well, just to maximize your opportunities. Again, all places are different, but as has already been mentioned above, commute, ability to pay expenses, work environment, and personal goals are some of the many variables that only you can know for yourself when figuring where to start. Emergency nursing has been wonderful to me, and has helped me to know the next steps I want to take professionally due to the nature of being exposed to so many different sicknesses in so many different presentations.

Best of luck in your endeavors to enter the ED after graduation!