Five week ER orientation

tiredfeetED · Jun 7, 2005

5 weeks for a level 1 trauma center does seem short, although my ER does about the same inservice. I know being a Charge in the ED that I watch over these individuals and If they do have trauma rooms that they have help. There are those individuals who find out during there orientation that the ED is not for them...thats ok too. You will prob. learn more in the next 5 weeks than in nursing school. One thing that comes to mind when i started is that i had no clue what all these xrays meant, C-spine precautions and the trust that the ED docs have in you. Remember that your patient comes first, even if that means you have tug-a-war with the docs especially residents. Congrats and welcome to the ED!

Tweety, BSN, RN · Jun 7, 2005

That does seem very short for a new grad. Our ER is a trauma center level II, and the orientation is task oriented. i.e. you have to do 12 traumas, 12 chest pains, 12 cvas, etc. and be checked off, (I'm making these numbers up) before you can come off of orientation, if it takes 12 weeks or 16 weeks, or whatever. That way if you run into a stretch of slow days you're not wasting your orientation.

Good luck. :)

rjflyn, ASN, RN · Jun 7, 2005

Way to short for a new grad who has never done pt care on there own. The last level 1 was in only hired new grads in to their 6 month intern program. An exception was made for people with EDT or Paramedic exp , even then they didnt hire their own techs as nurses unless they had GPA's over 3.75 . My orientation to that facility infact was 6 weeks and at the time I had 14 yrs of emergency medical exp. I currently work as a travel ER nurse and see staff getting hired at the various places I am and average is 8 wks.

Of course one persons busy level 1 is anothers slow level one.

Personally IMHO you are cheating both yourself and your patients with such a short oriention.

Rj:rolleyes:

akvarmit · Jun 7, 2005

I also work in a level I trauma center - and our orientation is about 6 weeks. We also hire new grads. I thought our most recent new grads did very well, as they had no "bad habits" to unlearn. I went to the ER after a bit of med/surg nursing and I was distracted by my old ways of working. I had to learn to think in a whole new way. However, I see that I had a much better understanding of common meds, etc. from my time on the floor.

(I found I was wanting to stop and clean up areas or "make rounds" when the current high-tempo at the time didn't allow for that routine work. Cleaning up can get done later. I've abolished my neat streak.)

The important thing is that in any job, your charge nurses or supervisor should be "watching" you to see how you are progressing through meeting the orientation criteria of that unit. Keep an open dialogue with someone - your preceptor or peers, etc. After a busy day when you may feel overwhelmed - say - hey - how could I have tackled that better? And get input. I'd rather ask my coworkers for input if I feel I missed something and learn from it.

In our ER also, we never seem to "work alone" unless it gets really crazy. Someone always seems to be in the room with you, or aware of what's going on with your pateints. As your confidence increases, you'll begin to pick up on what's going on with other folks patients, and you'll be jumping in too. It takes time - but I love it. (I wanted to run and cry at points - but I didn't let one or two days rob me of my goals)

Good Luck!

Dawn

Aneroo, LPN · Jun 7, 2005

I'll be starting next week as a new grad, with EMS experience, in a Level 1 trauma center, and I'm supposed to get 16 weeks of orientation (preceptorship). 5 weeks sounds like not much. Will you have some sort of mentorship or something after orientation is over? -Andrea

Dixielee, BSN, RN · Jun 7, 2005

5 weeks does seem very short. I assume the first week of that will be classroom general hospital orientation where you do all the HR stuff, check offs of accuchecks, CPR, etc. That will shorten your ER exposure. You still need to learn to be a nurse, not just an ER nurse. I usually don't recommend ER or any specialty to new grads until they have some solid med surg under your belt. There is so much to learn, don't let yourself get shortchanged.

I know with the current shortage a lot of hospitals are hiring new grads into high stress, specialty positions, and many do well. Personally, I think it is too much to ask. Nursing school teaches you to be a nurse about like a drivers license teaches you to drive. It just gives you the opportunity to continue to learn.

You didn't ask what your options might be, but I always suggest a good med surg base. You may hate it, but you will learn basic organizational skills, meds, hospital flow, how to deal with other members of the team, how to deal with families and patient personalities. You will learn disease processes, lab norms and abnormals, how to hang blood, indications for calling the doc in the middle of the night. You will learn when a patient "looks bad" despite what their vital signs show.

No matter where you end up, it will be challenged to your potential and beyond. None of it is going to be easy. But when you survive your first year, you will look back and be amazed at how much you have learned, and how far you have come.

Morguein · Jun 7, 2005

I don't feel 5 weeks is enough time for any new grad going into a specialty area. I went into the ICU right after graduation and got 12 weeks orientation and even that didn't seem like enough time for me to soak it all in. I feel like most new grads need 6 months, but most hospitals can't afford 6 months. If I was you, I'd ask for more time.

RN 2005 · Jun 8, 2005

I too will be starting out in the ER following boards. I was told I will get 6 weeks. This is just the ER part, the transition to RN, computer training etc. does not count towards the 6 weeks. Even so this does not seem like enough. If you need more time ask for it.....I plan on doing the best I can but I have no problems asking for a little more hand holding. :wink2: They need you or they would not have hired you and they sure do not want you to leave after investing time. That is my hope anyways!!! Anyway, just wanted to say you are not alone and I wish you the very best of luck!!! I am thrilled and excited by this opportunity and I am sure you probably are too!! :lol2:

Happy-ER-RN, RN · Jun 8, 2005

Thanks for all the responses. I absolutely loved the ED when I did my internship and I hated med-surg so I figured--why make myself suffer? I was very VERY lucky to get one of the limited positions they were giving to new grads in the ER, so I am really ready to give it my all. I guess I will see what happens in the first few weeks and if I feel like I still have no idea what's going on I will ask for more time. I have a feeling that won't be a possibility and I am going to have an overwhelming and stressful next few months. I suppose any new job is stressful though.

I love this forum, everyone is so kind and helpful. I might need some encouragement in the next couple months and I'll know where to come!

mommatrauma, RN · Jun 8, 2005

That does seem very short for even a smaller ER...The ER I used to work in that was a 25 bed suburban hosp still did 6-8 weeks depending on your experience...My level 1 trauma center does about 20 weeks when all is said and done...Can it be done in 5 weeks? Yes, but I think you get short changed a little, because you have a better chance seeing more in a longer orientation, because its much easier to teach you things as you see them, then to tell you about them and hope when you see them you'll remember what you were told. Our 20 week orientation also excludes, trauma and triage, which you won't do for at least 6 months to a year depending on how well you are doing and handling yourself in regular patient flow. I think 5 weeks is short but good luck and just don't be afraid to ask questions...

needsmore$ · Jun 8, 2005

As the preceptor for a community based ED -38,000 pt visits/year, I also believe 5 weeks is too short. We offer 3 months- with didactic review, skills review, etc as well as on the unit direct patient care. Many EDs are beginning to utilize a modular type of orientation similiar to, if not the actual, ENA Orientation Modules. Our GN orientation was designed similiar to this- 17 units that we review didactically as well as incorporating medication review, skills review-- I also use this for new to the ED nurse-maybe someone transferring from MedSurg/Critical Care to the ED but the program becomes more tailored to their individual needs- ie. maybe more peds/trauma/critical care then medical for the veteran medsurg; less critical care, more peds/trauma for the CCU veteran.

Keep communication lines open- ask questions- NEVER ASSUME anything in the ED- if you don't know--ask. Good luck- keep us updated and we're here for any questions

Anne