FNP clinical in an ER

[Floridanurse]

Hi everyone. I am starting my clinical in an ER which will cover regular adult ER, fast track ER and pediatrics on different days with my preceptor. My question is: What do you all think I should strive to take away from this clinical besides the obvious? ER was not my want or desire for FNP but will see how it goes (may love it). Just wondering what others positive experiences have been. Oh, and my preceptor is a physician.

[traumaRUs, MSN, APRN]

I loved the ER! Worked a temp position there and my nursing background is level one ER. Here's what I would look for:

1. Advanced assessment skills

2. Possibility of procedures such as staples, sutures (maybe, maybe not - may be more liability and take more time than MD has)

3. Ability to manage multiple patients. This is probably the best skill to come away with - in the ER you never know what you will have coming thru the door and being able to jump from one pt to the other.

Good luck!

[Corey Narry, MSN, RN, NP]

Not an ED NP here but was once a Level I ED Nurse and did an ED rotation as an ACNP student.

My rotation definitely honed my interview skills in terms of history-taking, my physical assessment skills, my problem solving skills in arriving at differential diagnoses, and my pharmacology skills in deciding what to order in terms of meds. All this while having a stack of 4 or 5 charts at one time in my hand and deciding which patient to see first. So there you, you also hone your triage skills. Also bear in mind that you will see patients in excruciating pain who are upset that they haven't seen the "doctor" as you introduce yourself as the nurse practitioner student (lol). Make sure your preceptor is there to back you up.

I definitely learned procedures. I sutured a lot of lacerations and by the end of the rotation, I got a compliment from the ED medical director about my suturing skills - I was stoked! I also did a lot of pelvic exams and depending on how you feel about this procedure, it gets sickening after a while and I'm glad I don't do that in my role now. I have some experience with splinting, joint injections, I and D's, but these were so limited that I don't feel I got enough of them in my rotation but again, I don't do them in my current role. I never did intubations or lines in the ED.

[newFNP2015]

My fast track ER was my first rotation and I wish I had the chance again to do some procedures. At that point, we hadn't had many skills labs and I was nervous to try without practicing. I have yet to suture, I&D, etc in the office in my other rotations. I would try to get as many procedures as possible.

[BostonFNP, APRN]

Procedures are the easy part, a monkey can be taught to do most of them! You can learn them quick on the job.