New to ER nursing....wondering if I made a huge mistake?

Nurses General Nursing

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Specializes in Float pool for 14 months.

Hey All, I need some advice. I have been a nurse for just about 15 months. I was a float RN for the first 14 and 1/2 months. I recently started working in another hospital in the ED. I am petrified, and worry that I made a terrible mistake in leaving my nice, comfy job at a small hospital. I am now in an ED that sees a massive amount of patients a day. It is a level one trauma center. I am freaking out. I thought honestly that my biggest problem would be throwing 18 gauges in ppl. Boy was I wrong. After two days, that wasn't a problem. I just feel like I am never going ton be able to catch up with the fast pace of the ER. I knew it was a huge challenge goin in. At my last job, yes I was a float, but I mainly floated to the behavorial science floors, which didn't require putting in ivs, foleys, and dealing with traumas and the like. It has been four shifts that I have worked down in the trenches and still feel so dang lost. My preceptor is an awesome nurse and knows her stuff inside and out. I feel like she leaves me on my own, because I was a nurse prior to starting this job. I don't want to give up so soon, but am terrified that I won't pass probation. This is something that I've always wanted to do, but I feel so lost and in over my head. Any advice on how long it takes on feeling comfortable? I feel comfortable with the basics, but the paperwork is a lot to get used to, as is triaging. My preceptor was the triage nurse the other day, and for some pts she left me alone. One pt, I feel like I did the wrong thing, and asked her what to do, and I felt like I screwed up, when all I wanted was a little bit of guidance. He comes in with chest tightness, I get ekg to come to triage. As soon as his ekg prints out, it read afib with rapid premature complexes or something like that. Sorry if I said that wrong, I'm really not familiar with all this, as I said I've never been exposed to this previously. I wanted to immediately take him to the crit area, but she said oh u can finish the triage, then take him to the room and go get an attending. I'm so new there, this place is huge, I don't even know who the attendings are. Arggggggh, I feel like a loser and want to give up. Either way, I got the attending and the outcome was pushing 20 mg of Cardizem. I want to stick with it and see this through, but I already feel like a failure. Any advice would be greatly appreciated. Thanks in advance.....

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Specializes in burn, geriatric, rehab, wound care, ER.

It seems a bit soon to leave you in triage all by yourself -in the facility where I work, you have to be an ER nurse for a year before you are even precepted to triage. Let your preceptor know that you do not feel safe being left on your own so much, and take a deep breath. You are there to learn right now, not run the show. As far as I'm concerned, ER is about judging whether the patient is sick or not sick, compensating or not, prioritizing what needs to be done now and what can wait, and ABC's. Good luck, hang in there, 4 shifts is just getting your feet wet.

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Stick with it. You are definitely at a disadvantage b/c you weren't a telemetry or med-surg nurse first. Doing that for a year is a HUGE advantage b/c you see a lot of everything and get a lot of good experience. I say stick it out and just continue doing your best and learning. It's going to be a huge learning curve for you, but eventually, you'll catch on and start to feel comfortable. Remember, nothing is ever easy at first. You can do it and you'll be just fine!

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You have to go with you gut feelings. If you think you made a mistake, you most likely did. Try to get another opinion next time when in doubt. It's okay to do that.

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Specializes in Float pool for 14 months.

Perhaps, I didn't explain correctly, I did float to med surg, but it wasn't like I was there all the time. A lot of the floats I worked with didn't like going to detox or psych, so being on the low end of the totem pole, I went to those floors a lot. My preceptor was outside of the triage room listening, but as soon as I saw the ekg, I went right to her and asked what she would do, and I felt like she thought I was an idiot. I mean they don't even assign you to work triage unless you have been there for atleast a year. It was my fourth day there and she basically left me to my own devices. Sometimes I feel like people forget that they were new at one point. I won't give up, because I really want to succeed. Even on my second day, I was basically left alone which was scary to say the least. It is such a high volume ER. I don't mind being out on my own, but I would like atleast a week or two to get comfortable before I'm left to my own devices. I don't think that is so unreasonable.

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Specializes in soccer.

What I ALWAYS ask before i float to a new location is I always ask the supervisor "How is your Mentor and Preceptor program." Just in case i need help. I think when i floated to Med-Surg i needed alot of help and i couldnt ask anyone for help. My charge nurse was lazy (She left eventually). So they asked me to become the charge nurse...and ive only been working for one year...I told them i was not ready..and i realized how bad that unit was in general...so i tried to float out of there.

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Most nurses that I know who transfered to the Er either know telemetry or required to finish a critical care class. Have you done either of those? There are so many medications that I didn't use on a regular basis, let alone was comfortable giving until I worked in the Er full time. Giving the right med, either too fast or too slow can be a critical mistake. Your preceptor in the Er isn't usually responsible for teaching you how to be a critical care nurse. They need you to have basic knowledge to build upon . They do need to teach you things you wouldn't have seen upstairs on other floors in the hosp. Think about it . Don't let your pride keep you there if you are not prepared to be there yet. Maybe they offer a critical care class at the hospital you could take. Good luck. You will know the right thing to do.

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Specializes in Corrections.

Its prolly time to go back to the old job.. until your skills are built up.

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Hey just wanted to let you know you are not alone. I was glad to see you posting my concerns as well. I just graduated last year and went right to an ER. I've been there 4 months and still feel extremely overwhelmed and question whether I can do this. I would definitely say give yourself more than 4 shifts to decide! There are days I love it... then days where I question whether I can do it. Like yesterday... get a septic patient from a nursing home going down fast with bp in the crapper, transport team showing up unannounced to take my 5 year old pt with an intussusception, (at the same time I might add) then I got slammed with two ambulances (all this happened in immediate succession) in addition to the pt I already had in my fourth room who was pretty stable with gi upset. I thought I was loosing my mind. I am at the end of my orientation with two weeks left to go. Thank goodness my preceptor was able to stay with my septic patient who was getting a central line put in while I tried to juggle everything else. I felt so inadequate and question all the time if I can do this. : ( I love it... but at the same time... just don't know if I am ready to be totally on own in 2 weeks. I am petrified.

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Don't worry, fellow Newbie. I started working in the ER after one year of working Med-surg. Before that, I was a psch-nurse for 18 years. There are some days I come to work with my stomach in knots. And there are days that are crushingly overwhelming. But the experience is invaluable!! Take advantage of any education your department offers you and don't be afraid to speak up and ask for help, ask questions. I too hate feeling stupid and feel frustrated by my inability to respond as quickly as my peers. Give it time and good luck!!:nurse:

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Specializes in Float pool for 14 months.

Thanks everyone for your comments. Like I said, I'm not a new nurse, just new to the ER. Drugs used in the ed are different from the med surg floor where I was floated to. Obviously a lot are the same, but as far as emergent drugs there are some differences. I am confident in my skills as a floor nurse, I know what I am doing. People sometimes forget that they were new at one point. I've taken the critical care core, have my ACLS. I'm just new to the er. I doubt anyone was perfect their first week. I've come along way in my first week. I just have to get better at my time management. My assessment skills are good, atleast I think so. I know two weeks from now I'm gonna feel a lot more comfortable. I would not go back to my old job, because there wasn't much to learn there. I became a nurse to help people and expand my knowledge. I want to learn as much as possible. I love being a nurse and I feel like this is where I am meant to be.

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