Help for this new grad in the ED??

[QueensNurseNY]

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[dixeechicken]

I don't know how other ER nurses will feel about this but for me personally.... I had an instructor that always told me to make sure I knew what I didn't know. In other words... be humble. Don't be afraid to admit that you don't know something or that you need help with stuff. In the ER (as well as other departments) you can't be cocky. It's ok to be confident but cocky will kill someone. Of course this is just my own opinion and you may take it however you wish. Good luck to you. I personally love ER and can't really see myself anywhere else at the moment.

[QueensNurseNY]

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[BeachyRNn08]

Hey Queens, Congrats on your first job in the ER! I too, have always wanted to work in the ER. I worked about a year in ICU-stepdown before I could finally get my foot in the ER door. I've been in the ER 7 months. Here's my advice to you, as a new ER nurse myself.

Your confidence is an asset. Assert your confidence, but like the previous poster has mentioned, also realize when your need help and ask for it. Compared to the floor I worked on, ER nurses have tougher personalities. You will learn who you can go to for help, and who you should probably avoid if at all possible, lol!

Good luck starting your first job in the ER, there's so much to learn, but guaranteed to be anything but boring! :)

[shoegalRN, RN]

I started off in the ICU as a new grad and then transferred to the ER. Best advice has already been stated here. Realize you know what you don't know. Also, this is the real world of nursing, not clinicals or nursing school. You don't need to try to "impress" your clinical instructor. Nursing school barely touched the surface if you ask me. It's best to be humble and TEACHABLE. Do not say things like "I was taught in nursing school to do an IV like this", or "I did it this way in nursing school" or you will be eaten alive.

It's ok to be confident, but let me tell you, it takes at least a year to feel somewhat confident in your nursing skills as a RN. Confidence is something you build everyday you go to work. You will have good days and bad days.

And ask tons of questions. There's nothing worst than a new grad who don't ask questions either because they are intimidated or they think they know it all. Check your ego at the door because it's about the pts and what's best for them, not your ego. So, ask questions, jump in when you can, be a team player, and find a mentor.

Good luck!

[QueensNurseNY]

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[aolujumu]

My lady is a new grad too, she passed the NCLEX board exams

and she is still having problems getting a jobs. She worked at home health

but that dosen't add to your experience resume. Any recommendation on what to do

to get her working in a renowned hospital?

[QueensNurseNY]

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[LilgirlRN, ADN, RN]

As a veteran ER nurse who has worked with numerous new grads... we know that you come to us with just the basics so we anticipate that you'll ask for help. That's just fine with us, we don't want you to mess up anymore than you do. To me there's no dumb questions. Ask, ask, ask, if there's anything you've never seen before such as a chest tube insertion, code, birth tell us. I try to make sure my newbies get in on the action if all they do is stand in the corner and watch. I also use this lil trick that med school uses... see one, do one, teach one. So first you'll watch me, then do it yourself and then you get to teach me how to do what you just did. That way I "know" that you actually know how to do what you just did. Good luck!

[Footballnut]

Queens, you sound like you are going to do okay. Anyone that puts that much thought and planning into making things happen should be able to chart a way through learning to be an ED nurse. Success for new grads is generally a matter of knowing the flow and tools available, getting a knowledge base and developing critical thinking skills. The process is somewhat sequential but also overlaps quite a bit.

First, get familiar with your department, charting, flow, processes and the people.

Also, work on your knowledge base and hands on skills. Find ways to get a knowledge base as an ED RN. Even if you just read an ED nursing text like Sheehy's it will help immensely. ENA puts out an online knowledge base although it is quite a bit more spendy. You should be able to spend time on this while you are in the pre-ED phase. Include basic certifications like ACLS, PALS and TNCC. I would find hands on instead of online certification classes since these are great confidence boosters. After you are in the ED if you have the time help other nurses as they do even simple things. Not only will you be getting brownie points but you will get a wealth of tips. Your preceptor would be the natural person to start to do this with during your orientation time.

And especially be very familiar with all the medications you will be using. You will need to know a lot about the critical medications and where to check the fine points as you are using them. These would be great to have well studied before you get to the ED. (I am sure the ED RNs would be happy to point you to a list.) Don't hesitate to use your resources and ask in addition to learning the medications like a playbook while you are taking care of patients.

Finally, develop critical thinking skills. Practice doing the nursing process with each patient in your head. Each patient I see gets a simple or a more complicated plan of management. Ask yourself: What is going on with my patient? How do I know? What am I going to do about it? What was the outcome? Check your hypothesis with the staff around you. Just ask them what they think is going on and how see how it matches with what you are thinking. I ask the MDs from time to time what they think and I still learn something new every day. And check your resources to see how they match your hypothesis. Your hospital should have a lot of good ones available.

If you are thinking about what you can learn and asking questions as you go you will get along fine with the staff. Remember we are most concerned about patient safety first so never hesitate to ask if you are not sure. All the best and welcome to ED nursing!

[Lunah, MSN, RN]

The online ENA training modules are fabulous! I had access to them as part of my ED nursing fellowship when I was a new RN (not long ago!!!). They follow Sheehy's, which is a must-buy book, IMO. :)

[QueensNurseNY]

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