How do I become a successful ER Nurse?

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Specializes in Pediatric ED, PICU, Simulation Education.

Hi! I am in my second semester in my nursing program, and I am loving the nursing profession and I'm doing well in school! After reading through different forums, I really want to become fit enough to become an ER nurse, and eventually become a ED Nurse Practitioner. But I don't know what is the best route for me to take to accomplish this and become successful at it.

For instance, I don't know where to go for my senior practicum should I go for Emergency Department or ICU? I want to be competent enough in all my skills, and ER nursing seems so exciting and challenging for me. On the other hand, should I learn my basic nursing skills first that ICU presents me with?

Next, with the grace of God, I pass my NCLEX and get my RN next to my name, should I go straight to ER nursing? I've read mixed thoughts about it. Some hospitals do accept newly grads in the emergency department (because they can mold them in orientation), others want experience for in the floor.

I want to know anyone's thoughts and advice about my issue. If you're going through the same situation as I am, comment as well! Thank you! :cat:

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Specializes in Trauma, Orthopedics.

If you want to learn basic skills, you'd go to a medsurg floor. .. Not icu. But if ER were what I wanted to do, I'd be picking ER so I could network and see if I really like it as much as I think I do.

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Specializes in ER.

If you know you want to do ER, try to get as much experience as you can there while you're still in school. Let your instructors know that's where you would like to end up. Request a spot in the ER for your practicum. Network and stay in touch with the ER staff. ICU experience will help, and you will get ICU exposure during clinicals, but it is possible to go straight to ER and learn what you need to know there.

I discovered my passion for ER during my second semester. I let my instructors know I was pursuing it and they managed to get me a coveted spot in the ER for my preceptorship. After I graduated in December, I applied to two different ERs that have new grad programs. I have a second interview coming up and I think I will end up getting a job offer. I'm using my Critical Care instructor and ER preceptor as references. The hospitals around here hire new grads into the ER but it is very competitive. Hopefully my good grades, contacts, and ER experience will set me above the other applicants.

As far as NP, just take it one step at a time. You never know what opportunities will present themselves, so enjoy the experience and learn as much as you can along the way. Good luck!

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Specializes in L&D, infusion, urology.

If you know you want to do ER without a doubt, then go for it! Aim to precept there.

One thing I know our school does is they make sure you have med/surg DOWN before you can precept in a specialty unit of any kind (ICU, ER, L&D, postpartum, peds, etc). Master those basics (ICU has a completely different skill set than med/surg) and show your instructors you can handle it.

Like you said, some places will hire new grads, some won't. It's good to get a feel for which hospitals run which way. In general, if you can get a couple of years of med/surg in, you'll likely have a better chance, but if you can precept there, you'll make key connections that will be very helpful if you're smart. I really hope to land a position where I'm precepting, and I'm letting it be known!

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Specializes in Pediatric ED, PICU, Simulation Education.

@lianna88 I got different advices from the nurses I come in contact with, either ICU or Medsurg floor. But thank you, I'll definitely network!

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Specializes in Pediatric ED, PICU, Simulation Education.

@learning as I go - I definitely would request ER if I can get it for my practicum! Thank you for your suggestion. Of course I would take it one step at the time, it's just sometimes I want to plan it all out (although, it may not work out the way I planned, or God's plans are different from mine). Yes, I'm just reading more and more about the ER and I know I have to be on top of my game. It's tough for my program to get ER as a practicum, but I will try my best and just go for it. Good luck with you too and thanks again!

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Specializes in Pediatric ED, PICU, Simulation Education.

@RunBabyRun - Thanks for the comment! Yeah, I'm definitely doing the best I could in terms of my knowledge and skills in med/surg. I have friends that tell me to at least do 6 months to a year in med/surg so you can be comfortable in your skills. I'm looking around my area and doing my research in terms of what the job entails (hopefully, I get more of an understanding if my clinical instructor lets me go to the ED). I have many connections in the hospitals around me for Med/Surg, OR, and Oncology, but I need to get to know people in the ER and get a chance to talk to them to see what I can do to get there.

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Specializes in Trauma, Orthopedics.
@lianna88 I got different advices from the nurses I come in contact with, either ICU or Medsurg floor. But thank you, I'll definitely network!

An ICU isnt really a good place if you dont have your basic skills down because you really need them to function in the ICU...I just dont think it's really accurate to look at an icu as a stepping stone for the ER because its an entirely different beast. Plus, you would never be able to gauge if you really do love the ER based off of an ICU practicum-theyre 2 completely different environments.

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The places that will hire a new grad directly into a critical care area like ED or ICU are vanishingly few; you have to have mastered a good deal more than what you think are basic "skills" to even walk in the door, and ICU is really not the place to learn them. The first answer that came to me was, "You'll take any job you can get and thank your lucky stars for it," since so many new grads have to wait months and sometimes more than a year to get any job at all. Do not hang all your plans on that.

If you can get an ED rotation in school, go for it. But you are in a very early place in your education. Just about any nurse you talk to didn't get his/her dreeeeeeaaaaammmmm job right out of school, and many, many of us ended up in something completely different, having fallen in love with another specialty (or two, or three) through luck or happenstance. That semester you spend in ER might totally turn you off-- it's happened to a lot of people before! (I know I am probably talking to someone who doesn't believe it could ever happen to her, but it has to be said anyway. It's like most people are really not married to the boy they couldn't live without seeing for a day in high school.) You know the old saying: If you want to hear God laugh, tell him your plans.

It's fine to have a goal, but while you walk that path, keep your peripheral vision working, because you can never tell what's going to pop up.

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Specializes in Pediatric ED, PICU, Simulation Education.

@GrnTea - Thank you for this! Haha, yes I've heard that quote before. He's probably laughing at me right now. I'm keeping my options open definitely. I just want to hear peoples thoughts about it. And I'm grateful for those like you who have replied. So if do want to learn the skills that I need, Med-Surg is what I'm hearing that I should go to first to learn these skills. It's funny because knowing me, I feel that I can fit into ER, Med-Surg or ICU. I can easily adapt, though ER just has that zing! I'll just have to see what I get when I graduate and go from there. But I do want to get SOME clinical experience in all of these fields. I want to know where I feel at home by being on that floor. Having an ED for my senior practicum would be great, IF I can get it.

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Specializes in Pediatric ED, PICU, Simulation Education.

@lianna88 - So what would be a good floor then for me to learn these skills if I were to go to ER?

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Specializes in L&D, infusion, urology.
The places that will hire a new grad directly into a critical care area like ED or ICU are vanishingly few; you have to have mastered a good deal more than what you think are basic "skills" to even walk in the door, and ICU is really not the place to learn them. The first answer that came to me was, "You'll take any job you can get and thank your lucky stars for it," since so many new grads have to wait months and sometimes more than a year to get any job at all. Do not hang all your plans on that.

If you can get an ED rotation in school, go for it. But you are in a very early place in your education. Just about any nurse you talk to didn't get his/her dreeeeeeaaaaammmmm job right out of school, and many, many of us ended up in something completely different, having fallen in love with another specialty (or two, or three) through luck or happenstance. That semester you spend in ER might totally turn you off-- it's happened to a lot of people before! (I know I am probably talking to someone who doesn't believe it could ever happen to her, but it has to be said anyway. It's like most people are really not married to the boy they couldn't live without seeing for a day in high school.) You know the old saying: If you want to hear God laugh, tell him your plans.

It's fine to have a goal, but while you walk that path, keep your peripheral vision working, because you can never tell what's going to pop up.

Yes, yes, and more yes.

The way the market is, we're kinda taking what we can get, as far as jobs go. A lot of people have changed what they wanted to do since going into school. I've known for 10+ years that I wanted to go into OB, and that hasn't changed. But I always thought OR would be interesting. After a day there, I was like, NO. I was bored to tears about 3 hours in. I'd do it if it was where the work was, at least for awhile, but I'd really rather not! I'm grateful for these rotations, if nothing else to get a taste of something before being stuck in a job doing it without knowing what I'm in for. Same goes for ICU- I was looking forward to it, and it was interesting, but definitely not my cup of tea. But then, placentas and breastfeeding aren't for everyone, either! :)

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