How do you know if you've got what it takes to be an ER nurse?

chip193 · Dec 25, 2005

Is the burn out rate high in this department?
I thought that you had to have a bit of experience under your belt before you could go into ER. Can you really go in right after you are done with your education?
Melody :Snowman1:

It's amazing what you can get right into when there's a shortage!

Chip

Beth_audrey · Dec 28, 2005

can you get in right after you've graduated or do you have to work somewhere else before you work in emergency?

ClaireMacl · Dec 28, 2005

Depends where you work, in the UK most say try and get experience first. Others here have said you can go straight in. I personally am thankful that I done an 8 month med/surg rotation before going into the ED, without it, I would have felt like I was sinking fast :)

Cx

can you get in right after you've graduated or do you have to work somewhere else before you work in emergency?

chip193 · Dec 28, 2005

can you get in right after you've graduated or do you have to work somewhere else before you work in emergency?

I suggest that you go right to the ER. You can always tell the folks who have worked other places first - they try to make the ER work like the ICU or Med/Surg and it just doesn't work. There's too much variability in the day to make it work like anywhere else - hence M/S or ICU will ruin you for the ER!!

Chip

Kidrn911 · Dec 28, 2005

The ER I work at gives new grads 6 months orientation. And just because someone works in a dedicated pediatric ER doesn't mean they don't care for adults. I get my share of adults. I am ACLS certified just as I am PALS certified.

clee1 · Dec 28, 2005

Hi,

There may be more experienced people out there with better advice, but I have done some emergency medicine work.

I think it is the place for me, and I'll tell you why.

I like the fast-paced, quick-but-accurate decision-making that goes on. I am an adrenaline junkie, so the ED suits me fine.

I also like the fact that for serious cases, you have not developed a personal attachment to the patient. You do the best you can for the patient, and then either discharge them or send them to a floor. Next!

ClaireMacl · Dec 28, 2005

I suggest that you go right to the ER. You can always tell the folks who have worked other places first.

I agree that some people who have worked elsewhere for some period of time will bring "set in their ways" ideas with them, however, I think that spending some time in a med/surg setting allows a new grad to get some grasp on time management, an ideal which is essential in the ED.

We no longer take new grads in our department, we don't have the staff to do with 6 month orientation, they get a maximum of 6 weeks, usually 4 weeks. I guess it differs from where you work, in the UK, shortages are so high, orientation just cannot be that long!

ClaireMacl · Dec 28, 2005

P.S. I got two weeks orientation when I started in my ED three years ago... virtually none shadowing staff in the department. Things, I think and hope, have changed since then!

bluestar · Dec 28, 2005

Others have given good advice here. I'd say try it and if after a reasonable amount of time (six months) you don't like it, move on. Good luck to you.

TRAMA1RN · Dec 28, 2005

You really need to be able to think on your feet and definately be thick skinned. You also have to have a sense of humor and be able to work as a team. You definately have to have more than a pulse just because there is a shortage does not mean that the standard has dropped or the expectation. ER nursing requires the brightest and best in the field.:wink2:

Jen2 · Dec 29, 2005

I went to the ER as a new grad and I love every minute of it. I externed in med/surg and ER while in nursing school and have about 10 years of experience in the medical field doing other things so I was able to fit in pretty well. If you are going to work in the ER especially as a new grad, you have to be very thick skinned. You will take crap from everyone, including the older nurses in the department that do not feel a new grad is worthy enough to be in their emergency department. You constantly have to prove yourself and you do that by a lot of self education. On my days off I still set and study. Just becasue I am out of school does not mean that I am done learning. I have subscribed to four nursing magazines and belong to the ENA. I will go home and read about the cases I saw that day, and about the standards of care for such cases. You must have a totally sick and twisted sense of humor. ER nurses make jokes out of things that some people find very offensive, but trust me it is the only way to get throught the day sometimes. You have to be a team player in the ER. You may have so many rooms that you are assigned to, but you need to recognize when one of your team members need help and step up, because they will do the same for you. Remember that a lot of policies and procedures that apply to other places in the hospital is unknown in the ER. We never get low census. We never have "no beds" available (I had a chest paint setting in a wheelchair in the hallway the other day with a portable monitor hooked up to him), we do not get pulled to other units, and there is no set nurse patient ratio. Where I work at the ICU's is 2:1, stepdown 3:1, and floors 5:1. In the ER we are suppose to be assigned 5 rooms for each nurse, but if there is a call off I have taken care of up to twelve patients before by myself. We cannot close beds just because we don't have enough staff to cover them. It can be very frustrating at times when you are takeing care of six very sick patients and you take two of them to ICU, three of them to stepdown, and one over to the cath lab because they just had an MI. It makes you think I just had all these sick patients and I am taking them to a unit where the ratio is 2:1 and 3:1, and believe me you are never welcomed when you take a patient upstairs. My best advice is to shadow and I don't mean for a few hours, do a few twelve hours shifts. I would recommend doing at least 1 twelve hour day, one twelve hour afternoon , and one twelve hour night shift so that you can see everything that goes on. We have had students come down for a few hours during a slow time and they think that it's not for them becasue it is boring to just sit around and wait for a patient. You really need to do a full shift on several different shifts to get the full picture. Best of luck to you in what ever you decide to do.

Beth_audrey · Dec 29, 2005

thanks so much Jen2. that's great info. i'll definetly take your advice and shadow a nurse for a full shift. thanks again.