How to learn this stuff

Have you taken an ICU class? Why do they need to take over? Have you considered telling your charge nurse that you want to be proficient in the trauma rooms and you'd like some more training?

I'm a newernuree to the ED. I worked on the floor for a few years. Transferred to th ED. Problem is, whenever I get a critical patient, like someone needing pressers and fluid resuscitation or something similar, more experienced nurses just take over and do everything. I am still worthless after 8 months in the ED when I get these types of patients.

#1 Stop calling yourself worthless. If that were true, you probably wouldn't still be in the ED. I suspect you are giving off that vibe to your co-workers. Believe in yourself!!!! You CAN do this!!!

#2 Understand that the culture of the ED is made up of a lot of strong personalities ready to dive in. More often than not, staff jump in because that's what we do. It's a team effort with a critical patient. I doubt they mean to take over. You equally need to be assertive. Where I have worked (unless discussed prior to the arrival of the patient), the primary nurse is the scribe and should oversee that everything is getting done for the patient. You vocalize over everyone, "I need the epi given." Is that the culture where you work? If you don't know, ask.

#3 If you know a critical patient is coming in, communicate with the charge nurse/team. Ask if you can do skills. Say "If the patient needs to be defibrillated I'd really like to do that." Or "Can I do the meds on this patient?" If there is someone on the team you connect with, ask them to oversee you to make sure you don't make any mistakes.

You are at the point where you MUST start getting these experiences so you feel confident in the months moving forward. I suggest you talk to your charge nurse, educator, or manager and ask for some tips of what might work best in the environment you are working in. Don't give up. It's a process, but I would start running toward the critical patients at this point. Sounds like you need that experience for your confidence. Best of luck. Hang in there.

We don't have a manager. He quit. We have an ANM who avoids responsibility like the plague.

I didn't say I am worthless, just that I feel that way when I can't contribute fully, nor am I learning things to be able to someday.

Next fall I begin an acute care NP program. I'd like more experience with these things.

It'll come. It comes with experience and sooner than you realize, you'll be one of the nurses grabbing and hanging critical care medications. It takes a while to get to that point, at least a year, and then sometimes two more before you feel so smooth that you are helping the new ones with their patients.

The problem is that we live in an instant gratification world and this level of care doesn't come the second you get hired. You can do this. Be patient and when a doctor says "start an epi drip" you can say "getting it!" and then do it with some guidance.

Thing is, I'd like to see more education. Like after difficult cases, use that as a learning experience. I feel that I'll be behind all the other NP students when I start in the fall.

I wouldn't worry too much about "being behind". I think the "fully comfortable in critical care" nurse is a minority in most NP programs.

Thing is, I'd like to see more education. Like after difficult cases, use that as a learning experience. I feel that I'll be behind all the other NP students when I start in the fall.

Don't worry about the other NP students. Many have zip experience with anything and now they're going to diagnose and treat the unsuspecting.

Listen here. At least you admit you don't know what you don't know or at least suspect it. This self questioning is really the essence of what will make you a good NP.

In many areas of nursing you can get by with faking it till you make it but to me all NPs should have a well rounded and solid clinical as well as didactic backround.

Many don't agree with this contention but I say this being on no one's payroll.

But your instincts are correct. The ICU thing is a good place to learn drips and get your chops down in a contained a-b-c environment. Many ICU nurses do have this backround but it is still no guarantee that any particular ICU nurse has the constitution to multitask or change gears as the need arises to take care of yet one flood after another of the A to Z type patients that darken your door.

As long as the ineffective ANM nurse manager thinks you have the drive and potential to learn, just dive into the fray when you see something you need to get better at.