I was just offered a spot in the New Grad program at the ER of my dreams!!

[HermioneG, BSN, RN]

Hi everyone!!

So I've always been a lurker on this specialty area of allnurses, and have posted a couple of times and everyone has always been so helpful!

I just wanted to share that I was recently offered a spot in the New Grad program at the ER of my dreams!!! I have wanted to work in this department since I was doing my pre-reqs for nursing school. I did my senior practicum/capstone there and fell completely and utterly head over heels in love with the place, and knew I had focused on the right place years ago when I first dreamed of working there during my pre reqs.

The program starts in about 3 weeks and I am beside myself with joy and am so thankful that I'm being given this chance! The unit is such a family, and the educators are so supportive and I'm over the moon right now :) :) :)

I'm wondering if anyone can give me some insight on how to best prepare for the program. I've done some research (allnurses is such an amazing resource) and have come across some articles such as the top medications for ER nurses to know, etc. I have the list of meds I want to start looking over, I also ordered a used ATLS book. I don't expect to be exposed to trauma for awhile (being a new grad, of course, and I know I'm going to have to earn it) so I also got a handbook of common non life threatening/non trauma problems seen in ER and their treatment. I am ACLS, PALS, and BART certified and currently have some CEN study guides from my stepmom that she's letting me borrow. Although I don't plan on taking the test for awhile, I figured it would be a good place to start. I also ordered a TNCC book from amazon for about $10 because they in house certify all the new grads and I wanted to start studying early. Its an older edition, but I figured most of the basics would be similar.

The nurse educators mentioned that they want a "blank slate" from me and to just spend this last bit of time cleaning out everything, seeing family, and relaxing because once the program starts I have to hit the ground running.

The thing with me, though, is that it typically takes me a little longer than my peers to get into the "swing" of things. Many of my clinical instructors and preceptors have described me as an "upward line" meaning I might struggle a bit in the beginning, but as I gain steam and push through and get adjusted to policy/procedure/the basics I'm totally fine and thrive. But the beginning of things can be a little messy and that worries me.

After the first round of interviews, the educators called me and let me know that I didn't need to come in to the second round of interviews that they're having. I was so surprised and so thankful since that was going to be a ton of stress. I also feel like this is a huge gesture of confidence from them since the second interview is with the Director (or so I've heard). I just want to make sure to "do right" by them, and work hard and do anything and everything that I can to come in strong and directly address my tendency to "struggle at the start." I want to make them proud and come in clearly having put in effort. I get that I'm a new grad so I don't know my head from my butt yet (and they and everyone else knows that), but I would at the very least like to make a clear effort to come in strong. Especially since they said I didn't have to come in for the standard second interview. That's a huge deal for me, and so I want to take it really seriously!

Do you guys think I should just take their advice and force myself to relax, or should I hit the books and start prepping? What did you guys do the weeks before your first nursing job started?

I'm sorry for the really long post, I'm just SO EXCITED its really hard to chill out lol. I am definitely a bundle of nerves and excitement right now.

And of course, while I totally appreciate any advice, I mainly posted this just because I'm so excited and I had to make it "official" and share it with the community on here :) I hope everyone is having a beautiful day.

-HermioneG

[JKL33]

Love your post - congratulations! You have a great attitude and therefore will succeed.

I appreciate your introspection and your ability to be forthright about struggling at the beginning of new endeavors. Just the same there are real cautions about your proposed approach; you run the risk of sabotgaging yourself just a little by trying to get your hands on too much information at this early juncture without really having any context for when or how you will use it. In addition, older materials are not recommended (IMO); things change and right now you don't even know what is basic and what is critical and what is "both", nor do you really know where to focus. I really think you run the risk of of becoming completely overwhelmed before you even start.

Here is one often-suggested resource, and I do recommend having it so that you can do extra reading to learn more about the things presented during your preceptorship.

Sheehy's Manual of Emergency Care, 7e (Newberry, Sheehy's Manual of Emergency Care): 978�323�78276: Medicine & Health Science Books @ Amazon.com

Take their suggestion! They know how these things work, and they are very familiar with the "gap" between nursing school knowledge and being able to competently function in an ED.

Your hunger for learning the information combined with your energy/outlook/excitement and your desire to "do right by them" = Recipe for Success!!

Come back here and let us know how it's going!

(congratulatory hug!) :)

[Lunah, MSN, RN]

Relax!!

Regarding TNCC (I am an instructor), there were some differences between the 6th and 7th editions, most notably in the recognition that hemorrhage needs to be looked for and ruled out immediately upon arrival, and if present, it reprioritizes the primary assessment. I also don't remember if the 6th edition talked about permissive hypotension and the judicious use of isotonic crystalloids in resuscitation. But a lot of it is similar otherwise.

Congrats! I am super excited for you! :) Welcome to the wacky world of the ED!

[HermioneG, BSN, RN]

Thank you so much for all of your thoughtful advice and perspective! I definitely hadn't considered the possible sabotage that I could be doing to myself by trying to take in too much too soon!

I decided to relax, and also do some intense cleaning to prepare :) I'M SO EXCITED!

Thank you :) :)

[HermioneG, BSN, RN]

Thank you so much, Pixie.RN! I wrote down the notes that you mentioned and will make sure to put them in my 6th edition TNCC for the time being until I take the class :) :) yay!!

[Kuriin, BSN, RN]

Congratulations! :-) I personally love the "Emergency Nursing Bible" because it gives diagnoses with nursing protocols that you should expect to be ordered.

[ILUVERNSG, MSN, RN]

Congratulations my dear! ER is the best, most fun area to work (imho).

Let me suggest that you get yourself some resource texts; Sheehy's is good and the Core Curriculum for Emergency Nursing. Get yourself a medication book or an app to reference at work.

I really enjoyed Laura Gasparis Vonfrolio's materials as a CEN review. It's way too early for certification yet but if you listen to her CDs, you will laugh a lot and learn a lot from her. She's a very smart and funny nurse educator with ICU and ER experience.

Good luck as you enter the wonderful world of ER nursing, it's a wild ride!

[confettireads, BSN, RN]

Congrats!

Not an ER nurse, but definitely wanted to give you some love and encouragement. I'm definitely like you in that I am an "upward line" person as well, so I can definitely relate. You've got this, and you will excel in ER nursing! Happy for you. :)

[bgxyrnf, MSN, RN]

Congratulations.

Many nurses loathe the ED but for some of us, there's just no better place to work.

Don't get me wrong... it can be very frustrating and sometimes mind-numbingly boring... on the whole, though, there's nothing like it and no other acute care floor/unit that I'd choose to work... and it's as good a learning experience as one can have.

Personally, I say start reading and learning now. To the references mentioned above I'd also add: Jean Proehl's book on emergency nursing procedures and Fred Ferri's clinical advisor.

[amzyRN]

Congratulations!! I'd hold off on anything but ACLS and PALS for now. Once you get some experience under your belt then consider TNCC especially if your hospital will pay for that. I'd also hold off on CEN until you have at least 1 or 2 years experience. What will make you valuable as an ER nurse is your actual skill set and knowledge base. You will get that through much practice. Try to do your best, reference the resources provided here, and don't let any negative experiences drag you down. It will probably be different than you think. Try to retain your enthusiasm and genuine compassion for people. Listen to your gut and don't let prejudices guide your decisions ever.

[HermioneG, BSN, RN]

Oh my goodness thank you everyone for your kind replies! I read EVERY SINGLE ONE OF THEM AND THEY MADE ME SO HAPPY!

Thank you :)

Today was the first day of orientation!! It looks like the program is going to be four months long, we are going to have weekly classroom time and they're even paying for a Jeff Solheim instructor to come and give us a two day CEN review course which will be next week! I had no idea that was going to be a part of our program! We also get to come in and shadow different members of the ER team including case managers, respiratory therapists, projector coordinators, team leaders, and even a nurse who coordinates and goes to meetings with local EMS! I AM SO EXCITED I CAN'T WAIT TO START ON THE FLOOR NEXT WEEK!

Thanks again everyone for your support and wisdom. I can't believe my dreams are coming true!

Hope everyone has a great night,

-HermioneG

[JKL33]

I look forward to future updates! :)