Infusion Nurse To ER Nurse - HELP!

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Specializes in Infusion, Nurse Educator.

My current specialty is biologic Infusion therapy and I haven't worked in the hospital for years. I am PETRIFIED but I start a new job in the ER in two weeks ?....The only saving grace is I get 3 months of training and it's only a level 4 trauma center with 12 beds and 8 fast track beds. 1:4 Ratio... Any advice or suggestions on what to study?? I'm planning to use the next two weeks to study! 

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Specializes in Emergency Department.

For the most part, you'll do fine. Review the basic EKG rhythms and ACLS. Review your basic labs (CBC/CMP) for what those values mean and know that in the ED, they're going to tolerate a little bit wider variance in those values than you might see in an inpatient or possibly even an outpatient setting. Hopefully you're going to get a good preceptor, and they'll usually start you off with 1:1, though that won't last very long. You'll quickly be 1:2 and that'll last a couple weeks, then 1:3 for a few weeks, then 1:4 with "easier" patients (at least as so far as they can provide you). As you're going to be working at an ED that's a Trauma Center, you'll want to at least do some reading and watching of videos focused on TNCC type stuff, though a Level IV TC is mostly a bandaid and transfer place. Also see if you can find a used "Advanced Medical Life Support" book. It's going to be focused on prehospital medicine but it'll be a good review of medical emergencies and how they're initially treated. 

You're also going to want to dust-off some of those old Med/Surg books as you're going to be doing some stuff that's along in that realm too, but that won't be your focus... doing focused system assessments will be. 

The ED will be a chaotic (relatively speaking) place to work. You're going to become a squirrel because you're going to be constantly changing your priorities of what to do with patients. A few will be really really sick but most will be meh-sick and probably could be best managed by their PCP but are coming to you because they don't want to wait for a day or two. 

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Specializes in Infusion, Nurse Educator.

Thank you so much for your response! I feel better now because labs, EKGs and ACLS were all on my list.  The Supervisor did say I will need to get PALS and TNCC eventually.  I will schedule PALS for next week. He said that they are working on becoming a level III, but I'm hoping that takes a while, because like you said at a IV I'm thinking we are like one step above an urgent care. ? Any suggestions for what skills to review? Also, I know you don't know this, but how long do you think they'll let me shadow ? I hope the first week I have no assignments ? I'm just so nervous! @akulahawkRN

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Specializes in ER/Trauma.

Heh! I'm the exact opposite - I went from ED/Trauma to Outpatient Infusion! ?
FIRST - try and relax! You're going to be no help to your patient if you're a nervous wreck (and this includes during actual emergencies!)
Understand and accept the fact that you have a learning curve ahead of you - but also allow yourself a pat on the back: you're a NURSE! You went through nursing school! You passed the NCLEX! You can DO THIS! Heck if a doofus like me can do it for 15 some years, YOU CAN TOO! ?

Flip and See ECG: Cohn RN MS NP ACNP DNSc CEN EMT-CC, Elizabeth Gross: 9780323084529: Amazon.com: Books
That should ease you into cardiac rhythms. 
* Understand that unlike outpatient infusion, the ER is "controlled chaos" - 

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