Just hired and don't know what to expect

Esme12, ASN, BSN, RN · Jun 23, 2012

What made you apply to the ED? Have you done any research about being an ED Nurse? What have you heard?

check this out...https://allnurses.com/emergency-nursing/new-grad-ed-744078.html

Larry77, RN · Jun 23, 2012

I really hope they have a good, lengthy internship program. The only new grads we have hired in the last 10 years have been those with some experience either in our ED as a tech or in the field as a medic. It is a very difficult department to start your career in but if you love it you will know the first week. Tons of topics on this site about starting out in the ED as a new grad so I won't go into that, but I would think during your hiring process they would have gone over your possible training schedule (ie. re-eval after 8 weeks or 6 months internship etc).

I'd be worried about an ED so desperate to hire new grads without any exposure or experience (if that's your case).

Crux1024 · Jun 23, 2012

Our ER hires new grads into a 16 week orientation program. The preceptors are pretty good (only certain people precept), but I really appreciated the time management skills I got from floor nursing for 2 years prior.

That being said, there are many new grads that are successful. It helps to go with the flow, do what you can, be honest about what you CANT do and ask for help. Theres nothing to be gained by keeping silent when you really need a hand.

All that you mentioned

I'm concerned about things like not having enough time for charting or not charting well, feeling panic and confusion during a code, being attacked by a patient on drugs or an upset family member, etc.

..these will all most likely happen (maybe not being attacked, but you get the idea). As i said, go with the flow, run any odd situations by your charge or coworkers and stay calm.

Also keep security's number handy. I cant say enough for the security in the ER im at. They are awesome.

jkr2020788 · Jun 24, 2012

One of the good things about documentation in the ER is that it is usually aimed at fast documentation. At least at my hospital it is. As far as what you should be concerned about is more about good primary assessment skills. On the floor, the intial assessment is completed by the ER and you have gotten somewhat of a report. In the ER though, YOU are the one who makes the inital report. You really dont want to be caught off-guard when someone asks you something about the patient. You dont want to sit there with your mouth open and say "I dont know..." You just dont have anything to go off of aside from what the patient tells you and your assessment skills.

brainkandy87 · Jun 25, 2012

Did you not have any clinical rotation through the ER in nursing school? I'd write a letter and complain to your nursing school if not. Of course, I'm biased and think nursing schools need to put students in the ER far more than they do in order to learn essential skills, especially IV starts. /soapbox

As far as your concerns, even experienced nurses get behind on charting. Sometimes you get slammed with three patients inside of fifteen minutes. It happens. You can always go back and chart something, just remember to write down what you did and what time you did it. As someone mentioned, ER charting is usually focused on fast charting, not the sometimes monotonous charting you'll find on floors.

If you aren't able to handle upset family members, angry people, etc., definitely find another job, lol. You have to have very thick skin to be an ER nurse. If you don't have it, grow it. You'll have patients crying, screaming, cussing, and so on. I had a patient the other day whose husband despised nurses because he had a PCN reaction in the 60's and "almost died." So, he was cussing me the whole time I was starting an IV on his wife. People are idiots. People are overly dramatic in the ER. You can't let it affect you either way or you'll never be able to do your job.

Pneumothorax, BSN, RN · Jun 25, 2012

Hi,
I'm a new grad and just accepted a position in the emergency room. I honestly don't know if I'm getting into water that's way over my head or not? I'm concerned about things like not having enough time for charting or not charting well, feeling panic and confusion during a code, being attacked by a patient on drugs or an upset family member, etc.
Can anyone share some of their experiences and overall impression of being an ER nurse? Some people have told me that this job is really dangerous. Comments?

All those things u mentioned are the best parts of the job. ! It's not nearly as dangerous as working in the field I can tell u that lol.

You'll be ok I worked in a large urban level 1 trauma center as a tech and saw anything and everything.. You'll be fine :)

docomo · Jun 25, 2012

Thank for all your comments. For those who may have forgotten, nursing school has very little concern for teaching skills. They spend far more time teaching about far less important stuff like roys adaptation model. Those kind of things have their place, but IMO the choice for nursing schools to all but completely abandon nursing skills has been a serious mistake. These days, nursing skills are glossed over at best, and the only real practice you'll get is on a rubber doll. I'm a former medic in the military, so I'm well practiced at drawing blood, IVs, etc. Most of my former school mates have never drawn blood or started a real IV.

Also, in some of the other post a lot of people say that they think new grads shouldn't be in the E.R. I'm not sure why some people think that way. It seems a bit unreasonable. It might be challenging for a new grad to start in the ER, but there's nothing wrong with taking on a challenge. It would be different if I were going to be in a small ER all alone and no one to turn to when I didn't know the answer, but there are plenty of experienced people around, and everyone knows at least the basics of life saving measures or else they never could have graduated nursing school.

I think the only positions that new grads should never take, are those where they don't have someone there to mentor them, or at least no one who show's them how to be a safe and effective nurse. Yet, I hear all the time about new RNs taking jobs in nursing homes where they are the only RN on duty etc...

Given the choice, would you rather be cared for by the new grad surrounded by other health professionals who are guiding and teaching that person, or the new grad who is out there all alone figuring things out as they go along?

Esme12, ASN, BSN, RN · Jun 26, 2012

Well....you asked a question and you got answers. Being a medic in the military while it will give you an edge....is completely different than your role as a nurse. You asked if you might be over your head as a new grad and didn't divulge that you have experience in the medical field.

MOST new grads will find the ED challenging. The pace the acuity, the drunks, the crazies, the codes are way beyond the non ED nurses roles. Even ICU nurses struggle with the ED for volume and juggling patients and priorities. Even you will find the pace, policies, rules organization challenging as a new RN. I have seen very experienced street medics really struggle in their roles as RNs' for it is vastly different than being the RN. Medics are far more independent (for the most part) than nurse are allowed to be.....especially when you are the new kid on the block.

While your actual skills for IV's and labs will definitely be a bonus, you will be expected to act as a new grad. Just a friendly reminder.......Reminding everyone about being a medic will not ingratiate you to the seasoned nurses hearts. You are the new guy.....fresh out of school.....like it or not and act accordingly. I know this is second "40ish" career for you but you are the "new grad" and those ED nurses will help you to learn and rememver that accordingly.....My advice? Tread lightly and kindly.

I want a nurse new or old who recognizes their limitations, acknowledges their shortcomings, and are willing to learn...... for it makes them a much safer competent nurse. New grads in charge of the nursing homes? Irresponsible, but that is the nature of the beast these days and it's all about the money. That poor new grad doesn't realize the risk/responsibility to her and her license and the Administrators.....like it that way. Sad really.

Good Luck on your new position and I wish you the best on your new nursing journey. Peace