LTC To ER

I apologize for all the typos! Thank you to anyone that responds.

On 2/8/2019 at 10:36 AM, ASC111 said:

Hello all, i need some advixe, ive recentky been hired at a small emeeg department. I have 1.5 urs of long term care experience and a few months experience in critical care while i was in school. My orientation is almost up (1.5 months) And im feeling apprehensive. I think i can handle a full patient load if everyone is stable and admitted and i judt have to give meds, do procedures, ecgs, ivs etc. But i dont feel confident that i would be able to manage someone thats not doing well. Im not surr if this is new department jitters or if i really should be nervous. Also i doesnt help that the more senior nurses openly discuss to one another infront of us new nurses that we shouldnt be there as we aee not experienced enough. Apart of my cant hrlp but think they are right. So what do you think guys, stil in emerg and tough it out or try and ask to see if i can get some floor experience?

You speak of uncertainty about managing someone who isn't doing well. Many newer ED nurses would say the same and are able to succeed by proactively consulting more experienced nurses for guidance in learning how to assess and take care of more complicated patients.~

But I would like to raise a point that I hope makes sense (because some of what you've written is concerning): You seem to believe that the care of apparently relatively stable patients in the ED is mostly a matter of tasks. But what about recognizing a situation that is changing? Or being cognizant of the potentials involved in the various patients' presentations?

Even in a small ED, a 6 week orientation is unlikely to be adequate in the majority of cases (in my experience/observations). I would talk to your manager about this and request more time. If you talk it through and really feel that you should start off somewhere else, there's nothing wrong with that either.

Best wishes ~

On 2/11/2019 at 12:12 AM, JKL33 said:

You speak of uncertainty about managing someone who isn't doing well. Many newer ED nurses would say the same and are able to succeed by proactively consulting more experienced nurses for guidance in learning how to assess and take care of more complicated patients.~

But I would like to raise a point that I hope makes sense (because some of what you've written is concerning): You seem to believe that the care of apparently relatively stable patients in the ED is mostly a matter of tasks. But what about recognizing a situation that is changing? Or being cognizant of the potentials involved in the various patients' presentations?

Even in a small ED, a 6 week orientation is unlikely to be adequate in the majority of cases (in my experience/observations). I would talk to your manager about this and request more time. If you talk it through and really feel that you should start off somewhere else, there's nothing wrong with that either.

Best wishes ~

Thank you so much for your responce. Just an update..the 6 weeks orientation was actually comprised of mostly in class preparation with just a few days of floor orientation. I brought these concerns up to management and i was given a few more shifts. Although i am appreciative, i cant help but still be apprehensive and think this isnt enough time. In responce to your concerns regarding my previous post, I just want to say thank you for opening my eyes to the reality that just because a patient seems stable doesnt mean they are, and that i have to refrain from focusing on the tasks at hand as much. Again thank you so much for your honest and helpful responce!