Nervous about ER Preceptorship

[amzyRN]

Hi All:

I'm going to be doing an RN Residency Program, it's an unpaid educational program, where I get about 300 hous in the ER. Hopefully this might lead to a job. I'm just worried about the experience a little bit, because the ER is totally new to me. In addition to being a "new grad" I never did a preceptorship or clinical rotation in the ER, just 1 day in the ER. The primary reason I'm interested in ER is because of the variety. I got bored in Med/Surg/Tele. Not because I mastered the time management, basic nursing skills, and all that good med/surg stuff, but because I felt like it was too task-based, and I was always struggling to stay afloat. The amount of tasks were overwhelming in med/surg and tele and I felt burnt out a lot of the time. Anyway, I don't want to do poorly in the next preceptorship. Should I ask for one in med/surg/tele (I'm comfortable in that setting) or should I try something totally new (the ER), outside of my comfort zone. How can I better prepare? What about time management/nursing "brain" sheets in the ER? Any suggestions greatly appreciated.

[brainkandy87]

I was in your shoes not too long ago. I went from a tele (SDU) floor to ER and had precepted in the ER in nsg school. The ER is an amazing place, but if you felt overwhelmed in tele, you will feel overwhelmed in ER. It's all about prioritization in the ER, just as it is on the floor, but there are different priorities. You could have two critical patients both going down at once in the ER and you need to prioritize who needs you the most, what they need, what you need to get help with, etc. Nursing is all about tasks, that's just a fact of the job. You won't be passing meds at set times and doing dressing changes every # of days, but you'll be doing tasks in the sense of CP protocols, abd pain protocols, etc.

Here's some tips for starting in the ER:

1.) Paper towels are your friend. They're a great brain.

2.) Always be confident in what you do. That doesn't mean do something even if you aren't sure about it.

3.) If you aren't sure about something, ask. There are (usually) no stupid questions, but it's better to ask a stupid question that kill a patient.

4.) Never forget about your pts. Even if you're too busy to check in on them, have a tech or another nurse go see how they are. In the ER, you're susceptible to pts getting angry, leaving AMA or sneaking out, and of course, crashing.

5.) It's better to do too much that too little. If you're drawing blood, just draw a rainbow set. The MD is going to yell at you if they've got an IV already started. You get the idea.

Anyway, there's plenty more that far more experienced nurses can provide. Those are just some basics I've picked up along the way. Best of luck!