New ER Nurse

[MikeyBSN]

Hi, I'm starting a job in the ER as a new graduate. I have some EMT experience and I've done a few rotation days through the ER. Do you guys have any advice?

[MacERRN]

Best advice is don't complain and just do your job. The doc's will like you cuz all of us old nurses are jadded and love to complain about everything.

[TazziRN, RN]

Yes....forget a lot of what you learned in nursing school (procedure-wise, I mean) and watch how the seasoned nurses do things. And learn as much as you can about the norms of chronic diseases, because that was a hard one for me. I, too, was a new grad in the ER and I now regret not getting medsurg experience first.

[JMBM]

I was (a long time ago) a new grad ER nurse and former EMT. Your EMT experience will help some, especially in trauma cases. However, the ER is a world onto its own. Except for basic pathophys, the stuff you learned in nursing school will be only minimally relevant. My advice is to find the good and willing teachers in your department. Ask questions and volunteer to assist in every procedure you can. Do your teachers some favors - maybe clean a room or three - its hard to take time to teach when you are tired and busy. Keep your eyes open all the time and jot down stuff, drugs, conditions, procedures you need to look up at home. Whatever you do, don't be afraid to look dumb. Ask for help. The good people in your department will gladly help out. The others? Well, life is too short. Keep smiling. Best of luck.

[erjulie]

never assume that you know what's going on....it'll come back to haunt you! ALWAYS ask if unsure, no matter how many years you've worked. There is no shame in failing, only shame in not asking for help.

old erjulie

[MMARN, BSN, RN]

From other posts I've read in similar threads, humor is the best advice. Don't take everything to heart; ask questions no matter how dumb they seem and be willing to go along with the ride. Good luck!

[joeys]

I agree, always ask or look it up if you are unsure. When I started in ER after school, I used a pda w/ drug book and such. That was very helpful when everyone was to busy to stop and show me what I needed.

[scrmblr]

find a mentor.

Never let a pt see you "sweat" they are already nervous...save the sweating for the breakroom.

know where everything is. take inventory. nothing worse then running around like a crazy person looking for the foley cath's.

if you are unsure of a medication (route, dose etc) double check with someone else.

it is ok to question orders.

never piss off the unit sec or the tech's. your life will be hell.

learn what you can and can't order. the doc's (sometimes) like to have the labs and xrays ordered before they see the pt. most places have a list of protocols for things like abd pain, lower ext complaints etc

know MONA:)

[ER2Ed]

As a one-year old new-grad who started out in the ER (and still there), I agree with the above postings - especially the "don't p--- off the tech's or unit clerk". In addition, I'd like to add: - Find out where the "Clinical Pathways" book is and make a copy.

It may be called something else, you may already know about it. It basically has the steps (pathways) that should be followed for patients with particular complaints - i.e., chest pain = O2, EKG, Monitor, at least 2 large bore IVs (I find three is better if someone is in the middle of an MI), etc. Also ours states to give NTG and ASA - this can be done prior to the doc seeing the patient. It lets you know what you, as the nurse can do for the patient and stay within the guidelines of the hospitals policies for your practice. But be sure it doesn't have you doing things outside of the legal guidelines of your

State's nursing practice. I found that getting to know these pathways right away helped me be a lot more proficient a lot faster. Unfortunately - I was there for over two months and off orientation before I ever knew such a thing existed.

Good luck - you will love i

[paphgrl]

Help others whenever you have a free minute. Whether its a mini cath or cleaning rooms or poop duty, always jump in and help. whether techs, secs or RN,we are all part of a team.

[sweetVTnurse]

Great advice. I myself am new to the ER setting. It has been a great experience. I am the youngest ER nurse by 9 years!! Everyone has been great. I have found that most nurses have there OWN way of doing things. Find mentorship in many different nurses and emulate the ways that you feel are the best. Definately, get in good with the unit secretary!! They can be a huge asset (they should be paid big $$$). I agree with never let them see you sweat, save it for the breakroom. Most of the time if you seem calm then you're patient will maintain more confidence and calmness also. Everyone elses posts were great advice along with other similar threads. I am so greatful to find allnurses. It has been nice to find others with same insecurities as my own. Thank-you, thank-you! I read it everday.

[joeys]

i hear you loud and clear on that paphgrl, always help when you can. You never know what is coming in the door next and you may need a return favor.