New to ER

I don't have any advice for you. I know that ultimately this is what I want to do-- ED. I just wanted to say congrats on your position and I'm sure you will do fine. Out of all my rotations in nursing school, once going to the ED one time, I wanted to go back every day. I was a MA before getting into nursing school and blood draws are sooooo easy. I find starting IV's to be a little more difficult for me. But hey, I guess practice makes perfect! Good Luck!

Enter with an open mind. Ask questions.

IV skills and others are just simple OJT.

...it will come.

The only people that have problems are the

ones that think they know more than they do.

No one knows it all.

Expect to give it about 6 months to a year before

you get comfortable. Good luck.

Do every IV you can, and draw blood with every IV start....if you don't you will need it later.....everytime!

Finding IV sites .....AC, and almost every one has one off their thumb/wrist area. I agree with EmergencyNrse give yourself a year to adjust....its fast, hectic, but oh so much fun!

It comes with time. Start an IV on anyone that you can. I went into the ER as a new grad, where I had been working as a PCT/extern while in school. During my senior year of nursing school when I had downtime, I would walk around and ask all the nurses if they needed an IV started...once you get a technique down, it's pretty easy. It probably took me 3-4 shifts to get comfortable with it, and by the time I graduated, I could get an IV into a rock.

DO NOT LET THE PATIENTS INTIMIDATE YOU! My response to, "I'm kind of a hard stick..." was, "That's ok, I've got plenty of supplies! Do you want pink or green?".

If I had a good feeling that the patient was going to get admitted from the get-go, I would try to get a line in the hand, wrist, or forearm. Though it's usually pretty easy access, they just don't last in the AC and the pumps constantly alarm 'occluded'. It's a nice gesture for the patient and the floor nurses.

Don't let your nerves show, and enjoy! There are so many things that I loved and miss about the ER. Good luck!

Give it about 2-3 months before you start feeling good about IV starts and blood draws. I came from the floor and feel more confident now since I practice every day!!! :) It gets better.

Yes, your comfort level and skill will improve with practice.

I'd also like to add that sometimes, when a patient emphasizes what a hard stick they are, sometimes they are right, and sometimes not.

Just last night, I had a young woman tell me "my veins roll, and they usually have to use butterfly needles". She had a big fat firehose in her AC and I got a 20g in there no problem (also explained that we don't use butterfly needles for IVs). Other times, a patient will tell me what a hard stick they are, and boy are they right! So, listen to the patient and don't dismiss their concern, but also trust your own assessment.

If you have anyone in your ED who is a rock star on IV starts, take opportunities to watch them start difficult lines. If you have to call someone else in to start a line on your patient, stick around and watch. You will learn a lot!