New Grad Advice on ED



so I am a nursing student interested in ED/Trauma. I know from what I have briefly researched that I can get an entry level job in the ER right after school (ie some sort of residency/internship/preceptorship). But I'm going to be moving to a new city (Seattle- Im so pumped!!!) and i know that the ED can get crazy with crazy shifts and alot of stress. I imagine that just being a RN for the first time in a new city will be enough stress for the first year or so of my career.

So the question- are there any units that you guys would suggest to get experiance before jumping into the ED? Or do you think I should put my fears aside and hit the ground running after graduation?

any personal experiance you could share would be of great help to me-

Thanks in advance-

Jim O

Specializes in ED, ICU, Heme/Onc.

I think you should try to find a job in the ED. You are moving and will be starting a new job all at once, so it might as well be the one you want if you can find it.

You'll get a crash course in *everything* in the ED - which if you decide it isn't for you, you can go to the unit or a med/surge/tele floor or outpatient, etc.



497 Posts

Agree with the previous poster.....going into it knowing there will be stress involved and finding healthy coping mechanisms will help you transition to a new city and a new job.

Specializes in ED, ICU, MS/MT, PCU, CM, House Sup, Frontline mgr. Has 15 years experience.

If you can land a job in the ED, then do so. Otherwise try to land a Medical Surgical unit that is fast paced with a varaiety of patients or highly acute specialized patients or a Cardiac unit. This way when you transfer you will have a lot of experience and knowledge to survive an ED (this is the advice told to me by RNs who know I want to work in the ED someday.. my hospital will not hire New Grads in the ER). :twocents: GL!

-Now a New Grad!:clpty: :w00t::monkeydance::flamesonb

Specializes in Emergency, Nursing Management, Auditing. Has 16 years experience.

Agree with the above posters. I started out as a new grad in the ED in May 2007. I feel that it was basically a crash course in "a little bit of everything." At first I was scared out of my mind, but now I feel much more comfortable with my responsibilities. I think it's probably this way for any new nurse, regardless of where they work. Just remember there are always more experienced people working with you to help. I think jumping right into the ED is good because you don't get into a routine like the floors have, and then you don't have to get "un-used" to that routine.


186 Posts

Specializes in Emergency/ Critical Care.

Hi there,

I just found out I got a part time position at the ER where I live. I'm very excited because this is where I have always wanted to work. I got a little taste of it doing my consolidation and LOVED it! My question is, is there anything I should do prior to starting that will help prepare me for the new job?

Thanks in advance

"No longer a student"


27 Posts

Specializes in ED, EMS. Has 3 years experience.

I have a interview this thursday in a level 1 ED. I just recently graduated from RN school waiting to take my boards. I worked as an LPN and EMT prior to RN school so I think that had some pull allowing me to land an interview of my choice. Good Luck!:up:

Jennifer, RN

226 Posts

Specializes in ER, telemetry. Has 11 years experience.

I started on telemetry and found that to be a great floor to learn on and then to transition to ER. It gave me a solid base of cardiac knowledge, as well as just basic experience in learning how to delegate, prioritize and critically think.

Good luck in whatever area you decide to work!


49 Posts

Specializes in cardiac, GI, ER.. Has 7 years experience.
I started on telemetry and found that to be a great floor to learn on and then to transition to ER. It gave me a solid base of cardiac knowledge, as well as just basic experience in learning how to delegate, prioritize and critically think.

Good luck in whatever area you decide to work!

I also started on a cardiac floor and It was very helpful when I decided to move to the emergency department. The learning curve is high but it is also doable as long as the enviroment is supportive. Best of luck!


7 Posts

I think it depends on the orientation process the facility has. I went straight from school to an ED with a facility that has a minimum 4 month orientation period. There were in-depth classes and workshops on just about everything you could imagine. At the end of the orientation period, if you don't feel comfortable going solo, you can stay with a preceptor longer. I feel like I was very well prepared to go solo!

star77, MSN, RN

219 Posts

Specializes in Emergency, Critical Care Transport. Has 4 years experience.

It's really refreshing to see the "do what you really want to" replies, because I often get the "You need other experience first!" replies (which have merit, I understand- but I also know a lot of FABULOUS nurses who started in the ED and haven't left- for a reason). I live in California, and the job market here for new grads is somewhere between difficult(central valley) and abysmal(SFBay area/Sac).

I lucked out and have an ED interview and I am ecstatic, even though it would require me to move elsewhere in the state.

Thank you for all of your support for those of us pursuing our true passions- it's refreshing to not have people rain on the parade. Some of us are motivated to go to the ED because we've worked in emergency as techs, and although we have a LOT to learn, it's exciting to have the opportunity to follow through on what led us to nursing in the first place!


90 Posts

Specializes in Emergency.

the ED is a great place to start because it really fosters honing all your skills and learning how to use your critical thinking and prioritizing skills as well. there are a couple downsides to it, though. not all people are cut out for the ED, even some of those who have a passion for it. some people aren't able to think quickly on their feet or work quickly at all so they hold their patients for much longer than necessary, which is aggravating to other staff members. also, if for some reason you change and go to floor will be a whole different world. getting used to the timed meds, actually having scheduled meals, etc....and dealing with all the adl's that you don't normally deal with in the ED will be challenging to get used to. it's certainly possible though! i started off in a fast paced med/surg....ER extension unit. we would get direct admits from the clinics associated with the hospital and get their iv's and foleys started as well as their initial lab work and admit orders....and then send them to the appropriate floor of their service (onc, plastics/med/surg/ortho/uro, etc.) sometimes those floors weren't open so they'd stay with us until they were, or until they were discharged, so we did floor nursing as well. it was a great learning experience for me because i got to hone my skills AND learn the fast-pace process of pt. flow all while doing floor nursing with the other half of my patients. the only thing i didn't really get was cardiac, since we weren't a tele-capable floor. rhythms and such came easy to me though so the transition to ED wasn't hard at all. there are some benefits to working tele before ed if you don't go straight in to it. BUT....if the ed you are wanting to work at doesn't have a large cardiac population, you will be lacking in dealing with any other type of diagnosis. good luck!

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