New grad ER nurse advice

applesxoranges, BSN, RN · Jul 29, 2015

Get to know your doctors. Some doctors will order everything under the sun. Some will order the bare minimums. Double task on things too. Does the patient need an IV? If so, bring the tray in initially when you go see them and draw blood at the same time. Learn the colors of the tubes and what tests can be done off of each tubes. I always send down a green and purple on most patients besides quick care. Blue is the next common. Knocking out a task like an IV initially can help you.

Learn to say that you're one person is something that is important. After all, you're one person. It is nice if triage or someone else can tell people that the nurse received patients back to back but that doesn't always happen. I just told a patient that the area was slammed with squads and patients so a nurse will be in there as soon as they can. Last week, I seemed to be the only one with patients that was moving so I was hit back to back. I told patients that sorry, I am one person.

Lev, MSN, RN, NP · Jul 29, 2015

One thing at a time. Delegate, delegate, delegate and if you're unsure of something, ask for help.

jarielle22 · Jul 29, 2015

Love the feedback and advice! You guys rock! It is true one thing at a time and I am only one person. Wise. â¤ï¸ðŸ‘

crashcartqueen, BSN, RN · Jul 29, 2015

Same here! I knew from my first clinical in the ER that it was what I wanted! I consider myself VERY fortunate to get to start as a new grad in the specialty I love! It can be nerve-wracking but all you can do is take it one day at a time and learn all you can! Good luck to you.

jarielle22 · Jul 31, 2015

Exactly! Good luck to you!

gemmi999 · Aug 4, 2015

I've been in the ER for two weeks total at this point, and this advice is very helpful. I've learned to write down times that things happen at if I am not near a computer. That way I can back chart with correct times. I've also learned that being honest with the patient is probably the best thing I can do. I'll stop in a patients area and tell them I just got a new patient, so it'll be about 10 minutes before I can do X or Y. They appreciate the update and tend to wait a little more patiently.

Birry · Aug 5, 2015

I started as a new grad in the ED a little over a year ago. The two most important things I would say for you to incorporate into your practice are to ASK QUESTIONS and DELEGATE TASKS.

Ask any question that comes up. Ask the attending, the resident, the grizzly veteran nurse who terrifies you..ask the social worker and the interpreter and the phlebotomist. People know you're new and they should be happy to help. I still ask a million questions. "Forgive my ignorance, but..." "Pardon me, I've never heard of ...".

As for delegation, it is essential. If a co-worker asks what they can do for you, give them something to do. In my department, everyone loves to start IVs. It's a solid bet that if I ask someone to do it, I'll get three volunteers. Don't be afraid to delegate VS and other errands to techs and CNAs. That's part of their job and if you're too busy doing things beyond their scope, ask them to do it. The flip-side to that is to BE PROACTIVE in returning the favor. You'll get a lot more help if you're seen as not just a taker. Got a few free minutes? Offer to help someone else.

I'll toss in a third key item. It may be the most difficult, but it'll really help you progress. And that is to TRUST YOURSELF. Yes, you still look up meds. You still look up policies and procedures. But you know a lot. You can speed things along for patients by keeping in close communication with doctors, and making relevant suggestions. Think a social work consult will be needed? Get on the horn and give SW a heads up. Suspect the doctors may be missing something? Bring it up to them. If your facility has nursing protocols for orders and such, get used to using them.

Congrats on your job! I think ED is a great place to start!

jarielle22 · Aug 5, 2015

I started as a new grad in the ED a little over a year ago. The two most important things I would say for you to incorporate into your practice are to ASK QUESTIONS and DELEGATE TASKS.
Ask any question that comes up. Ask the attending, the resident, the grizzly veteran nurse who terrifies you..ask the social worker and the interpreter and the phlebotomist. People know you're new and they should be happy to help. I still ask a million questions. "Forgive my ignorance, but..." "Pardon me, I've never heard of ...".
As for delegation, it is essential. If a co-worker asks what they can do for you, give them something to do. In my department, everyone loves to start IVs. It's a solid bet that if I ask someone to do it, I'll get three volunteers. Don't be afraid to delegate VS and other errands to techs and CNAs. That's part of their job and if you're too busy doing things beyond their scope, ask them to do it. The flip-side to that is to BE PROACTIVE in returning the favor. You'll get a lot more help if you're seen as not just a taker. Got a few free minutes? Offer to help someone else.
I'll toss in a third key item. It may be the most difficult, but it'll really help you progress. And that is to TRUST YOURSELF. Yes, you still look up meds. You still look up policies and procedures. But you know a lot. You can speed things along for patients by keeping in close communication with doctors, and making relevant suggestions. Think a social work consult will be needed? Get on the horn and give SW a heads up. Suspect the doctors may be missing something? Bring it up to them. If your facility has nursing protocols for orders and such, get used to using them.
Congrats on your job! I think ED is a great place to start!
Thank you for such great advice! It was hard yesterday trying to las he 4 pts all admitted at once, I hope I can find my flow better soon! I am back and forth on days and night shift (I'm supposed to work only nights soon), but it's been pretty hard when it gets too crazy in the ER! Plus I'm having a hard time dealing with a charge nurse who hates new grads on the floor, she has been giving me an earful and she is not kind about it.
I'm hoping through each day I remember to take it step by step and learn to prioritize better each shift. I love the ER and I just want to show everyone I deserve to be there. I will be asking many questions because I always want to confirm and stay free from making major mistakes with any pts

jarielle22 · Aug 5, 2015

I've been in the ER for two weeks total at this point, and this advice is very helpful. I've learned to write down times that things happen at if I am not near a computer. That way I can back chart with correct times. I've also learned that being honest with the patient is probably the best thing I can do. I'll stop in a patients area and tell them I just got a new patient, so it'll be about 10 minutes before I can do X or Y. They appreciate the update and tend to wait a little more patiently.[/quote
Thanks so much for the response! I'm learning to write things down as well I just need to work in writing times down when it gets too crazy.

erlissy · Aug 8, 2015

Don't try to be the big, bad ER RN. If you don't know something, please ask (but use your critical thinking skills first). No one likes an unsafe nurse who tends to "know it all". You are the eyes and ears for the providers, so you must know your stuff. A good preceptor will make sure that you know what you are doing and will give constructive feedback. Don't take the feedback as a failure or anything less. The feedback is your opportunity to learn from what is said or given to you. Best wishes!

jarielle22 · Aug 8, 2015

Thank you. I'm definitely bit that nurse who thinks she knows it all I always ask questions if I truly don't know.