New grad in the ER?

LORIsts · Oct 25, 1998

DEPENDS UPON SEVERAL FACTORS. HOW OLD YOU ARE,WHAT ARE YOUR LIFE EXPERIENCES,WHAT IS YOUR PERSONALITY TYPE,HOW ARE YOUR CRTICAL THINKING SKILLS AND PROBLEM SOLVING SKILLS. I AM A NRSE MANAGER FOR A LARGE LEVEL 1 TRAUMA CENTER AND HAVE WORKED W/ GN'S FOR SEVERAL YRS. SOME MAKE IT,SOME DON'T BASED ON THE ABOVE MENTIONED FACTORS.

MJ · Oct 27, 1998

Altough you have been working part time for1.5 years, you really need at least 6mos-1yr of fulltime critical care to feel even slightly comfortable in the ER. Also need ACLS, PALS, TNCC, ATLS before things in ER really begin to become "familiar." I use that term loosely because everyday in the ER you are constantly learning something new. Critical care will give you a strong foundation to help you anticipate your pt's needs at lightening speed. It gets you familiar with the lines, monitors and drips so that when you come to ER you have some life experiences to draw upon. I have been in the ER for 3years now and prior to that I had 6 years of critical care under my belt. I have to be honest though when I entered ER there was a lot to be learned- I had never stabilized a cspine or even applied an ace wrap. All my patients came from other units-OR, ER, the general floor. They already had ace wraps, bandages, ccollars. I just had to stabilize them hemodynamically and start a few IVs here and there. Of course doing this at 2am without a doctor being there to drop a central line in or place an ETT for you is a challenge in itself along with getting an order for vasopressors and blood. So you see my point about life experiences?! I am thankful that the ER I work in has ERcertified docs that trust us enough that we have a certain autonomy, yet when we yell that we need help, they are there and don't leave until they are sure you can manage.

Johnny · Oct 30, 1998

I graduated in 96 with a BSN and went straight into the ER. But, this was not done without me having some experience. I worked for a local ambulance service for 1 1-2 yrs as an EMT. I also worked as a tech in a CCU for 1 yr and and in the ER as a tech for 1 yr. With in six months of me being hired I was TNCC and ACLS cert. I felt confident in myself and so did the person who hired me. The last two things I spoke of are a must. Don't be scared-you will learn what you don't know, and that person who hired you will be there when you need help. For the most part if you are hired in an ER it was because the person who interviewed you say something she/he liked. Trust yourself and be willing to learn and ask for help.

Suz · Oct 31, 1998

Go for it! Help yourself along by having a telemetry course and ACLS. A triage class wouldn't be bad either. Certificates say alot. I had only 6 mo on a telemetry/critical care unit as a new grad before being hired into the emergency department. Try getting hired on at the place where you did clinical time. They already know you there. Talk to the boss, be honest about your qualities and fears. Hike up your scrubs and dive in. There's no more interesting, educational, exciting or fun to work place than the E.R.

Valerie210 · Jul 1, 1999

There are many sources available to help find comfort as a nurse in the ED. ENA offers some courses

NYMfan · Aug 2, 1999

Tanman, I too am a senior nursing student planning on an ER career straight from school. Well, hoping I'll get hired is more like it. I've been an EMT for almost 8 years, I work as a tech (read: phlebotomy and EKG experience) in an ER now and will have logged over a year at that by graduation. I'll be certified in ACLS and PALS by then too. And still i've heard people say I should do a year of Med-surg. I'm hoping I'll be able to find an ER job right away. I know a few of my equally as qualified friends that were able to. I'll be keeping my fingers crossed for both of us.

[This message has been edited by NYMfan (edited August 02, 1999).]

CHUBBY · Aug 2, 1999

To NYMfan, Tanman, I think the concern for having "a year of med-surg" doesn't come from people because they don't think you can function in an ER- you can and will- but you'll be depriving yourself of an important career link. I did 2 years of medical/cardiac before getting into Emergency Nursing. It was the best thing I did. I learned SO much, and within a time frame that didn't demand instant decision. Even if it's six months, it's better than nothing and if its in a teaching/university affiliated hospital...even better. By the end of your orientation, you'll know more than the first years...

pdrn2go · Aug 4, 1999

In ref to ER and prev experience. I started in an ER student nurse program in a Level I Trauma Ctr and continued from there. I, also had 6yrs of ambulance experience, prior to this program. As a student, I took ACLS/waited to test when a GRAD RN and had my cert. Then within 6months of Graduate RN, obtained TNCC cert. ENA membership/CPR Instructor/and taught EMT classes.

It's what you want!! And how much you are willing to risk and challenge too

GOOD LUCK

PDRN2go

[This message has been edited by pdrn2go (edited August 03, 1999).]

CEN35 · Aug 24, 1999

Tanman, I must say that all the other responses have their share of accuracies, and things I heard at one time. However, only you know yourself, and can honestly say whether you think you can pick it up?

Personally, I took an EMT class and did some clinical time in an ED. Then went to school for my RN. Like you I finished with clinical time in a Level II Trauma center ED. They liked what they saw, I liked what I saw, and wrote numerous letters to the organization. Three months later I was working in the ED. After 1 1/2 years, I had my BLS, ACLS, PALS, TNCC, MICN, and CEN. I have now been here three years, and never had a problem. I also know that as far as our docs are concerned, I'm one of their top choices in certain situations. The bottom line is can you do it? Only you know? Everybody is different, and thinks differently. I don't regret going about it any other way.

CEN

[This message has been edited by CEN35 (edited August 24, 1999).]

MollyJ · Aug 25, 1999

I had a friend that came to the ED as a new grad and I am sure she would say the same as the respondents that went there and thought it was "the right thing" for them. Downside: If you work the ED long enough you will see some new grads that just get eaten alive and it "scars them for life" I would guess and fear. No one should have to feel that they were incompetent and couldn't cut it, just because they got thrown into the deep end too soon. ED can be a pretty unforgiving spot to practice especially if the ED team does not have enough depth and the new grad has to pull weight really fast. While working in the ED can be a superlative experience, going to work in the ED is "never an emergency." (Pun ;-)) You have a whole career to get some varied background that will always be valuable to you and I am pretty sure that the ED will still be there when you are ready. Your previous experience may come in handy when you've decided that your adrenaline rush days are over and you are ready to move on. (Not everyone stays in the ED "forever".)

There probably is no one right answer to the question and I am convinced that resume building can surely be done in more than one way. I would rather spend 1-2 years on a med-surg unit and have a great reference than come out of the ED feeling like an incompetent (with a not-so-hot reference) because I got eaten alive by the circumstances.

Good luck in your decision.

missouriman · Sep 9, 1999

eaten alive.. yep.. that happened to me

felt like i could not do anything. just about quit. i have been a nurse for less then a year. I am in the intensive care unit now. and getting my confidence back. you will notice that most of these folks have had an emt background. i had a kid that seemed to be having a reaction in one room, a person that was going into DIC in anouther, a phyc pt that started tearing the hell out of everything and everyone. about that time a guy came rolling through the door with guts hanging out... i was over whelmed to the point that i could not think. i have told this story to other nurses and have been told even with thier experience they would have been overwhelmed... i got my butt chewed for not knowing that the phyc was going to go off. for not knowing that the kid had a food allergy, covered drugs ect but didn't ask about any new foods. the DIC was a jane doe, i could not draw any blood to send off, it clotted before i could get it into the tube.

got hit real hard by the phyc pt, so i was hurt too.. real bad night.. one of my first nights, i quit with appologies. i am working in the same hospital and am learning alot in the ICU. now after just 6 months i can see so many things that i would have, should have done differently. ER is right now.. and right now.. here and over here.. and then something else stumbles in the door.. what are you going to do...huh... now.. right now..

at least that is how i felt, and with out experience, i did not know.... hope this helps you out..

just what happened to me.