New grad in the ER with a twist....

[rideslikethewind]

I'm going to graduate in Dec. with an ADN. I have been working in the ER as a tech for 6 years and on an ambulance service as an Advanced EMT for 10 years. My career goal: Life Flight and ER nursing. I've been doing a preceptorship on a tele floor and realize I have so much to still learn about nursing but I don't want to work on the floor. With all these variables what do you say? Should I go for the ER or start on tele or ICU even?

[JBudd, MSN]

Wow, I really appreciate the support. I've had many nurses tell me I have to start in Med/Surg to be a good nurse and going straight to ER isn't a good idea. I've got an interview for one ER and have my fingers crossed on another one so far....

I've been of the school of thought that learning time management is better done on the floors because there is less (or at least different) stress on you than in the ER. It isn't quite so immediately life or death. I worked M/S for a lot of years before moving to the ER.

But, that said, I've worked with and precepted new grads in the ER; it is completely an individual thing. If you can do the time management multiple tasking thing, and are ready to learn to deal with multiple patients at the same time (my formerly EMS grads have never had to deal with 5 or 6 at once except in disaster scenes, they are used to being able to focus on one or two at a time); I'd say go for it!

[ed_rn1234]

I started as a new grad in the ED. I was worried about not knowing enough, but I didn't want to work on the floor. I had 4+ years hospital experience as a floating position, so I had worked with a variety of patients. In school I precepted in the ED and got some experience that way, but my orientation lasted 6 months, with the understanding that if I wasn't ready, I would move up to the floor for experience for a while. It worked out fine. If its what you want to do, you should go for it.

[Lunah, MSN, RN]

I'm a new grad RN in the same ED where I worked as a tech for almost 4 years. I've also been a paramedic for almost 6 years. It IS different, switching from medic-brain to nurse-brain, but once you get in there and get into your groove, it'll click. I've always been a multi-tasker, so that works well for me. The nurses I work with are very nurturing with new grads -- it's a wonderful environment, so I didn't hesitate to stay there.

I'm also going to ride the orientation train for as long as I can -- it'll probably end up being December before I'm on my own, so it'll be about 5 months of orientation. I start going to our hospital's ER nursing fellowship next month, and there was no point in putting me on the schedule, then having to cover my shifts because I'll be at fellowship half the time. (I hear Lord of the Rings music every darn time I say/write "fellowship." LOL) I got my probationary evaluation on Saturday, and it was all great! :) Whew.

I went from tech to RN, and unfortunately there wasn't a tech to replace me -- and I was on the same shifts! Ugh. It was then that I truly appreciated a good tech. So thank you, techs everywhere, for everything you do. Yikes.