New Grad hired in the ER, question.

[Alexx_xox]

Hey guys,

So I want to bring up a hot topic here that I hear often. As I have stated before, I am a new grad, about to take my NCLEX and I was hired in the ER prior to graduation. I was only one of 2 new grads offered a position in the ER at my local hospital.

I often here MANY seasoned nurses say that new grads should NOT be hired in critical care positions. I feel I have an advantage over other new grads since I have worked as a nurse apprentice in the ER prior to graduating.

I know a lot of students do not feel they belong in med/surg or any "stepping stone" unit, so I am here to ask you guys your opinion. Whether you're a nurse for 2 years or 25, what is YOUR opinion on a new grad starting in the ER?

In case anyone is wondering my opinion, I am a firm believer that some people are meant to go into critical care- BOTTOM LINE. I don't really believe new grads NEED to start on a med/surg floor to gain their experience and time management. I truly believe some just do better than others in critical care right off the bat.

I am a mother to 2 sons, as well as a hairstylist and managed to work full time throughout the entire RN program, so I do not feel like I am lacking in time management.

I know I still have soooo much to learn and I absolutely LOVE being given the opportunity to learn in a critical and fast paced environment.

Let me know what YOU guys think. Im also going to add a poll in case some of you guys do not have the time to write out your answer, but if you do, please take the time to respond because I truly am curious.

Thanks so much,

XO, Alex

[Cat365]

I think it depends on the nurse and on the ER. If the ER has a strong support from experienced nurses. Then it's fine. I started in the ER and so far I haven't killed anyone (that's only half kidding). There have been nights that I wanted to run away and cry. However, my hospital has a good crew. If I didn't have the support I do I would have quit.

[Jory, MSN, APRN, CNM]

I do not agree that new grads should start out in critical care with the one exception being the NICU. This is because there really isn't much experience you get in other areas of the hospital that I feel, really prepares you for working with the unique patient population.

[sallyrnrrt, ADN, RN]

45.5 years ago I was meant for critical care, upon graduation CCU, CV ICU, & I moonlighted a lot in ER.

I think you will do well, since you worked ER in an apprentice role prior to graduation.....

Critical care fine tunes your critical thinking, as things change quickly.

Best Wishes

[Racer15, BSN, RN]

I started as a brand new nurse in the ED. I didn't care for med/surg during clinicals so never applied for any of those positions. It was a pretty rough orientation and I cried a lot. But 5.5 years in, I'm very satisfied with my choice.

[LovingLife123]

I started in ICU, I'm still in the same ICU. I've seems new grads do well, and others fail. I've seen medsurg nurses come in after some experience e and do well and others fail.

It truly depends on your ability to critically think.

[HiddencatBSN, BSN]

I think it depends not only on the new grad ... but also on the particular ED or ICU. Some ED's/ICU's have been hiring new grads regularly for a period of several years and have orientation programs appropriate for new grads AND support systems in place for new grads. Those units are prepared for new grads. Other units don't have those support systems in place -- and may even have unrealistic expectations for any new grads they hire.

Avoid the units that do not have the appropriate supports in place. But if the unit does offer the appropriate support, I see nothing wrong it.

llg (started as new grad in NICU many, many years ago with no experience and no problems)

I agree. It's not a question of whether all new grads need med surg experience or not but whether the new grad has the support available to them. I started in a pediatric ED as a new grad and that has remained my specialty. I had many classmates start in various critical care areas and they didn't seem more or less successful as new nurses than the ones who started in med surg.

The notion of med surg as "nursing basic" is an antiquated one. It is it's own specialty with it's own specialized knowledge and skill set and I think it's a little dismissive to see it as "junior nursing" prior to "real deal critical care nursing." I spent 2 years working on a pediatric med surg floor AFTER a few years of experience as a pediatric ED nurse and I had to relearn prioritization, planning, and time management skills as well as a myriad of things we don't do in the ED.

Is there a chance that you'll start working in a critical care capacity as a new grad and realize it's not a good fit? Sure, but that's true in any unit you could start in.

[Savit0123]

Congratulations on the job!!! Hope it's going well. But I personally think it depends on the orientation,the hospital and the ER staff. If it's a lengthy orientation and the staff is great and helpful then it should be manageable. But if the orientation is less then3 months then maybe it's wise to reconsider and try i to get some experience in med surg first. I got a 3 month orientation in a step down unit and I could honestly say I didn't feel 100 percent confident going in. But the staff was super friendly and helpful whenever I have a question so I managed.