Specialties Emergency
Published Aug 15, 2007
kimber3ks, ASN, BSN, RN, EMT-B
71 Posts
I hope this doesn't offend any of the seasoned vets out there, as I hold all the respect in the world for you all, but here I am a new 'adult' RN preparing to start my orientation to the ER.
I would love to hear some positive feedback on how and why starting in the ER is a good thing. I am a high energy, task-oriented person by nature. I am hoping that the way I can manage my house, 3 kids, at home business, and every other curve ball that comes my way, I can manage my newfound path in the ER.
Ever the realist, and a wee bit of a perfectionist at times, I am fully anticipating a certain level of frustration on my part, with being in the green. I want to see and learn and am praying I get an open and willing preceptor.
I would appreciate any tidbits of wisdom to help me through what should prove just a continuation of the past few years!
K
ICRN2008, BSN, RN
897 Posts
I am a floor nurse, but my only advice (as a fellow perfectionist) is to go easy on yourself in the first couple of months. Put forth your best effort but allow for the fact that you will likely make a few mistakes. Always ask questions and use your resources, even if it slows you down a little bit. Most of all hang in there, because although it is difficult at first, it will get easier :) Good luck!
longjourneydream
145 Posts
I am a new grad in the ER.
I made a mistake yesterday. I was unable to give two meds that I did not see in the orders, I had to tell the Dr. this.
He was understanding and was ready to lecture me, and I told him this will be great lesson to me to always check orders before the patient discharges. He looked at me and knew it was hard to admit my mistake, but I took ownership of the mistake and documented my error.
I will not forget this and will always check my orders before I close a chart out.
Fortunately the patient has to followup with PCP and has RX's that will be filled and taken @ home, the doses that were missed were initial doses.
I am learning a lot of trial and error, so far nothing life threatening...
RNcDreams
202 Posts
I'm a new grad in the ED as well, and like most other new grads, (ED or otherwise), I'm constantly double checking and asking questions and feeling nervous.
I can offer the following advice:
-Look up every single med you give before you give it, even if it means people are grumbling at you. Protect that license.
-Consider a palm pilot with programs for Drugs, ED info, etc-- I have one and I'm warming up to it quite a bit. You can look up patient teaching for meds, right from your pocket when the pt is on their way out the door!
-Check out the thread of a question I posted about documentation--there's some GREAT info on there from the experienced folks, because charting is very, very different in the ED than it is on a floor.
-It's your responsibility to follow up on info you're unsure of-- understand lab values, normal VS, and basic EKG's.. but don't panic if you can't remember all of it, just know where to look and you'll be fine :)
-I keep sticky notes in my pocket at all times-- jot down VS, assessments, meds you gave, etc with times so you can go back to the chart and document correctly
-Ask questions whenever time allows, and be a self-directed learner ( meaning, know what you are weak in and seek out the guidance and knowledge to get better)
Overall, keep your head up, be safe, use common sense, and ENJOY IT!
Don't let other people's attitudes hold you down. Develop into the nurse you are meant to be
:)
sumas8
17 Posts
Welcome to the wonderful world of Emergency Medicine! You sound like you have good life experience and a good attitude that should serve you well. I hope where you are working has a good internship/preceptorship for new grads. Starting in the ED is monumentally difficult as it encompasses all age groups and all illnesses/medical-surgical specialty areas.
Don't be too hard on your self- you can never know everything in Emergency Medicine, every day is a learning experience no matter how many years you work here. Give your self 6 months or longer to really assess yourself, you'll be amazed at much you know and can handle.
And as the other posts say, check and double check yourself, ask questions, look things up after your shift. PDA's are great for some, but where I work as we have internet access everywhere, we have approved pharmacy sites for references, and Google for every other usual and unusual syndrome, disease, etc.
Find some good mentors and role models. KEY POINT= When you feel like you are drowning in your assignment, call your charge nurse or let someone know. Sometimes just talking to someone about the 6 or 7 things people are all telling you need to be done NOW will help you prioritize them, or someone pitching in and doing 1 or 2 of them for you
can help you get back on track. As a night charge nurse, I often can help or find someone who can and would rather do that than find out after the fact that a pediatric septic work up waited 2 hours because you were too busy but didn't tell anyone. Remember, PATIENTS FIRST
helps to whittle down what is really the most important thing to do next.
I hope where you work has good support for new staff, it is so all important. Enjoy the humor/entertainment factor in the ED, it helps you get through your shift (see 'stupidest reasons to go to the ER' thread on this site). You can't make up the stuff you see here.
Best of luck= you sound you will be a great asset to nursing and
the ER where you work. A year from now you will be very proud of
yourself!:welcome:
To "Sumas" et al....
Thanks so much for the "cheering" me on from the sidelines. It is EXACTLY what I needed right now.
I am a lady in waiting right now, lol, awaiting that ever important "official" RN license # !!!! Need this before I can start, ya know
Then off to orientation. I will keep you all posted on my progress, frustrations and triumphs. I am so glad to have this site for info as well as camaraderie!!! I think I have learned already that we all need to stick together rather than butt head with each other !
Toquay
128 Posts
Years ago when I first started in the ER I used a little EMS Pocket Guide. They provide quick and easy reference for Cardiac, Neuro, Respiratory (gases etc), ACLS, emergent med guidlines and fits nicely in your pocket. When I would have quiet moments, I would review it. Remember to be true to yourself, admit when you don't know something and never ever be afraid to ask. Know your limitations and when things get hairy ask for help or a brief timeout to regroup. Be a team player, we nurses are all in this together and together we can get through anything.
Toq