New Grad thinking to start career in the ER

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I'm a 46 yo male, new grad, thinking of starting my career in nursing in a very busy ER. I have no experience accept for clinicle through school and a summer extern program. I ran a very busy business for 20 years so I know what hard work and long days are like. I would like to hear from any past new grads that started right away in the ER and if its the right move. I'm worried that I dont know enough, and do not want to fail in my first assignment.I'm hoping to hear some positive encouragement or not. Any insight will be greatly appreciated.

Thanks,George

I am also an ED nurse and started straight from school into a large hospital seeing 75,000-80,000 per year. I had a great orientation that included class and bedside learning and I had a preceptor for several months. I felt that I didn't know enough either and after 7 years I still feel like there are things I don't know because...well...there are still things I don't know. It is okay. You don't have to know everything to start in the ED. Just be prepared to learn and ask questions as needed. If that is where you want to be then you need to go for it. Best wishes.

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Specializes in Emergency Department.

Hey...

Well for me...I had worked as a tech on a med/surg unit for 3 years...okay well I just started on June 12 in a Level I Trauma Center...and I FREAKIN' LOVE IT!!! We have a "back" side with ER patients and the front with Trauma/Code patients. I am on the back side until I finish my classes and stuff....but it's awesome!!!! You will do fine. Follow your heart. You can do anything you want to.

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Hey...

Well for me...I had worked as a tech on a med/surg unit for 3 years...okay well I just started on June 12 in a Level I Trauma Center...and I FREAKIN' LOVE IT!!! We have a "back" side with ER patients and the front with Trauma/Code patients. I am on the back side until I finish my classes and stuff....but it's awesome!!!! You will do fine. Follow your heart. You can do anything you want to.

Can you tell me what you LOVE about it??? I will be on the ED floor sometime end of this month!

AmyD RN

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Specializes in Emergency Dept, Cardiac Cath Lab.

I started my nursing career in the ER and don't think I would have wanted to start anywhere else. If I'd started on MedSurg I think I would have quit forever. I began in a smaller community hospital and eventually advanced to a busy Level 1 Trauma Center which treats approx 80-90,000 patients/year. The difference is that I worked there previously as a Nursing Asst, and I was also a Volunteer EMT and transported all of my patients there. I knew everybody. It was still very different though. I worked with a lot of old fashioned nurses who believed everyone should have Med Surg experience prior to the ER, but I didn't really care what any of them thought. I did what I wanted, and I did it well. And if I may indulge myself just a little....I turned out to be a better nurse than some of the nurses with prior Med Surg experience.

The bottom line is....you're going to feel like a new grad no matter where you begin your career. Do you think you'd be any less nervous on a Med Surg floor?? Best of luck. You'll do just fine!!:monkeydance:

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Let me place my personal vote of NO! I am doing my last semester/preceptor hours and spent the last month in the ER of a local hospital. I now know exactly what the phrase "cattle in, cattle out" means. Other than perform dozens of IVs and blood draws and plenty of foleys, I learned virtually nothing.

I learned nothing because in the ER, the ONLY thing personnel care about is how quickly you get the pts in-out. Period. It is probably the worst place for a student to be, and by extension the worst place for a new grad to start, based heavily upon the many many posts in this forum.

While the doctors and PAs and other staff were energetic and fun to work with, the bottom line is ALWAYS just triage the pt, quickly chart, quickly admin whatever they need, quickly discharge, then get another and repeat. How much learning comes from that? For a few days I learned time mgmt and quick charting, but since the game is treat and street, it is no place for an inquisitive student. My preceptor considered me free labor to increase her pt turnover rate. When I informed them that I was paying for this experience and my main goal is to learn, not be a fulltime unpaid assistant, they informed the school I was not a "good fit for the ER."

I could not agree more. For what it's worth, I do not think it's a place for a student or a new RN. It's single focused and lightspeed. Nobody has the time or the want to mentor, even if they agree to and get paid extra for it.

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Specializes in ER.

It all depends on you and the facility you choose to work for. You do have to have thick skin but more importantly you have to not be scared to ask questions if you don't know. You can be educated to the ways of a unit but being a new grad in the ER is not necessarily any different than being a new to the ER nurse. The ER is a totally different place to work. The ER I work at has had some recent turn over and we have 2 "new grads" that we trained and they are fantastic and fit in great, we also just had to "relocate" a tele nurse that came to us with a year experience because she just couldn't keep up and more importantly, she wasn't improving after months of training.

So I guess if you are interested you just need to know, it takes a while to adjust ( 3 months or so) and if that ER isn't working out, you may want to try another ER. Administrative support is really important. Don't let them throw you out there with out having a good training program. Good Luck!!

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Specializes in Medical-Surgical, Education, Community Health.

Currently, I am an LVN and have been for two years. I started out in Medical/Surgical and then worked at a Long-term Acute Hospital. I got a lot of experience at both, and currently, being that I'm in RN school, I took a position at a rehab facility.

So, would I be considered a "new grad' if I chose an ER internship? Do you think my experience as an LVN in Med/Surg, etc. would really work in my favor?

Thanks!

Dave

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As many said- it depends.

The fact that they want to hire yuo means yuo are ready.

Abigger question is whether they are ready for a new grad. Best bet is to talk somebody who went through orientation as a new grad.

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Specializes in ED, Forensic, Long-term care.
kf15 said:
Let me place my personal vote of NO! I am doing my last semester/preceptor hours and spent the last month in the ER of a local hospital. I now know exactly what the phrase "cattle in, cattle out" means. Other than perform dozens of IVs and blood draws and plenty of foleys, I learned virtually nothing.

I learned nothing because in the ER, the ONLY thing personnel care about is how quickly you get the pts in-out. Period. It is probably the worst place for a student to be, and by extension the worst place for a new grad to start, based heavily upon the many many posts in this forum.

While the doctors and PAs and other staff were energetic and fun to work with, the bottom line is ALWAYS just triage the pt, quickly chart, quickly admin whatever they need, quickly discharge, then get another and repeat. How much learning comes from that? For a few days I learned time mgmt and quick charting, but since the game is treat and street, it is no place for an inquisitive student. My preceptor considered me free labor to increase her pt turnover rate. When I informed them that I was paying for this experience and my main goal is to learn, not be a fulltime unpaid assistant, they informed the school I was not a "good fit for the ER."

I could not agree more. For what it's worth, I do not think it's a place for a student or a new RN. It's single focused and lightspeed. Nobody has the time or the want to mentor, even if they agree to and get paid extra for it.

"Wow" was my reaction to this one. The ER I work in, and the others I have worked in, people care about their patients. They are also aware that often, the most important thing to a patient, pain management aside, is how long they have to wait. It's about customer satisfaction. I've only been a nurse for six years, and about four of those have been in the ED. I learn something new just about every shift I work. If I don't understand something, I ask - the docs and PAs are always willing to show and expain what I don't know. We have people who "shadow" all the time, and we talk to them about reality vs TV image. We also answer their questions and teach as we are able.

Attitude is everything, and the attitude of being willing to do whatever needs doing is important in any area of nursing. That's what "teamwork" is about. I also did an internship/preceptor as a student, as well as hundreds of hours of unpaid clinical time. I remember how it felt to want to be in the role of nurse, but yet be in the role of a "fulltime unpaid assistant." I also felt frustrated because I wanted to know and be on the same level as the nurses. As an ED RN, I still do all those things I did as a "fulltime unpaid assistant," but am now responsible for so much more. As to it being a place for a new grad - that depends on the individual and also the place. I spent time in two other EDs before I found one where I felt "at home." Are we fast? Sure we are. In this day and age, we have to be. But we also learn, all of us, all the time. For this writer - the ED was clearly not the place to be, at least for now. For others, it is the right place to be. As with all posts, readers should be cautious about adopting one person's experiences and making assumptions based on someone else's experiences.

The attitude of being willing to do whatever needs doing, not being afraid to ask questions, and never doing something you are unsure about are all key ingredients to being successful in the ED.

As for me, I am studying for my CEN (at home on my off time) and am amazed at what all I am learning. And that's after completing my MSN where I did indeed complete hundreds more of unpaid clinical hours. That's simply the way it is.

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I have a decision to make, OR or ER. This will be my first RN experience and I'm having a hard time which one to pick. There are great posts in this thread and thank yall for that. Please help, I need some words of wisdom.

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Specializes in ED.

kf15

so sorry to hear about your experience in the ED! that is not my experience, either, and I hope that is true for others on here. I am a new grad started in the ED and also love it. every day I learn something. every day I see a disease or procedure that I haven't seen before. and throughout my preceptorship it was drilled into me that if I don't understand what I'm doing, why I'm giving a med, what my differential diagnosis are, where the MD might be going, and the entire thought process behind it all then I had no business in the ED.

while in school one of my classmates, who had been a medic, said she would never work in the ED because all you did was stabilize a patient long enough to get them somewhere else, stick an IV/foley in them, and ship them out. I have found this to be the opposite. I have found that in the ED I need to know more about everything than people on other floors do, I use a wider range of medications, I see a wider range of people, and I love love love love it. if I love a patient I'm sad because they'll be gone soon, if I hate a patient I'll be happy for the same reason. I love people coming in and spending some time thinking about where they might go, what might be wrong, what we might do. the only thing I don't like about the ED is the fact that I rarely see how my patients do long term

good luck to OP! you will love it! and if you don't there are so many other things to do, you will find your niche!

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Totally depends on the nature of the ER hiring you, will they in fact orient you and help you get up to speed in a fast paced work area, or will they toss you onto the floor like most places, and expect you to be productive on day 1?

I was into that area until I did a lot of research, then did my internship in an ER, and for me it amounted to doing 20 IV's per day and performing endless rapid-fire assmts of ppl who were anything but "emergencies". Lots of sniffles and idiotic self-diagnoses, and drunks and old pple who fell.

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