I would like to hear what you think of new grads starting out in the Emergency Department. I just finished an Accelerated BSN program. Some of my classmates are starting in the ER.
My clinical instructor and my preceptor killed my chances by giving weak references and using the "everyone needs to start in Med/Surg". But I loved my clinical preceptorship in the ER and another (more experienced than my preceptor) nurse even said I should apply to work in the ED.
I am a 46-yo, ex-accountant, no medical background, but I did have straight-A's in our program.
I have to work tonight, but I thought I'd add something.
Mexico has for a long time been the training ground for American medical students, particularly at University of Guadalahara. Its a great medical school and has many grants from U.S. companies.
Graduate students from there pass their boards and practice here as do many Mexican physicians. It has a long association with the Pan American Health Association and much research comes out of it concerning tropical diseases.
There are other countries that supply us with physicians, particularly India.
Most physicians specializing in plastic and reconstructive surgery study in Rio Dejaniero, Brazil. Ask any plastic surgeon where he studied and he or she will certainly mention Rio. Patients come from all over the world to have their work done there.
Nurses from India already have degress and then study at the National Health Services schools. All speak English and most also speak their native Hindi, Urdu, some also Arabic or Farsi. they are exceptionally well-educated.
Russian doctors, on the other hand, do not do so well here. Because their training is much different than ours, they must receive extra study or, like a few I know, end up being CNAs (What a waste. I know a pediatrician who works as a CNA in Framiningham. she says: "They say I don't know enough".)
Irish, English, Scottish and German Nurses know a great deal, but it seems Canada wants them more than we do. they all have national health care and I can only guess that is the reason.
The fact is that health care is "internationalizing" and the companies over here know it. They are taking advantage.
They offer these nurses, all single and female, portage over here, set them up in living quarters, arrange for their transporation, train them to pass the exams and make them sign very long term contracts. In many cases it is near indentured servitude. The company holds the means to the "Green Card". (don't do right? Back to old country).
I cannot begin to tell you how many Irish nurses practice in places like South Boston. Great nurses, by the way.
the large hospital conglomerates have their international ties and are recruiting like mad, especially in long term and rehabilitation care.
There is a clause in the Immigration Act that says that if a person is enough of note or has a skill that is sufficiently needed, he or she can immigrate immediately with no waiting. Nursing is one of those. and don't think the big boys don't know about it.
Next, we'll be converting to Euros. (the Euro is now worth $1.25)
I've been in the medical field, in one area or another, for the past 10-plus years (funny, I don't feel that old). I cut my teeth in a LTC as a CNA, worked my way up to Med Tech, eventually ending up charging an ambulatory Alzheimers unit as a Charge CMT. I left that job, taking a HUGE paycut, to go work as an aid in a hospital. Why? Well, I still wasn't absolutely certain I wanted to be a nurse, and I wanted to see what else was out there before I made my decision. I tend to stagnate pretty easily. If there is nothing else to learn or grow from, then I look for new opportunities.
That being said, I have worked med-surg (mainly orthopedics) for the past 7 years as an aid while taking classes here and there toward a degree. This May, I will graduate with that nursing degree. AND (imagine this), I want to work in the ER. Fortunately, my hospital does hire a small number of GN's each semester. I've given a lot of thought to this, and have talked with a good number of seasoned nurses, asking for their input on the matter. Having worked with me for many years, all of them have agreed that ER would be a good fit for me. My nurse manager told me that if she felt I couldn't hack it, she would not be submitting a recommedation for the ER. All my instructors have supported my choice to go into Emergency Nursing.
After alittle over 7 years, I have no interest in working in Med-Surg. It's just not my bag, baby! Neither is Tele, Onc, Psych, Peds or L&D. I'm not declaring that I now know everything and I am ready to move on to the shark-infested waters of the ER. I finally got to do an ER rotation this last semester, and I loved, LOVED it. It felt natural, and it felt like it was the place I needed to be. I know it's not glamorous, and I am prepared to run myself ragged. It's simply a good fit for me. When you know, you know.
I don't take offense at those who think I can't find my butt with two hands simply because I am a GN (or at least will be). In my lowly aid station, I have managed to save the backsides of many a nurse because I (being the know-nothing nursing student I am) somehow caught things that went unnoticed. Everyone is fallable...no matter what their experience may be. I'm not afraid of whatever I don't know, but I am also not afraid to roll my sleeves up and learn it. I'm a fast learner, and I'm pretty good at that whole "critical thinking" thing. :)
I am grateful to work in a facility that encourages learning, and welcomes new grads with open arms. I've asked about new RN orientation, and we have a really good GN program. I would never accept a position that did not offer me adequate training.
This has been a really interesting thread to read, but has not dissuaded me from going into the area of practice that I have decided on. I agree, ER may not be for everyone...but neither is Med-Surg or Psych. Don't discredit someone just because they haven't been in the trenches as long as you. I think everyone brings something to the table. I am the wiser as to some of the discrimmination I may face after I graduate, but you always hear about "those people" anyway.
So, I guess what I am saying is that I don't give a flying horses orifice as to what someone thinks about GN's in the ER. If the ER nurse manager is more than willing to hire me, who is anyone else to say otherwise?
A few years ago the World Health Organization rated the best ER teams in the world. The winner, get this, was the Havana General ER. I saw them in action on a video about ER operations.
They do more with what they have than any group I've ever seen.
And they are outstanding in Pedi trauma.
Che Guevara, a physician himself, had said that, children, not the the troops or anyone else, should come first when it came to medical care. (Great doctor. Great speaker. Great charismatic. Lousy administrator and a rank stupido in guerilla warfare. It took his buddy, a lawyer named Fidel Castro, to do the real stuff.)
You know, we could sure use some of those Cuban ER people around here.
Anyone questioning my politics should know that I am a registered Republican who votes, for the most part, Independently.
For anyone who likes revolutionary figures, I recommend the Canadian movie starring Donald Sutherland, "Dr. Bethune" (He was a physician to the whores and indigent workers of Detroit, surgeon in the Long March of the Chinese Revolution and died there because no one would sell him any antibiotics; He died of gangrene from a surgical cut on his forefinger.)
Another doctor, Armand Hammer, the American industrialist, helped save the new Soviet Union from mass starvation by sending millions of bushels of wheat, oats and barley, and was a friend of Vladimir "Lenin" Ullyanov. His father was a communist and Armand maintained an apartment in Moscow to the day he died.
Sister Elizabeth Kinney, an Australian nurse, was the founder of what we know today as Physical Therapy. Had not President Franklin Roosevelt had her therapies he would have, for the rest of his life, been bed ridden with the ravages of polio. A movie was made about her and how the medical establishment thought she was a kook.
I'm 28 years old and my life-long ambition had been to be an RN (not MD) in the ER. I'm putting myself through nursing school after having worked 10 years in another profession. To pay for school, I agreed to a "nurse loan" program with a local hospital. During the interview process with the hospital, I was very clear about my goal to graduate and start in the ER. The nurse interviewing me was an ER nurse and supported my goals and approved me for the loan. She even went so far as to guarantee (although, not in writing) that I would get an ER position. This loan carried a two and a half year employment committment to that hospital. Now that I'm nearing graduation (in May), the hospital is telling me that under no circumstances will I get a job in their ER because they feel I should start med/surg first. Of course, the nurse that interviewed me is no longer with the hospital. I am considering other options to buy myself out of the loan because I refuse to be relegated to two years of med/surg just because that happens to be the person's opinon that is in charge at the moment. I have nothing against med/surg nursing it is just not my area of interst. My next goal is to attend the ER Nurse Practitioner program at a local university. They require at least one year of level-I trauma experience. Having to work two years in med/surg will delay my entrance.
I have recently accepted a position with another hospital as an extern in their ER. They are very supportive of me joining them as a new grad. Of the nurses that I've worked with thus far (7 total), all of them went directly from nursing school to the ER. I'm even running into resistance from a clinical professor that happens to work at this hospital. She doesn't even think I should be allowed to work as a tech in the ER.... sheesh!
Do what you want to do! It's your life. You've struggled finacially, physically & emontionally to get through nursing school - it's not anyone else's call to make.
if the hospital you signed a contract w/ was made aware of your desire for ER only, and now they are backstepping....then as far as i am concerned it was false misrepresentation on their part...of course they want you on m/s - they are hurting for nurses....i wouldn't talk to them about "buying" back your contract - i would very strongly push the fact that you were NEVER told you would HAVE to do m/s and that you were VERY SPECIFIC in that you only wanted ed.....DO NOT BACK DOWN.....they are wrong on this not you!!
Play it safe. All you want to do is graduate. this professor could hurt you and I think he or she is being very uncollegial about the whole thing. Best to keep your mouth shut, your eyes down, do what she says, be nice and make it through. She (he) may, however, feel so strongly about you becoming a well-rounded RN that she or he is insulted that you are externing at another ER.
(either way, she or he is there to prepare you for the exam and the life of a RN, not to ruin your dreams).
Some instructors think you will need their recommendations and references. You don't. I've never used one of them and most nurses don't either. (But, back in my day, rebels were everywhere and I was just one of them. Peace, Love, Spare change.)
Most hospitals, if they know their school contractees don't want to stay and the RN says she just cannot do Med/Surg, will make other offers. Admins have MBAs and MHAs and don't know squat about Nursing. And don't care about anything but their corporate careers. And the bottom line.
The hospital where you are externing, if they want you that badly and you get along that well, they may be willing to help you out.
It seems they need you worse than your contracting hospital.
You know how I feel. I still think you need some Med/Surg experience. You could do it for awhile and then go to your manager and say you cannot stand the type of work. You do this after a year on the floor. Its usually minimum requirement for entry into a specialty. She (He) may go to bat for you to ER. (No manager in his or her right mind wants a nurse on the unit who is unhappy there and doesn't under any circumstances want to be there anymore.)
You can always just stand pat. The hospital doesn't own your license; You do. It can't even threaten to take it. I can, though, sue, which is a civil issue, not having anything to do with the BORN.
If your contract was not a school loan, look into bankruptcy, though your financial reputation will be totally ruined and you have to pay 15% of your outstanding dbts before you can even file.
If you have money for a lawyer, get some legal advice. I hear contracts are renegotiated all the time.
In the meantime, please get your Prof. CPR, ACLS and PALS. Most ACLS instructors are ER nurses. You may not need PALS or ACLS on a Med/Surg floor, but it will help. You will need them in ER.
Sometimes hospitals will make threats. "We will not give you a recommendation". (so what) "You'll never work in the town again." (untrue) "You are dishonest." (not so it you let them know how you feel. Besides, they might try to find a way to fire you after you've been hired.)
Do remember though, you have made a contract. If they will abide your needs, you should do all you can to honor it. You must be totally honest and forthcoming.
Your goal right now is to get that ticket. That, to me, should be your only present goal.
Please look at your contract. If it mentions your preference and its commitment to that, in writing, they must abide by it.
However, most of these contracts seem to have a bit that says, "wherever needed" or some such.
One thing you might be able to do is contact that administrator who presented the contract and have her sign an affidavit saying she promised you your ER. (whether she had the power to promise it or not, she had the power to present the contract and agreed to your terms. I think this is called a "tacit" agreement. Unless you can prove it, I think you would have a tough time. If she did not have the power to negotiate it and you signed it, it may prove misrepresentation and therefore could indeed void the contract altogether. And, since she doesn't work for them anymore, she might just delight in helping you with such a legal statement. Please see a lawyer or check with the local Legal Aid Society.
I work in ER and see many new grads...floundering...I don't care what your GPA is or how well your clinical evaluations were on the floor. In ER you have to be multitasked, organized, efficient and competent. (The same with the floor BUT usually not STAT with situations). The best advice I had ever received was get floor experience first, fine tone your skills then get into your specialty of preference.
For example, last p.m. I was working with a new grad...who was so fixated on dept. restocking...PRIORITY was 8 admitted pts. to our ER with no beds. ?&*%^$ Needless to say...I was quick to get her attention on the tasks at hand. Also, we had a 3rd year student mentoring with her preceptor who was very thorough and the NEW grad said "I am so glad I am not a student anymore." "I've never felt insecure in anyway, not even now." OMG red flag if I have to work with her again.
I would like to hear what you think of new grads starting out in the Emergency Department. I just finished an 
cadeusus2004
44 Posts
I have to work tonight, but I thought I'd add something.
Mexico has for a long time been the training ground for American medical students, particularly at University of Guadalahara. Its a great medical school and has many grants from U.S. companies.
Graduate students from there pass their boards and practice here as do many Mexican physicians. It has a long association with the Pan American Health Association and much research comes out of it concerning tropical diseases.
There are other countries that supply us with physicians, particularly India.
Most physicians specializing in plastic and reconstructive surgery study in Rio Dejaniero, Brazil. Ask any plastic surgeon where he studied and he or she will certainly mention Rio. Patients come from all over the world to have their work done there.
Nurses from India already have degress and then study at the National Health Services schools. All speak English and most also speak their native Hindi, Urdu, some also Arabic or Farsi. they are exceptionally well-educated.
Russian doctors, on the other hand, do not do so well here. Because their training is much different than ours, they must receive extra study or, like a few I know, end up being CNAs (What a waste. I know a pediatrician who works as a CNA in Framiningham. she says: "They say I don't know enough".)
Irish, English, Scottish and German Nurses know a great deal, but it seems Canada wants them more than we do. they all have national health care and I can only guess that is the reason.
The fact is that health care is "internationalizing" and the companies over here know it. They are taking advantage.
They offer these nurses, all single and female, portage over here, set them up in living quarters, arrange for their transporation, train them to pass the exams and make them sign very long term contracts. In many cases it is near indentured servitude. The company holds the means to the "Green Card". (don't do right? Back to old country).
I cannot begin to tell you how many Irish nurses practice in places like South Boston. Great nurses, by the way.
the large hospital conglomerates have their international ties and are recruiting like mad, especially in long term and rehabilitation care.
There is a clause in the Immigration Act that says that if a person is enough of note or has a skill that is sufficiently needed, he or she can immigrate immediately with no waiting. Nursing is one of those. and don't think the big boys don't know about it.
Next, we'll be converting to Euros. (the Euro is now worth $1.25)
What will we do?