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 literally got bored w/ my orientation a week in. I had gastriclavaged over 50 patients, ON MY OWN, as an ER tech (we were frequently short nurses, and they trusted me, and were willing to sign off on the chart)
This is illegal, and as far as the nurses who "signed off" on your charts with you, an unlicensed tech performing gastric lavage or any nursing task for that matter, is preposterous, and stupid. Apparantly they do not value their licenses....
>>I had done everything but pass/hang meds as an ER tech...
including:
I triaged
I lavaged
I NG'd
I defibbed
I started IVs
I splinted
I taught splinting
Helped w/ pelvics
Set up IV pumps
Spiked IV fluids
I actually took an assignement one night as we were 2 nurses down, but did not pass meds
so you are telling me that, as an ER tech, you did all of the above, including take assignment and perform direct patient care??? I seriously doubt it, and unless Arizona has laws that are way more lenient than California, Colorado, Kansas and PA. (states where I have practiced) then, it is highly unlikely that you performed these tasks too. If you were a paramedic practicing in the ED, I can see you performing some these tasks, as long as RN's would sign you off. But not as an average ER tech. If you can do all of this, why be an RN????
>>You seem quite arrogant yourself.
Your attitude is all too common. You think You're at, or near the top of the nursing food chain, quite willing to eat his young, as is all too common in nursing nationwide...I'll wager you are rude and bossy to the ER techs, unit secretaries, and registration staff, and likely don't even speak to the housekeeping staff (other than to order them around)
After the above comment, you are calling ME arrogant?? HAHAHAHAHA... Since you dont even know me, you have no grounds upon which to base this judgement.... Its people like you who make the nursing food chain all too willing to eat its young.
>>I encountered a couple of ER nurses like you on my way to and after graduation...
I was a part of the "dedicated triage team" AS A TECH...
I was the "official RN/LPN trainer/orienter" of new staff 6 months after graduation...
I did all of the QCs and yearly staff training for the accu check machines...
had ACLS and PALS pre graduation...I defibrillated DAILY as an ACLS trained ER TECH
As I said above, if your hospital allows non-licensed personnel (providing you are not a paramedic ) defibrillate patients DAILY, then someone needs to report them to JCAHO.
>>How dare you brush me off as working at some 5 bed ER where everyone is in charge, just because I was a new grad. You and nurses like you are the problem...
your obvious offense at my comments and your defensive attitude just proves that you have heard this argument before. I am not the only nurse who has ever voiced these concerns. You might as well learn to live with it....
I think we all need to realize that ER Techs come in all shapes/sizes/capacities. In the ED I work in now our techs are wonderful but are CNA II's which can start IV's do twelve leads etc. They unfortunately can't even hang fluids. But at another hospital I frequent the techs are certified Paramedics and can work to their full scope of practice, including IV meds, ET intubation, even IO's. They all have ACLS, PALS and PHTLS as part of their certification. So you can see how someone with those qualifications working in an ED for two years who had strong skills would zip through an orientation process in no time.
I work extra shifts in the ER (after 2 years med surg and 5 years ICU experience.) I can tell you I would NOT want to work there without my critical care background. I can also say I learn something new every time I work there. Couldn't do it all the time though, I'm really thrown by the psych patients:D
hogan, personally, I couldnt care less what you did as an ER tech. It is obvious that you are working under dangerous conditions if your management allows unlicensed personnel to work as RN's.
And if the RN's in your dept allowed you to perform the skills that you listed as an ER tech and then they "signed for you" then they are in violation of the Nurse practice act and in addition, they are stupid.
Like I said before, I think JCAHO needs to do a unscheduled survey in your hospital. Which, BTW they will be doing exclusively across the board starting 1-1-04... good luck
I..... But at another hospital I frequent the techs are certified Paramedics and can work to their full scope of practice, including IV meds, ET intubation, even IO's. They all have ACLS, PALS and PHTLS as part of their certification. So you can see how someone with those qualifications working in an ED for two years who had strong skills would zip through an orientation process in no time.
Medic 946 you are absolutely correct about some Er Techs being certified paramedics. Those individuals are invaluable to have as part of the team and from my experience I have worked with some paramedics who were better than some RN's....
Right now in our dept we have 2 medics who have gone on to nursing school and are now working as RN's. They both had some problems transitioning from the paramedic mindset to the RN critical thinking mindset, and are doing well after some RN orientation. I would proudly work next to them in any situation.
Personally, I wish our ED would utilize paramedics again. They phased them out about 5 yrs ago, in favor of an all RN/LPN dept...
well veetach - instead of name calliing and arguing w/ you about my career - i will tell you just as hogan did - you cannot GENERALIZE all new grads - i started in a er that saw approx 40,000/yr - w/ 2 nurses and 1 tech at nite.....so there was no one to "guard me" - as well i was made a charge nurse - i believe that there are those who excell at what they do - i believe that if you work hard for what you want then noone has to carry you - like i said prior to graduation i new how to read monitors, i was acls, tncc etc.....and i don't think you will ever find an "experienced" nurse that i worked w/ that would tell you i couldn't carry more than my fair share.... if you want to call me a prodigy or whatever - feel free - but it is attitudes like yours that keep nursing from furthing as profession rather than a job.....
do new law grads HAVE to go to a certain area??
do new docs HAVE to go to a certain area???
no - they train for and seek out what they want and accomplish it - just like nurses.....
and for the record i am a woman and i graduated at age 21 -
as well as being accepted into a top 75 CRNA program at the age of 26 with only ER experience - which everyone said "couldn't be done"
hmmmmmm.....guess everything is possible veetach....
so for those new grads out there - don't let these old sterotypical ideas dissuade what you want to do - if you feel the ER was meant for you - learn your critical care data - be familiar w/ alll your cardiac meds/doses etc.... and you will do just fine...
i am soo glad that i worked w/ ED nurses who encouraged my strength rather than shrugged it off - rather than those who generalized everyone --
i don't suppose that veetach liked being generalized as an old nurse w/ old fashioned ideas either....
so for those new grads out there - don't let these old sterotypical ideas dissuade what you want to do - if you feel the ER was meant for you - learn your critical care data - be familiar w/ alll your cardiac meds/doses etc.... and you will do just fine...
i am soo glad that i worked w/ ED nurses who encouraged my strength rather than shrugged it off - rather than those who generalized everyone --
i don't suppose that veetach liked being generalized as an old nurse w/ old fashioned ideas either....
I have a right to my opinion, just as much as you do. In MY EXPERIENCE new grads are not an asset to the ER, they are a liability. The "old stereotypical" ideas are formed from experience. something new grads do NOT have.
It appears that we have 2 nurses here who feel that they didnt need orientation as a new grad (see previous posts) and even one who practiced as an RN and was only an ED tech.!! Since I do not work with either of you ( and you do not work with me) I can and will not judge your quality of work or the safeness of your practice.
This post was originally a question, I gave my answer and some of you didnt like it..... too bad.
It is still my opinion, and obviously that of others. You can not change it.
My suggestion to you both is to learn from those experienced nurses you work with, and from others around you......
as for the "old nurse with old fashioned ideas comment." I am not old and my ideas are forged from correcting many mistakes made by new, inexperienced nurses, and from my experiences as a preceptor of new graduate nurses.
athomas, why bother going to CRNA school, just let the OR know how good you are and I am sure they will let you give anesthesia without a certification
C'mon guys! You all have valid points, but the hostility is corrupting the board. We are all professionals and of course as individuals have a right to our opinions and to voice them on the site, but let's not get downright vindictive. We're ALL above that, am I right?
I didn' t realize someone could obtain their TNCC prior to becoming an RN. When I did the class, we had a few that "audited it" since they were not RNs yet but they weren't allowed to get the certification. ?? Erin
I would like to hear what you think of new grads starting out in the Emergency Department. I just finished an 
:rolleyes:
veetach
450 Posts
text in >
>>I literally got bored w/ my orientation a week in. I had gastriclavaged over 50 patients, ON MY OWN, as an ER tech (we were frequently short nurses, and they trusted me, and were willing to sign off on the chart)
This is illegal, and as far as the nurses who "signed off" on your charts with you, an unlicensed tech performing gastric lavage or any nursing task for that matter, is preposterous, and stupid. Apparantly they do not value their licenses....
>>I had done everything but pass/hang meds as an ER tech...
including:
I triaged
I lavaged
I NG'd
I defibbed
I started IVs
I splinted
I taught splinting
Helped w/ pelvics
Set up IV pumps
Spiked IV fluids
I actually took an assignement one night as we were 2 nurses down, but did not pass meds
so you are telling me that, as an ER tech, you did all of the above, including take assignment and perform direct patient care??? I seriously doubt it, and unless Arizona has laws that are way more lenient than California, Colorado, Kansas and PA. (states where I have practiced) then, it is highly unlikely that you performed these tasks too. If you were a paramedic practicing in the ED, I can see you performing some these tasks, as long as RN's would sign you off. But not as an average ER tech. If you can do all of this, why be an RN????
>>You seem quite arrogant yourself.
Your attitude is all too common. You think You're at, or near the top of the nursing food chain, quite willing to eat his young, as is all too common in nursing nationwide...I'll wager you are rude and bossy to the ER techs, unit secretaries, and registration staff, and likely don't even speak to the housekeeping staff (other than to order them around)
After the above comment, you are calling ME arrogant?? HAHAHAHAHA... Since you dont even know me, you have no grounds upon which to base this judgement.... Its people like you who make the nursing food chain all too willing to eat its young.
>>I encountered a couple of ER nurses like you on my way to and after graduation...
I was a part of the "dedicated triage team" AS A TECH...
I was the "official RN/LPN trainer/orienter" of new staff 6 months after graduation...
I did all of the QCs and yearly staff training for the accu check machines...
had ACLS and PALS pre graduation...I defibrillated DAILY as an ACLS trained ER TECH
As I said above, if your hospital allows non-licensed personnel (providing you are not a paramedic ) defibrillate patients DAILY, then someone needs to report them to JCAHO.
>>How dare you brush me off as working at some 5 bed ER where everyone is in charge, just because I was a new grad. You and nurses like you are the problem...
your obvious offense at my comments and your defensive attitude just proves that you have heard this argument before. I am not the only nurse who has ever voiced these concerns. You might as well learn to live with it....