New grads in the ER

BecomingNursey · Jun 6, 2015

I was a new grad straight to the ER and I am so happy that I was. I could not see myself doing anything else and if I would have had to get med/surg experience first, I would have been miserable.

I was just talking with my director about this very topic the other day and I was asking her about her thoughts on the matter. She told me that she prefers getting nurses straight out of nursing school rather than from another unit because we can then shape that nurse into an ER nurse and not have to break any habits that they had on the floor.

ER nursing and floor nursing are two totally different types of nursing. You have to totally change your time management. It's not about getting the meds passed at 9 o'clock or q4hr sugar checks. It's about being ready for whatever walks through the door and prioritizing your care by acuity.

Everyone has different views on this and this is just my two cents. I've had other seasoned nurses that I work with already suggest to my director that I become a charge nurse. I've only been a nurse for a little over a year. So no matter which unit you work in straight out of school you can succeed if you are a hard worker and do your absolute best. Never be too cocky to think that you know it all. Always ask questions. When you feel something is wrong but can't quite put your finger on it grab a fellow nurse to look at the patient or grab the doctor. It's always better to be safe than sorry.

Anyhow, like I said. Just my 2 cents on the matter :)

armygirlabn, ASN, BSN, CNA, LPN, RN · Jun 10, 2015

I am a new RN and I would love to get a job in the ER. But unfortunately many hospital do not want new nurses. I was thinking about taking ACLS and PALS just to add to resume. You think that will help?

Jo

BecomingNursey · Jun 10, 2015

I am a new RN and I would love to get a job in the ER. But unfortunately many hospital do not want new nurses. I was thinking about taking ACLS and PALS just to add to resume. You think that will help?
Jo

ACLS, PALS and NIHSS all add to your resume and look really great to ER directors. Also, the NIH Stroke Scale is free online it just takes some time but a lot of facilities require it for ER nurses.

kjhinckley · Jun 10, 2015

I recently applied and interviewed for a graduate nurse program in Florida. We could name which three areas were our preferences to have applications sent. I am already working as a graduate nurse in another state (med/surg) and I have been a CNA 4+ years (some of that spent on a med/surg floor also). I still chose med/surg areas as my preferences because I just don't think it's a good idea to start brand new nurses in critical care areas with no previous experience. What if it's the one moment they're alone that day and a patient is circling the drain quietly? How might that graduate nurse know to notice subtle signs of trouble without the proper experience before it's too late? That's just what I see, though. I did part of my preceptorship in the ER and absolutely loved it! But I want a sufficient amount of experience first before I try for the ER.

LadyFree28, BSN, LPN, RN · Jun 10, 2015

I didn't start out as a new grad in the ER; I had experience in home care, LTC and Sub Acute prior to securing a job; these out-of the box positions helped me with time management, focused and head to toe assessments, how to cluster assessments and how to identify acute problems without the use of technology, and how to handle delegation, and challenging personalities.

If I had bad habits, those habits have been self corrected enough to have a positive experience.

WannaBNursey, ADN, ASN, RN · Jun 10, 2015

I went to the ER after 6 months of med-surg experience and 5 years experience as a CNA. I think those 6 months of med-surg made a huge difference in my assessment skills and my overall nursing practice. Another one of my classmates went right into the ER and is frankly considered a failure. Unless you find an ER that has a very specific training program for new nurses, with very long orientation, I would not go into the ER or ICU with no prior nursing experience. Even having been an ER nurse for almost 6 months now, I wish I had some more critical care background for when we have to hold ICU patients. I love the ER, but I'm so happy I had my 6 months of Med-surg experience to help me out.

emtb2rn, BSN, RN, EMT-B · Jun 10, 2015

Straight into the er from school. We hire a fair amount of new grads, almost all work out.

PS0812 · Jun 17, 2015

I don't think there is any one perfect answer to the question. My preference is to have the nurse gain experience in med surg before coming to a speciality unit like ER (or ICU-CCU). This experience gives the nurse time to sharpen their assessment skills and to learn their strengths and weaknesses. ER nursing requires one to shift gears and to change pace as needed, you have to be able to prioritize and be a good observer, multi-tasking goes without saying, you have to remain calm during chaos, think fast on your feet and above all, have a good sense of humor. Without an internship I would not suggest starting an ER career in a Level 1 trauma center. A community hospital ER may be a good place to start.

Lev, MSN, RN, NP · Jun 17, 2015

I still work in medsurg and have been working in the ER for 6 months, so I can have an informed opinion on both sides. For me, personally, I would have not been able to survive as a new grad in the ER unless I had a very supportive new grad orientation that lasted from 6 months to a year. My med surg experience was invaluable to help me transition to the ER - I could already assess patients, start IVs, knew about many meds and their side effects, how different procedures worked, etc. However, I will not say that transition was easy. Med surg can be very task oriented sometimes because there is so much to do and not much time to do it. Plus, unless you have an unstable patient, most of your patients are at a certain level of acuity. In the ER, there is a very strong focus on prioritization and you will have patients with varying levels of acuity, so if you are used to your routine, it's hard to get out of that mindset. There is also a lot of primary nursing in my ER. The techs don't really have a specific assignment. The teamwork is great. Another nurse is always available to step in if you need help. I love the ER, but sometimes when it gets really crazy or when I take my ICU patient upstairs I wish I worked in ICU, but then pretty quickly, I don't...