New Nurse....Please Respond

talaxandra · Apr 8, 2006

Hi. Sorry I can't help with any of your questions, but I thought I'd give this a 'bump' to see if anyone else has input :)

PS Welcome to allnurses!

LCRN · Apr 8, 2006

You should really think hard about what interests you...I'm sure everything at this point. A lot of people feel before you start ER/Trauma/or SICU that you should have experience with organization, task management, and dealing with patient's assessment's that are not as complicated as "critical" care. It's all a personal decision, a tough one at that. I started on a respiratory step-down unit...we had telemetry, vents and some drips. It prepared me for a lot of what I needed when I went to critical care. I worked on that unit for about 1.5 years. As I said before it's a personal decision but if you go directly into critical care be prepared the learning never ends. I guess that's true of any specialty of nursing :)

LCRN

scrmblr · Apr 8, 2006

I started in ICU 6 months after I graduated with my RN. I had worked in rehab/med-surg and long term care. I wish I had done a little stint in ICU. ICU and ER are kind of "hand in hand" ER gets them first and ICU gets them next (sometimes) I just wish I had a little more experience with drips and critical care...

But I love the ER!

Ruby Vee, BSN · Apr 8, 2006

i've read the threads, too, and i know a lot of folks advocate for going straight into specialty without stopping in med/surg first. i still think that's a bad idea for a number of reasons -- first and foremost being that it hastens burn-out. since you're undecided, go for the tele unit first. practice your basic nursing skills, learn how to talk to patients and their families, communicate with physicians, rt, pt, pharmacy, etc., learn how to make a rapid assessment, slam in an iv, ng and foley and become familiar with some of the more common meds. learn how to organize your day and pay attention to what you love about the job and what you hate.

if you want to spend all of your time with one patient, fine tuning the labs and getting to know their families, icu may be a better place for you than er. on the other hand, you may get a thrill out of doing a 2 min. assessment and slamming in iv, ng and foley then passing the patient off to someone else. er may be your thing. if you aren't sure, take the time to make up your mind while learning as much as you can and getting paid for it!

good luck!

Trauma Columnist · Apr 8, 2006

Personally, I love the ER! (I am biased). Is 12 weeks long enough?? Unsure and really depends on the type of ER. I work in a very busy level one trauma center where 12 weeks would be the bare minimum - just enough to get your feet wet and know what you didn't know.

pricklypear · Apr 8, 2006

I loved critical care in nursing school. But I felt that I didn't have the skill level to practice competently in that area right out of school. So I started in telemetry. Worked there for about 3 years then went to ICU. I had the basics under my belt, so I could concentrate on higher level skills. Personally, I wouldn't have done well starting in ICU, but I have seen others do it with success.

Good luck with your decision - it's a hard one!

paphgrl · Apr 8, 2006

Personally, I love the ER! (I am biased). Is 12 weeks long enough?? Unsure and really depends on the type of ER. I work in a very busy level one trauma center where 12 weeks would be the bare minimum - just enough to get your feet wet and know what you didn't know.

I had a twelve week orientation. After orientation I was thrown to the wolves. I had no support. When I had too many patients, I wasn't given to option to say no to additional patients. I was working at the same level as the more experienced nurses. I was expected to take on the same patient load. Now I am going to another department where I can get my confidence back up. This is not how you want to start your career.

Trauma Columnist · Apr 9, 2006

Paphgrl brings up a very valuable point: with the nursing shortage acute in different parts of the country, it is sometimes impossible for new grads to flourish in a busy ER...it just depends. I would definitely job shadow to see the climate of the particular ER you are considering.

RunnerRN, BSN, RN · Apr 10, 2006

I am a new grad that started in the ER last summer. I disagree with the burnout comment. If I worked on a med-surg or tele floor, I would be burned out by now! I absolutely hate routine, hate having the same pts 2 days in a row, and love my adrenaline rush. Plus, I get to work with all ages (from birth to 150) and all medical problems.

I am at a large level I, and we had 20 weeks of orientation with classes and tests, lots of shadowing and preceptorship. We had the option to remain preceptored after the 20 weeks, and had meetings to decide if we were ready. We were also WONDERFULLY staffed, and our supervisors would have floats keep an eye on us and step in if we seemed to be drowning.

One personality aspect I think you need to think about before deciding to go directly into critical care....can you ask questions and scream when you need help? If you play the ego card and don't admit when you're in over your head, you'll never make it in critical care directly out of school. I have come out of rooms and said to my supervisor "I can't handle this patient on my own, there is too much going on with him and I need some help." I have never been reprimanded for it, have actually been praised a few times.

Think about it, and good luck! And definitely job shadow (no matter where you decide to go) to see if you like the atmosphere and pace of the dept.