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Newer Nurse Offered Job in ER, Scared! Help!

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SMK1812 SMK1812 (New) New

Hi all,

I am looking for some support and advice. I am a newer nurse. 8 months of experience in L&D and then almost 1 year in a clinic. A new hospital opened in the area and I have been asked to join as an RN in the ER.

The hospital is a Level II Cardiac, Level III Stroke, ER is not listed. It is a "crossroads" hospital so it gets patients who can't make it to the major ER's in the city quite yet. I don't believe it gets the most intense patients, but I am not sure?

Anyways, I had a horrible first experience as an RN in labor and delivery. I was bullied out of the job and made to feel very stupid. I left with very little confidence on my own accord, but I know that they wanted me to leave too. I left at the end of my residency, but they let it be voluntary so that it didn't look like I was fired. They asked me to leave though. I don't think I did bad job, but I always had people breathing down my neck for answers and I am a very quiet person... a thinker... and they were all outgoing and put my down so much I couldn't think to even answer them.

Working in a clinic is rather boring to me though :( I miss pt interaction. I am in charge of all of the prior authorizations where I work.

What are some of the major skills I should be studying to even be ready for this job if I take it? What meds are important?

I admit, I'm a bit of a perfectionist and at times I am slower if I don't fully understand something. Is this a terrible idea to take this job? Can I do it?

What meds are important?

How do I become the best nurse possible for this position?

How do I gain better critical thinking skills? I tend to be the type where if you tell me what to do I can do it, but I don't have the skill or expertise yet to be able to think through every situation yet. How do I get there?

Should I take this job?

Why, sure you can! You don't have to be outgoing. You do however have to be bold. You can't be afraid to interrupt a Doc who may believe he's doing the most important thing at the time, and be able to convince him why your patient needs attention NOW. You are going to have to learn to be quick with decisions. You need to master critical thinking on the fly. You have to get past being bullied by ANYONE. Peers, other docs, departments, patients and families. They will all compete for your undivided attention.

The type of hospital you are in sounds like critical access? Correct me if I'm wrong. You will get the most critical patients of them all, stabilize and transfer out.

I will say, I'm a little worried since you've only had a small amount of clinical experience and it didn't go well, and then your administrative job. Could you start out taking fast track type patients? Get comfortable there and move up in acuity.

If you want this, go get it. But it's not going to be easy. Get a copy of one of the Sheeny's and take TNCC now! Good luck, keep us updated on your progress. xoxo

Have a look through the Emergency forum, there are two fantastic posts last month about the common ER meds.

Do some learning into EKG interpretation.

Brush up on basic X-ray interpretation.

Sheehys manual is a fantastic starter for emergency nursing and helped me a lot.

good luck!

See, I feel like it'd be hard to get the critical thinking down right away. Is there any way to get better at critical thinking outside of a job? What does it even mean to be good at critical thinking?

Yes, it is a critical access hospital. They actually have an opening in med surg where I can float to the ER every once and a while. I think I am going to apply for that and see what happens. I know that they want me to work there.

Thanks! I started looking through those :)

Lev, BSN, RN

Specializes in Emergency - CEN. Has 7 years experience.

You will have to get over some of your perfectionist tendencies if you want to work in the ER. ICU may be a better choice.

I'm going to apply to the med-surg position. They train you for med-surg and then you float over to the ER to learn how to work in the ER...overtime you can transition to the ER. I think that's a good move. I hope it all works out though!