Jump to content

newER

Posted

I have recently been offered employment at a local ER. I do not have nursing experience. I have been in EMS for 11 years, 7 as a paramedic in an advanced system (pumps, drips, paralytics, narcotics, etc). While I feel confident in my pt care and decision making, I am not familiar with anything hospital-wise. I know I will be precepted and all that, but I am looking to get a head start by asking for both general advice and tips and things that you wish you knew when you started in the ER. Thanks in advance.

exit96

Specializes in RN. Has 3 years experience.

So, are you a nurse now? I can't tell from your post...

So' date=' are you a nurse now? I can't tell from your post...[/quote']

I think he's a new grad...

I think you'll do well. I'm a medial assistant with 8 years of experience going to b a nurse soon and I feel confident .. I'm sure u will b a great nurse because you have the basics...

sorry, yes, I passed the nclex last august. I only did it for NP school, but they wouldn't take me without nursing experience, so here I go...

You'll be taught. You'll do. You'll either love it or hate it, lol. I went through RN training and work as a RN only to get into a psych NP program (which I'm in). There are many of out there like you.

turnforthenurse, MSN, NP

Specializes in ER, progressive care. Has 7 years experience.

With your background, I don't think transitioning into the hospital setting will be that difficult for you.

sorry' date=' yes, I passed the nclex last august. I only did it for NP school, but they wouldn't take me without nursing experience, so here I go...[/quote']

Just don't say this in front of the majority of nurses you work with. LOL

Posting from my phone, ease forgive my fat thumbs! :)

ChristineN, BSN, RN

Specializes in Pediatric/Adolescent, Med-Surg.

sorry' date=' yes, I passed the nclex last august. I only did it for NP school, but they wouldn't take me without nursing experience, so here I go...[/quote']

I echo the advice, do NOT say during an interview that you want to be an NP. I know my ER hires new grads and my boss has told me she has turned down new grads when they tell her the only reason they picked our hospital was because they want to go back to school and we offer tuition reimbursement.

Esme12, ASN, BSN, RN

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma. Has 41 years experience.

sorry, yes, I passed the nclex last august. I only did it for NP school, but they wouldn't take me without nursing experience, so here I go...
Yeah.......I wouldn't be too public that you are only in to til you become an NP....you know us ED nurses might not take that well. Most "hard core" ED nurses don't want to take the time with someone who is using them as a stepping stone. While your boss might know I would keep it on the DL from the staff especially at first.

The roll of a paramedic and a nurse while similar are very different. To be honest I think you are going to be frustrated by the lack of autonomy especially at first....for you will have to "ask" the MD and not "do" by your assessment. Especially If you went to an online school....you are in for an adjustment about how nurses are actually treated.

You are accustomed to making your own decisions based on your assessment.... you won't be able to do that as a nurse......not like a medic in the field. Nurses can't/don't intubate. We need to ask to start the dopamine, give epi.....etc.

You will need to remind yourself that you are a nurse now and act accordingly. I have been a medic and well as a nurse...I was a nurse first.....it "expanded my skill base. I have worked with medics that were initially VERY FRUSTRATED with how the nurses were treated and what little input they actually had....and how the MD's treated them.

As a medic you might be frustrated at first at what you can't do....especially when there is a patient that they can't intubate....remember you are now governed by your RN license and hospital policies regarding nurses ..... not that you are a paramedic or what you can do as a medic.((HUGS))

Take deep breaths...remember you are now learning THIS role. I wish you the best.

Edited by Esme12

bjflymed

Specializes in CEN. Has 30+ years experience.

I had my LPN did floor nursing and ED and then went and got my paramedic did ground, and flight returned to the ED as an LPN while going back to school to get RN. A couple of things that I tell paramedics that are getting their RN. 1) at times you will be frustrated when you have to ask to start some medications that as a paramedic you could just hang, same with intubations. 2) the hardest time that medics turned nurse have is caring for multiple patients at a time. Just remeber there is a learning curve and enjoy it

thanks. that's a good point about multiple pt's. that will be very different. fortunately they have a 4:1 ratio where I'm going so it won't be as bad as a lot of them are.

emtb2rn, BSN, RN, EMT-B

Specializes in Emergency. Has 21 years experience.

thanks. that's a good point about multiple pt's. that will be very different. fortunately they have a 4:1 ratio where I'm going so it won't be as bad as a lot of them are.

Staff 4:1 or a hard set ratio of 4:1? Methinks the former. Which means it's a guideline. When everybody has 4 pts and the squad rolls in with cpr in progress as a chest pain and a new onset facial droop/slurred speech come into triage at the same time, you might see a modification to that ratio. Could be wrong.

exit96

Specializes in RN. Has 3 years experience.

Some good advice has been presented in these few posts. Some nursing experience will do you good, seeing how you are going to be an NP (nurse). Why skip laying a good foundation? :-), good luck.

hodgieRN

Specializes in ER trauma, ICU - trauma, neuro surgical. Has 10 years experience.

They will teach you everything that you need to know. You have to make sure that your thinking as a medic doesn't cross over into your thinking as a nurse. I've seen medics (that have become nurses) argue with certain protocols or methods of thinking because they did it differently as a medics. It's hard watching someone that can't get a pt tubed, when you know that you did it everyday in the field. You have to sit back and just be the nurse. But, there are things only you will be able to in the ER vs medics in the ER. So, it plays out.

Spend some time concentrating on the protocols, hoops, and politics of the hospital. There's always a paper to fill out, an order to sign, or some bundle that you have to initiate. Your autonomy will change and you have to make note of the things you can do and what you can't do. There will times when you will feel compelled to act, but you can't...you have to call the doc over. You can't do a needle decompression when there's a doc that can put in a chest tube. And, you won't have a captain that watches your back on the engine. The higher-ups will reprimand you for the smallest thing if you don't have a good charge or manager. Be ready for cattiness, people talking behind your back, and burnt out nurses that can't retire just yet. Don't sleep with anyone from work. If you have a good team in the ER, it's an awesome place to work. If you work at an ER that's falling apart, it sucks. Don't talk about your sex life until you have made some close friends. Some nurses can't stop themselves from writing people up. It can be very high schoolish.

Many hospitals are moving toward patient satisfaction as the sole indicator of care. The fact that you save someones life doesn't matter if you aren't smiling when you do it. Practicing becoming like a waiter that offers anything a client wants. It doesn't matter if you save the city from burning down...if a patient says that you didn't bring them pain medicine the moment they asked, you will be a candidate for firing. So, practice giving service with a smile because they even survey the patients that threaten the hospital for not offering a turkey sandwich. This is the new standard and we now have to adapt to bowing at the patients feet. Make sure you get familiar with these expectations or you are gone. Welcome to saying thank you while you are being abused.