Not Hiring New Grads in ER's

[cel589]

Hello! I'm going into my 4th and final year of nursing school and have a quick question about ER nursing. I know it's what I want to do. I've spent weeks outside of my clinical's shadowing in different ER's and love every minute of it. However, the hospitals near me including the one I will be doing my externship at this summer do not hire new grad RN's into the ER. I completely understand this but it faces me with a dilemma. Do you think it's better to get a different job at one of these large, urban hospital's where i really want to work and wait until I could possible transfer/ get a new job in the ER there or is it better to start at a smaller hospital whose ER hire's new grads and then try and find a job at a large, city ED.

Also, if I decide to try to pursue a different job for a year or two until I have enough experience to apply to an ED, where would you guys recommend?

Thank you in advance!!

[Footballnut]

Either choice is good and I agree with the poster who says to find out which option increases your chances where you would eventually like to work. Some hospitals give preferential treatment to internal applicants. And, having ED experience also always helps.

Also check out the possibility of resident RN programs for new grads in the ED. We have a great program in our ED and every new grad we have hired has done very well. Of course we have had many great applicants to choose from so that has helped too.

[nurseinnyc&nj, BSN, MSN, RN, APRN, NP]

I started as a fresh new grad in a very busy inner city level 2 trauma center ER in NJ (over 90,000 ER visits yearly) 2 years ago......BEST DECISION EVER!!!! IT IS POSSIBLE!!! I was so lucky to land my first nursing job as an ER nurse and would never go anywhere! It is stressful and requires lots of quick critical thinking but I am learning every day and I've became more comfortable taking care of critically ill and imminently dying patients each day. I think it really depends on how you are willing to learn and adapt to the environment fast or not. I am a quick learner and adapt to stressful environment very smoothly and quickly. I had 16 weeks new grad orientation. I took ACLS while I was in the last semester in nursing school and volunteered in level 1 trauma center ER for 6 months to get the feel of it (My only hospital experience other than clinical rotations). There was other new grad that started with me who couldn't make the whole orientation and made let go. I really think it really depends on your passion, dedication and effort. Not everyone needs to start on the floor to be an ER nurse.....GOOD LUCK!!!!! :) I strongly recommend you to take ACLS.

[guest901464]

@ERGirl83

What size facility are you talking about with the smaller community ED?

[lizrn1214]

It might be a good idea to also try to get "ER" type certifications - ACLS, TNCC, ENPC, etc. If it's going to be awhile maybe even consider taking an EMT class - you would likely find it simple after nursing school but pre-hospital it's a WHOLE different area. You could volunteer on a local FD if you have them - if you have EMS type experience AND you are an RN it is much more likely you could get an ED position. Good luck!

[zmansc, ASN, RN]

Personally, I went straight into the ED. Many have argued that new grads should not go directly to specialty areas, and my hospital has even made this change recently. I think it's wrong, but I'm already in so I'm not going to argue that point with our admin. I will say some of the best ED nurses I've met never worked the floors, and the same for some of the best ICU nurses, and other specialty areas.

When I was graduating there were a few large hospitals in bigger cities that had new grad programs (I don't recall the term they used, probably a residency), where the new grads who were selected had both a didactic program and worked a certain number of shifts in the specialty area of their choosing. If it hadn't been so far, or my local hospital hadn't offered me the job they did, I would have gone that route.

Since my local community access hospital did offer me the ED position when I graduated, I took it, and I'm not dissatisfied with the results of that at all. IF ED is your goal, you can certainly learn all you need to there. I stepped up to a larger ED two years after I started (PRN only) because I wanted to learn some things that I thought we didn't do... Turns out, there wasn't alot to learn that I hadn't done here, just more volume divided by more nurses.

I will say that I strongly suggest against making up your mind of what specialty you wish to spend then rest of your career in too early. You are very new to nursing, and there is alot you could do. If you have interest in one specialty (ED) then by all means put it at the top of your list, I did, and I'm glad I did. I now work as a float though. I still get to play in the ED when they need me there, other days I play in the ICU, or wherever they need me. You may find that you have multiple interests as you learn more about the various areas. As you gain experience in an area or two, you may find other areas that peak your interest. I only say this because you are the only one who can determine the best path for you. The great thing about nursing is if you don't like what your doing, there are many other areas for you to go and find a better fit, a better job.

Good Luck!

[PacoUSA, BSN, RN]

Every ED job posting I have seen wants ED experience already. So who hires into the ED with 3+ years tele experience??

[Dyingbreed]

A very select few new grad rns are cut out for ER. Just because you want to work there doesn't mean you should.  There are way too many being hired to fill shortages and it's a scary situation. Healthcare is a scary place and now you have the blind leading the blind. Just because you graduated nursing school( a basic expectation ) does mot make one fit for this area. The common misconception is they need support and guidance so they can learn,  and be kind and patient with them. LOL. The level of arrogance and entitlement they display is shameful and it's dangerous. Sub par if any basic nursing skills in 80% of the ones over the last few years. These skills should not be acquired here or assumed to be possessed with a completion of schooling. We are accused bullying them or we are just getting them through orientation  so we can be staffed and this giving them a false sense of security which is beyond the burden of training here. These girls/guys  are gonna lose their licenses before they even have a chance to renew them, and it's not fair to them either. Mainly because they think they are out here making it based on lowered standards of training and care because a body is a body to upper management and we are overwhelmed with workload anyway. Then you cut them lose and there is assumed experience  with little or no monitoring. Er is no longer for the elite. Playing T ball qualifies you for playing major leagues these days and everyone gets a participation trophy. 

[FiremedicMike, RN, EMT-P]

Dyingbreed said:

A very select few new grad rns are cut out for ER. Just because you want to work there doesn't mean you should.  There are way too many being hired to fill shortages and it's a scary situation. Healthcare is a scary place and now you have the blind leading the blind. Just because you graduated nursing school( a basic expectation ) does mot make one fit for this area. The common misconception is they need support and guidance so they can learn,  and be kind and patient with them. LOL. The level of arrogance and entitlement they display is shameful and it's dangerous. Sub par if any basic nursing skills in 80% of the ones over the last few years. These skills should not be acquired here or assumed to be possessed with a completion of schooling. We are accused bullying them or we are just getting them through orientation  so we can be staffed and this giving them a false sense of security which is beyond the burden of training here. These girls/guys  are gonna lose their licenses before they even have a chance to renew them, and it's not fair to them either. Mainly because they think they are out here making it based on lowered standards of training and care because a body is a body to upper management and we are overwhelmed with workload anyway. Then you cut them lose and there is assumed experience  with little or no monitoring. Er is no longer for the elite. Playing T ball qualifies you for playing major leagues these days and everyone gets a participation trophy. 

1 year ago, there were 6 of us in our new grad/new hire orientation group.  1 had prior experience as an ED tech, me with my EMS experience, and the other 4 were brand new nurses, 3 of them were straight from high school to college to the ED, so brand new to the workforce.

When you are a new grad, our ED does a minimum of 6 months with a preceptor prior to being cut loose.

There is one from our group that still struggles at times, although to be fair I think they have some external factors at play.

The others - fantastic nurses and I would let them care for me if I were sick.

We agree on one thing - the ED is not for everyone, but being a new grad isn't the deciding factor.  As a matter of fact, we have several nurses in my ED with many years of experience who have no business working in patient care.