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Discussion

Nurse Extern in the ED

Hello everyone! I'm starting as a Nurse Extern at a level one trauma center ED. We were trained as clin techs but the focus of this externship is to learn nursing skills. My preceptor is great and is always eager to teach me, but I find when we have patients coming in and she asks me questions about what I suspect is going on with them that I'm unable to answer her questions. I've only taken fundamentals, maternal/fetal, psych, and community nursing at this time, so I don't really have any experience for med/surge and am not able to answer the questions she asks me (some examples: we saw a patient with a rotated leg that looked shorter than the other. she asked me what I thought it was and I just didn't know. also, she had me looking at an EKG and asked me what she thought was going on with the patient. another example was there was a patient who had would have upper abdominal pain when they would eat fatty foods that would pass, i didn't know it would mean a gall bladder issue)

I feel a little behind since I haven't taken med/surge before being placed on this unit. Does anyone have any tips for resources that I can start going over before my shifts to get some better knowledge? I'm considering starting to read my med/surge textbook for school. I really want to be able to impress since the point of the externship is sort of like having a 6 week long interview. I've only got 5 weeks left, any suggestions on how I can try to get up to speed?

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    The point of a capstone/practicum/internship/externship is to learn. The aspect of the extended interview is not to learn about your knowledge, you are not an ED nurse and they expect that. What employers want to see is that you work well with others, have good critical thinking, and are able to learn.

    I wouldn't make studying from a med/surge text book a priority during you externship. There are many books and study guides available, I would ask you preceptor what they recommend.

    I would recommend trying to think things through and bounce ideas off of your preceptor when you don't know something. If I asked one of my orientees why they thought why a hip is rotated and shortened I'd hate if the answer was "I don't know." Even if they answer was wrong if I could see the clinical reasoning why they thought something then I can teach from there and appreciate their attempt at working through the question.

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    I FIRMLY believe that you should take note of these diagnoses and look them up later. Get the Emergency Nursing Bible. Get the Rapid EKG Interpretation book. Get Sheey's Manual of Emergency Care book.

    Medicine is all about education. Many nurses (even in the ED) follow orders blindly without questioning them. Educate. Have fun. :]

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    Sorry for the ignorance here, what is the purpose of this externship? I'm not completely familiar with the concept of extended externships like this outside of the final externship at the very end of the educational experience. Are you at the end - without having acquired any basic med-surg experiences?

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