Specialties Emergency


hey all,

was just wondering if anyone could share some pearls of wisdom on how to get the most out of my 'on the floor' esd orientation. i've been in the residency classes for the last 2 weeks, but this friday night will be my first time with a preceptor on the floor for 12 hours. i'm not that green since i have one year med-surge/tele experience, but i've never worked in an er setting. any tips would be greatly appreciated! thanks for the input~


neneRN, BSN, RN

642 Posts

Specializes in Emergency, Trauma.

Do EVERYTHING you get an opportunity to do! After you've done something once, it becomes less scary.

Don't be afraid to tell your preceptor to let you try to handle things on your own, with them just supervising rather than doing and you watching. I'm saying this because before you know it, you will be on your own.

I've been precepting a nurse to our ER for the past few weeks, and after the first few days of getting used to things, she asked me to just let her do her thing. I stayed close by for any questions, concerns, but for the most part just let her be. I think this is a good way to let the preceptee learn to critically think and handle situations, but still have a good resource right there should something come up. She's done an incredible job--and sure enough today we were short staffed and her orientation got cut short-she was on her own and had no problems.

When I was a new grad, one of the things that I did that helped me most was to stick my nose into everything, especially the pts I was scared of-codes, vents, etc. If there was a code going on, I jumped in. You can never have enough help, so you'll always be welcome into the rooms that have a lot going on. Then, the more you're exposed to the more critical pts, the more comfortable you'll be.

Oh, and definately get your ACLS if you don't already have it.


30 Posts


Wow, thanks for your input, great advice! The Residency is 14 weeks long (class and clinical time), but I hope to be doing my own thing soon, with my preceptor close by of course. I'm a bit scared, but mostly excited. It's a Level I, teaching hospital so I'll see and learn many things! I'm praying for a good preceptor, one who will teach me what I need to know, yet also let me do lots of "hands on" myself. It's that balance that's hard at first since we don't know each other, but that comes with time.

Specializes in ER, ICU, L&D, OR.

Howdy yall

from deep in the heart of texas.

rules for to live by

1> you are there to learn

2> listen carefully, then ask questions

3> ask questions then listen carefully

4> dont hesitate to try a new experience, your preceptor wii be watching you to ensure its done correctly...

5> you said you are not green, trust me in this. You are green. But dont be afraid of that, just learn. ER is totally different from M/S, or tele. There is no comparison.

6> keep the faith. Your preceptor will be your guide. Hopefully you will have a good one.

hang in there

what hospital are you at


17 Posts



30 Posts

Again, GREAT advice, thanks everyone. Tonight's the night, yeow! I'm at Parkland, teeituptom. You're right, I am green. Although I've done IVs, foleys, dressing changes, dealt with MDs, etc I've never done it in an ER setting. I'm ready to be a sponge and soak it all in, but also ready to jump in and DO IT (in a safe way, of course)!


17 Posts



Specializes in ER, ICU, L&D, OR.

Howdy yall

from deep in the heat of texas

Well Tex, Once you get caught up there and decide you are ready to relax. I will get you started on wgat all ER nurse need...


It preserves your sanity. It works better than beer or wine or those other mind altering drugs some nurses get prescribed for them. Golf is more expensive but it works a helluva lot better,

So give me a jangle when your ready

doo wah ditty

Specializes in Case Management, Life Care Planning.

Great advice Tom but really, is there really anything the golf doesn't solve? I think not.

Good luck Texas!


30 Posts

Hmm, haven't heard of a Dr. Bob Slaney but if I ever do I'll tell him "Jim" says HI!

Well, I survived my 1st two nights. Please allow me to vent a bit: I think it would have gone better if I had a more receptive preceptor, ugh! The 1st night she didn't even know she was orienting me that night!!! Going on and on about how she never had preceptor class yet and didn't know what she had to do. What's up with that? I knew it would be rocky before then when I asked my ER friends how she (preceptor) was, they said she gets stressed very easily. I found that out right away. I was the one telling HER it would be ok, we'll get through this (when she was freaking about orienting me) She has never precepted before and made a comment about the only reason why she's doing it is so she won't have to start being Charge nurse. THEN, she has to tell EVERYONE about her personal drama how she just found out she has skin cancer on her foot, how she's sick from the ABX she has to take, how she feels sick and has a sore throat and how tired she is, how she hasn't gotten any sleep for the past 2 days, on and on and on. I know I have to be proactive and step up to this orientation and I WAS, but it's hard to do that with all her drama, and I sure as heck am not going to orient myself to the ER. After a few hours she calmed down. She was very thankful I was already a RN and not a new grad. I told her I was still new to the ER and still needed orientation to the ER. Part of me wants a new preceptor but maybe I should give her a chance (?). She also only works weekends which means I have to work almost every single weekend (gags). I've heard the saying that anyone can put up with anything for 3 months, but darn it, I want a good orientation because come December I'm on my own. I'm on again this Saturday and Sunday, she's on vacation so I'll have someone else for those two nights orienting me, I guess I'll see how that goes.

Tom, methinks I need some major GOLF lessons after the nights with her. I'll just picture her face on the ball (just kidding!).

!!! FORE !!!

Specializes in ER, ICU, L&D, OR.

Howdy yall

from deep in the heart of texas

Well Tex, that form of therapy, putting someones face on the ball and whacking the bejasus out of it is very therapeutic.... Then you can just look at that person and smile.

There is an advantage to working all weekends

1. you get paid better

2. you have your time off during the week when the rounds of golf are less crowded and a lot cheaper.

Good Luck Tex

doo wah ditty


30 Posts

Let me know if golf lessons are available after 1630 since I'm in class during the week from 0730 till then. By the way, great weather we're having here, eh? IF YOU'RE A DUCK!

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