Preceptor placement

[Sam Last]

Hi, I'm a nursing student about to start my preceptorship next semester. All I've wanted to be was an ED nurse, but due to COVID there are next to no ED or ICU placements.

I'll likely be on a telemetry floor and choosing from one which has
post op hearts, complex angiography, MI, OR another floor with less acute tele, dialysis and complex medical clients.

Which would best prepare me for a future in the ED?

Thank you for any guidance!

[13grad71]

Unfortunately none of those will really prepare you for an ED position. ED is a completely different animal. The focus is so different in the ED vs Tele or medsurg. 
 

we are currently training a Tele RN into our ED and he is having some trouble transitioning.

[gere7404, BSN, RN]

The ED I work at only hires new grades that precepted there or in critical care. I wanted to be placed in the ED for my practicum but they gave it to a different student (who then dropped and went to a different unit for his last semester because he thought he was being bullied), so I ended up doing my first year as a nurse on a telemetry/cardiac progressive care unit.

it was good because I got some experiences in emergent situations like rapid responses and code blues, and I’m good at managing cardiac stuff that walks through the ED. On the flip side, I see way more than just hearts in the ED — most of the pts that get admitted to to the med surg floors. The problem some nurses that go from the floor to the ED have is a lot of them thrive on routine and planning, and are accustomed to doing much more in depth assessments and chart digging than we need to do in the ED. 

[meanmaryjean, DNP, RN]

Take the placement that will help you pass NCLEX- where are your weak content areas? 

[igtgrnokbye]

How max out your pre ED career...Telemetry is a great place to start. Aim for a general unit if possible. Do not specialize as ED are generalists.  Ask for a unit with as much variety as possible a general medical floor or general telemetry is best as sometimes telemetry acts as ICU overflow in smaller hospitals. Float to surgical every now and then to learn orthopedic injury and abdominal disease (very common in ED). Did I mention stay general? Learn your rhythms and their respective drug management. Print off your stated EMT P protocols and memorize them. MEMORIZE THEM. As you will be taking report from them so you must underage what they have done. Finally join your local fire rescue department. 

[speedynurse, ADN, BSN, RN, EMT-P]

I think it does depend on your perception as to what floor works better pre-ED experience. I will second what others have said that the ED is completely different then the floors. However, saying that, the floors do teach time management. The cardiac floor sounds better for experience because you will likely get cardiac drips, have patients’ acuity change to where they are downgraded or upgraded, etc. I honestly think it’s really beneficial to see different sides of nursing. I know I started as a new grad in the ER and while it did teach me a lot about nursing and various skills, time management, etc., I also think it’s important to see other sides of nursing to empathize with different specialities. I am in surgical services now (pre and post) and it has allowed me to slow down to actually really feel for my fellow nurses in the ER, floors, and ICU. I am a lot more patient because I have more time on my hands as a nurse to actually HAVE that patience.  I think any experience you can get will help to direct you to the area of nursing that you want to go in.