Scis

Erin: No, maybe I didn't make myself clear. I was a GN (graduate nurse) for three months before sitting for the state boards. I graduated at the time when the boards were paper and pencil tests, twice a year, so you had to wait to "sit" for them, then wait for the results. I was an RN prior to taking ACLS and TNCC. Anyone can "take" the TNCC but I am unclear as to whether you need to be an RN. There are no medications administered, however mastering the skills stations requires pretty intense knowledge of anatomy and physiology. Maybe a TNCC instructor can offer advice on that area.... ACLS is another matter. Remember, medications are administered in the protocols, and one must have pharmaceutical knowledge of the indications for administering certain drugs and the potential reactions to look for to see if what is done is appropriate. An RN license or paramedic certification is required to push meds. in a cardiac arrest situation. Scis

C'mon guys! You all have valid points, but the hostility is corrupting the board. We are all professionals and of course as individuals have a right to our opinions and to voice them on the site, but let's not get downright vindictive. We're ALL above that, am I right? Scis RN CEN

Pabrid: I concur. Well said. Scis, RN, CEN;)

I don't believe an ER nurse can ever "look stupid" by asking a question, especially when patient care and safety are at stake. Let's face it, sometimes our actions can "make or break" a situation (or life or death, literally). What does "look stupid" are mistakes done when they could have been avoided. I think in the ER, one should never be seduced into thinking they "know it all". Just when you get to that point, BAM! something will catch you off guard! Trick is to stay current, keep knowledgeable, and double-check your actions if necessary. In the words of ol' Flo Nightingale: "A woman (or man nowadays) who thinks of herself, "Now I am a full nurse, a skilled nurse. I have learnt all there is to be learned", take my word for it, she does not know what a nurse is, and she will never know: she has gone back already."

ER's are ER's. No amount of med/surg. prep will prepare one to be proficient in the emergency room, anymore than thinking that OB/GYN floor experience is necessary due to the amount of "outside" deliveries that happen in the ER. It is a specialty area that requires much expertise, however, I do not agree that there is no place for eager, willing new graduates. Let's face it, "tasks" like mentioned in one of the posts are just that, "tasks". With training, ANYONE can perform those tasks. You don't have to be an experienced RN to do them. What is necessary in an ER, especially a busy one such as the Level I, Level II trauma centers are nurses that are eager to learn and are not afraid to ask questions of seasoned ER veterans. The attitudes posted don't seem like new grads would be comfortable with asking for assistance from them. The new nurses must be aware that they can ask for help with anything, and those managing the nurses need to know their capabilities at the present time and what they need for the future. Don't "eat the young", help them mature into the specialty they feel fits them. I started in a Level I urban trauma center right after I graduated from nursing school as a GN, before I even sat for the state boards. I was hired because I told them that was the only area I wanted to work in the best hospital in the area. I learned all I could to specialize right from the start, ACLS certified by one year, PALS by two, along with Trauma Nurse Cert., then sat for the Emergency Nurses exam two years after being in ER Nursing. I knew it was what I wanted, I went for it, I had excellent mentors who I felt comfortable asking anything I needed to ensure patient safety, and succeeded. I wouldn't want to see anyone discouraged from what they feel they want to do. I've been at it for ten years now, just accepted a Clinical Coordinator position in a slightly less busy ER, but I could not envision working in any other specialty area.

RNangelER: Thanks for the tip on Tenet. You mean they actually post their indiscretions? I'll check it out. Love to be informed. Happy New Year Scis

The responsibility lies with the registration clerk, however, if the patient is acutely ill or a trauma, the band comes attached to the chart and the RN usually applies it after verifying that it is the correct patient, especially important since the sickest patients usually can't acknowledge who they are so they REALLY need the name band.

lizz: Thanks. 'nuf said.

Guys: Hate to sound naive, but what exactly is "Tenet"? I'm from northeast NJ and have never heard the name? Thanks!:)

Rayrae: Beautiful tribute. Your grandmother was very lucky to have you. Thanks for sharing. :kiss

kate930 That "expert" certainly does not work in an ER!

I don't know about you guys, but if I had the flu, the LAST thing I'd want to do is bundle myself up and go out in the cold to sit in an ER waiting room along with others who had the flu also, maybe even worse than me! I don't get it. I guess they think we have a magic wand to wave over them to help them be cured spontaneously! I would take Tylenol/Motrin, drink plenty of fluids, wrap myself up in bed, and stay there until I felt better! I try to tell my patients that as they arrive in triage, but the STILL choose to wait for hours! Unbelievably, in the northern NJ ER I work in, the waits can be up to 8 hours or more during peak times! I guess I blame the media for the mass influx. It has been all over the news about the flu deaths, so people panic. Yes, this season may be worse than some others, but if everyone tries to stay out of crowds, stay home if not feeling well, and treats their flu symptoms at home rather than go out infecting everyone in their paths, maybe we could avoid some casualties!

nurse51RN: Of course we would have also referred the patient to a cardiology clinic or PMD (I assumed they had one since they were a direct admit) to find out why they've had chest pain for 2-3 months! In the hospitals I have worked in, no one gets directly admitted to any specialty unit without an ER workup. The beds are too scarce nowadays! Good Luck to you in the ER! ScisRNCEN :)

See, now if that direct admit had gone through the ER, they could have ruled out the cardiac dispo and the patient could have been given food and discharged! ScisRNCEN

sabRN2b05: Only have a second, but I had to comment! Yes, I went straight to a level I trauma center upon nursing school graduation and never looked back! The hospital is located in a very poor, very urban center in Newark, NJ, but is a teaching hospital as well, associated with the state medical school; I have learned much during my ten years here. I sat for the emergency nurses certification test 2 years after nursing school graduation and have remained certified. I love emergency nursing and have seen many people come through, try it, and leave, and I'm telling you, YOU HAVE WHAT IT TAKES!!!!! There are emergency rooms that treat solely pediatrics, along with separate areas for adult emergency and traumas. You have such a unique handle on all aspects of the ER route, from registration to hanging around waiting during treatment, to discharge. C'mon. Give it some thought! Maybe the stint as an ER tech will change your mind.! Good Luck in whatever you do, you sound like you are going to be great in nursing! Scis RN CEN