Ikikaeru

Just went through this process myself going from a rural ER to a much larger city ER. They asked the same questions most interviews ask, how do you deal with conflict, how do you describe yourself, why do you want to work in ER, etc. Prep for those questions mostly. The only ER specific question was a triage question. I always go into an interview convinced that I don't need the job. Takes the pressure off and lets me just flow with the questions.

The problem is the stigma of behavioral health issues. They may feel that they don't want to be labeled. I've worked in the past with behavioral health patients and there were many times when they were out in the community that they did not want to talk with people about there diagnosis or past histories for fear of being labeled "crazy". I do believe that just being straight forward and asking the patient point blank can be an appropriate measure. We don't have psych in the hospital where I work so we have no way of getting a consult. I find talking to people frankly, but with empathy, tends to be the best course.

Network , lots of people that work per diem will be working in other places. You can also look at job boards and such to see how much is out there. If your really intrested in an area you can always talk with the HR department to see what they are looking for. Just a heads up though be ready for HR to give you a general response. my wife is head of HR for a company and she has very little time to give indepth responses to inquiries.

Thanks for the info. Lots of good posts and information in that thread.

Maybe its the tone you use. Personaly I take all of the experienced nurses tips and insights to heart. I hope you do not take offense but the tone of this post seems to be a bit harsh. Sassy5d seemed to state her opinion (as you did with your post) and you seemed to take it as an attack and "look at how bad other nurses are". You probably are a wonderful nurse with great input but sometimes when were to a breaking point the things we say can come out harsher than we mean them to. But thats just my two cents.

Some of you get peeved over regular stuff. I've been working ER for only 9 months but im so used to not having lists of medications it doesnt even bother me any more. The one thing that bothers me is a pt that comes in every couple days by ambulance for chronic pain in his shoulder. Always states its chest pain, fall , etc. Last pick up he had fallen and was unable to get up when they were dispatched. When they got there he got up and got on their cot. when they got there he was kind enough to get off the cot and go down the stairs and then get back on the cot. At the hospital he walked to the bathroom three times not problems..... these people frustrate me especialy when they think the should be cared for and medicated right away (like that guy over there unresponsive and tachy should have to wait )

A woman came running in to our ER and started stating in a excited tone "I think my daughter broker her leg" several times. I was ready to run out the the car with a wheel chair when the girl came skipping (kid you not) into the ER, no tears, smile on her face. Apperantly a broken legs looks like a 3 cm surface scratch we treated with Neosporin and a bandaid. The women still had us do a complete x-ray of the leg. She banged it against a metal pipe (at least that was the story). Funny thing is most of these stories end up with the parent asking for Narcotics but this one didnt. She seriously thought it might be broke.

Had a pt with slightly elevated Troponin levels the other day and the ER doc stated it was probably due to her dehydration. He even consulted a cardiologist friend and he agreed. Personaly I didnt know that was something that could elevate it. Learn something new every day.

No system like that where I work but I work in a small rural hospital. Im just happy when I have help in the ER and that everything is plugged in so my computer isnt dying (we used portable carts with battery power).

Im not an expert but I dont think getting antibiotics a few min earlier would have "saved" her. She was already pretty bad if she crashed that hard. Not sure about the MD but maybe he was jsut willing to get everything going so it covered him as well. Assertive may have gotten toe antibiotis a little sooner but who knows if that would have done much. I hate when you have a pt that doesnt seem to be that bad off just go down the toilet so quick. You always look back and think what could I have done differently. I think when you dont really have that "oh crap this is a bad one" and then they pass you look harder at what you did and less at what the pt had going on. Hope you are doing well. FYI if anyone has information on antibiotics or a different opinion please let me know!

Networking! I started in the ER straight out of school. I took an ER certification through my school which had us do our externship in the ER which gave us over 90 hours hands on expericne and a full semester of simulations in our school. I knew a nurse that worked at a rural hospital and she was getting hired into the ER out of school (she worked med surge at the hospital) and told me to apply for the other positiong. I also had my EMT-B license though I didnt do much on a rig (who has time with nursing school and a job) and I also had a few other certifications. Moral of the story , network , find out who is hiring , Look at Rural hospitals , they tend to be more willing to look at new grads compared to Urban hospitals.

Had a woman come in with her friend for chronic knee pain, goes on to state a WHOLE list of allergies, suprise supries NSAIDS and Toradol first on the list. Gets a couple percocet and discharge later. Next day her friend comes in with her and her friend has "knee pain" same list of allergies same issues, same doc and me. They now know he isnt going to give our narcs though they stop in reguraly to see who is on. =( This is the one thing that kind of gets me down and out about ER nursing. Give me someone that NEEDS REAL help any day not matter what they come in for!

As far as people being mean on here I would assume its the same reason you hear of nurses eating their young (seen it happen in clinicals and in my nursing profesion so far, though not to me). Some people get off being jerks and making others feel miserable. As far as getting top marks, Some GREAT nurses I know were middle of the pack in school but have the right stuff in RL nursing. In classes you needed to know stuff about every freakn aspect of nursing, once your out in your chosen area you develope expertise. Put an med surg nurse in OB and see how they do, or ER nurse in psych. Grades well show you if you need to improve but they arent always the end all on whether a person will be a good nurse. Last note ive seen straight A students go to their clinicals and SUCK BIG time when preasure was placed on them, or they had horrible bedside manners.

I work in a Rural hospital, Not bad for a new Grad. ER exp. , Med surg charge nurse Exp. , LTC thats attached and cross training if I want, and we can even do pre op / post op training. Overall Ive been trained on a lot. That being said it can get scarry and intense because I work nights and unlike larger hospitals We do not have ancillary staff on (just on call). So when we get something major like a trauma its up to 1 ER nurse and we pull the charge nurse from med surg to help out and the doctor. Thats pretty much it until we can get lab and Radiology in.

Why not go for your RN and work to pay off debt, you can get NP or PA and work in the ER as well. Its really up to you and it will show you if you like the ER. Its a bit different than EMT (I have my EMT-B), but as rewarding. Med school can always be an option down the road as well if you do get set on MD.