BackpackingRN

Congratulations! :)

I am a new grad in the ED as my first position too! It is going well, I have 2 weeks left of a 3 month residency program with two phenomenal preceptors. In addition to the full time work in the ED with a preceptor who guides you then supervises your independent work when they feel you are ready, you also have class every week focused around an Emergency nursing textbook put out by the ENA that focuses on ED care. I love the ED so far and am learning so much but I honestly go home every day scared and sometimes wake up in the middle of the night thinking that I forgot something... Apparently this goes on for a while; I have been told at least a year. The most important thing I can tell you about starting out in an ED is that to them, you know nothing - which is pretty much true. They have been doing this a long time, and while we may have newer Evidence Based Practice and tons of new knowledge that we are bursting to share and we are dying to prove ourselves, we know nothing compared to what we need to know. I went in with a "please teach me" attitude, basically I shut up with what I knew, asked a ton of questions and everyone was bending over backwards to help me. If you stay humble, ask questions and practice safely you will do fine. On the other hand there were 4 people total in my residency cohort, one other girl who took the same approach as me and then a male and a female who decided to go a different route. They basically told everyone right off that they had experience, answered with "Oh Ive already done that" or "We learned it this way, I don't think that's right".... talk about shooting your own horse. Well, needless to say the ED staff, nurses, techs and even doctors were not pleased. The nurses let them flounder and the techs ignored their requests. One lasted 3 weeks the other lasted 6. Be nice to your techs do as much of your own works as possible remember it is a team and ask for help and help out if you can ASK QUESTIONS, we have so much to learn and they WANT to teach (as a caveat to that, don't be a pain in the ass and ask at appropriate times) remember that this is their house, you are the new kid and while you have o prove yourself, don't ever say that you already know how to do something so you dont need to see it done or you don't need to do it. This is how I have survived in the ED, I still go home and thank God I made it through the day. I talked to my preceptor and she said if I wasn't scared she would be worried. You can do it. Any other ED RNs have any advice? I am flying solo in 2 weeks and while they keep telling me I am more than ready, I am nervous!

bahaha, This is ridiculous. Hopefully you showed her how to use a manual cuff... I am all for education over writing up, I think it does more good for the majority of the people in the long run. If she refuses to learn or even try to learn, thats when she just has to go.

That is the only way anyone in my graduating class from December got Residencies or Jobs.... I got a Residency in the ER in part because I was willing to call and not harass but make my presence know to a few people... They are people too so be polite but let them know you are worth listening to and hopefully they will notice...

When we do wound irrigation in the ER we use gown, gloves and a mask with eye shield.... don't mess around! I would imagine with irrigation NCLEX would require the same!

haha, thats when the real works begins.

Im a 75 question passer too, I did Kaplan before but still was literally dripping sweat I was so nervous before, during and after... I agree, you never feel ready but honestly if you know how to prioritize the answers like kaplan teaches you and you have a grasp on content, you'll be set! Good luck :) I know how you are feeling, I was there in Febuary (graduated Dec 2010) you got it!

yea I have only ever seen that scale used on all of the floors. I would have said 3-4 are not exactly high acuity but perhaps there are different scales, I would be interested to know.

:/ I guess OP has hw answers now. I am sure a few of my classmates must have done this too but it doesn't seem that effective as a learning method.

In that case yes, I did misunderstand you. I was also saying though that it stinks to have a student thrust upon you and that I saw a lot of that and felt fortunate to have an assigned nurse (who was also getting paid more). I do agree though that the majority of what I saw was not this way.

guys don't fight on my thread!

Caroladybelle, I would agree. Luckily my school set us up with a preceptor for the semester. We worked with the same person every single shift and we got the assignment with them as they got it. A lot of the time from what I saw the people who were assigned nurses the morning of the shift also were given info on their patients the night before so they could research etc.... that doesnt make a whole lot of practical sense to me for learning in the long run but to each his or her own I guess. I am sorry you haven't met any nursing student that was actually helpful... My senior practicum instructor pretty much let me operate on my own, I had my own patient load and it was in the ER so honestly there was not a lot of flexibility, slammed is slammed and I held my own but was supported if I needed help... I bet it is harder the lower the semester or if your student doesnt ask questions if they need help and just goes at it so you need to constantly watch them... Hope you get a good one soon!

I work 12s, Mon Tues, Fri, Sat Sun..... but then I have an entire week off..... Good and Bad I suppose. Works well for the summer because I can take long trips, In the winter I teach skiing as well so its kind of like I live two lives....! Good luck deciding :)

AH! I am jealous. I am doing a residency in the ED on nights and I would love days. For me it would also mean a pretty big paycut though. Is that an issue for you? is it that bad doing nights...? If not, why not just stick it out, you seem to have a sweet team on nights :)

As a new grad, nurse preceptors are still working with me in my residency and the ones from school are very fresh in my mind. My best preceptors were honestly the ones who were the hardest on me. They were amazing teacher and expected me to perform well. I had a few nurses that were outright rude... calling me "hey you there candystriper" or getting annoyed when I wouldn't do things out of my scope of practice, but honestly, these were the on the minority. Most of my preceptors were amazing. I could not have asked for more special, intelligent, caring individuals. WHen I did my senior practicum in the ED, my preceptor introduced me to all the nurses slowly who he thought would be good additional teachers. These nurses hollered for me to do IVs, foleys, blood draws, cultures, see a really sweet lac, help with a code, run with the code team.... everything. I would say that PRETTY MUCH every nurse is a great teacher when they want to be. A lot of these nurses did not want a student trailing their every move, but they were fine with an independent student as I had proven that I would not do anything I was not allowed to do or that I hadn't done, or needed more practice on... Most nurses are eager to let the new, eager nursing students or nurses do the hard foley. I mean, Jeez sometimes I swear they asked me to do stuff just to get a laugh when I looked at them like... erm this is NOT what it looks like in my textbook... And you know what, it was funny. Anyway, basically I'm saying that not all nurses should precept, the ones that were rude were the ones that had been forced to precept. Everyone else was great! I only hope I continue to work with excellent nurses. Even the nurses who set me up to get a laugh - they aren't bad people, I am honestly just easy fodder for jokes because I am sooo gullible and new-grad-oh-my-I-need-help-ish..... My mentor gave me good advice. She said, look, they are all just people. If you have a problem with them, remember that. It seems sooo simple now! I wish I had understood it when I stood hyperventilating in the utility closet after a particularly bad nurse-eat-student encounter on peds...