melmacrn

How does the process of nurses from other floors coming down to get pts from ED work? Is there a timeframe that receiving nurse must come get the patient from ED? Any information you can give on this is appreciated. I am so grateful for all your replies. One thing we are looking at is the benefits of the ER nurse not leaving the ED. Do any of you have information on this?

My hospital's current ER to floor admissions process involves the emergency department nurse taking the patient to their assigned room in PCU, ICU, medical-surgical or where ever the patient is admitted. This takes an emergency department off the floor in an already short staffed and busy ED. We have researched other facilities and are finding that other hospitals have individuals who come to the ED and take patients to their assigned room once a room has been assigned. Does your hospital have staff members who take admitted patients from the emergency department to their assigned rooms/departments? Is there a specific name for this process? Also if you have any research articles you would like to share regarding this (especially ones concerning patient safety). We are trying to collect research and sharing your experiences would be greatly appreciated.

I'm so glad I posted this! I felt like everyone I talked to made moving to Portland sound like an awful idea (people from Portland). I think some want to keep Portland to themselves. Selfish. Lol. :-)

Hello everyone, My family is planning to relocate to Portland at the end of the year. I'm getting discouraged looking at the job market! I started in the ER as a new grad and have been there going on 3 years. I'm ACLS, TNCC and PALS certified. I also have a BSN (and BA in journalism and communication studies). How do I establish a network when I'm over 1,000 miles away? I would really like to stay in ER (or go to ICU). With my credentials, is the job market for RNs as tough as it seems? I've never done travel nursing, but if I started with a travel company--could I stay in Portland or would you be required to travel further? Any input is appreciated.

I've been an ER nurse for a little over two years (as a new grad). Before the ER, I fainted during an abdominal packing, an epidural, a wound scrub, an even before a cesarean section even started! I still faint if I'm poked with needles. Lol. It makes me empathetic towards my patients. To this day, I haven't fainted while being an ER nurse. Almost everyone has fainted--or near fainted. Some of our best tenured nurses have faint stories! In the ER. I've relieved tenured nurses because they are getting pale and woozy! I was terrified of starting my job and fainting. The more I focused on the fear, the worse it was. You're so busy and overwhelmed the first year of the ER that you don't have time to worry about your fear. It will pass. Don't give up and you'll be laughing at your old fainting stories later along with other nurses. I promise! [emoji4].

Our department is always looking for ways to improve, as I'm sure many departments are. For those working in busy emergency departments with 15 beds or less, what has your department successfully done to be more efficient? Pod system, strategic schedule, specific nurse assignments, fast tracks? Anything your department has done that has benefited the patients and the staff, I would love to hear about. Your input is greatly appreciated!

I've never worked third shift, so this might seem like a really really dumb question. :-) I've been working first shift for the past month, but switch to the 7pm to 7am shift in a couple days. I'm scheduled November 4th (Monday) from 7p-7a. I assume I go in Monday night at 7p. Is this correct? Somebody (not a hospital worker) has me worrying that they might mean I go in on Sunday at 7pm since I'll be working over half the shift on Monday (after midnight). That doesn't sound right to me, but thought I would get your opinion. Thanks :-)

I've been taking plenty of the advice offered. :-) I found nurses I feel comfortable with, so that has helped tremendously. One of the nurses had me start an IV without assistance and then said "I'll be right back" while I was in the process of inserting the catheter. I waited for her to come back once I got a flash, but she never showed up! I did the entire IV, drew blood and sent the blood to the lab with NO assistance. I walked out of the room and there was my nurse laughing with a bunch of other nurses. THEY SET ME UP! :-) It was nice not having someone hovering over me since that's nerve wracking for anyone and even better that it was successful. I've also done like 15 ECGs without assistance, accessed a port (I was sweating on that!!! Luckily wasn't by myself), did a foley with no problem, and now I'm finishing ACLS tomorrow. I feel like I've improved in one week, so that makes me feel way better. Still worried about codes, traumas, etc. (and obviously not ready to be alone yet for everything). I just felt I should report that you were all right and things have been better. :-) Thanks again.

Good luck! I'm glad the post was able to help you out as well. :-)

I can't thank you all enough. I've been wiping away tears the entire time I've been reading your replies and wish I could hug every single one of you. I love the idea of keeping this post and going back to it in six months or so--just to see how far I've come in my position. I think I have had the mindset that they expect me to perform like a tenured nurse in the ER and I need to be realistic with myself--that is not going to happen. I really need to stop being scared of everything and just relax. I need to allow myself to make mistakes. And I definitely need to stop worry about what might go wrong (ex: what if I faint, what if I do it wrong, what if I look stupid, what if, what if what if..). It's the "what if" attitude that is really bringing my confidence down. I also need to stop worrying what other people are thinking and just worry about myself. You have all been so helpful. Thank you so much.

I was so excited to start as a new grad in the ER. After three days of training (not ER directed, just hospital orientation) and taking two ECG/rhythms classes, I was introduced to the person I'd be with for floor orientation. I was so excited and felt like I would be comfortable with this nurse since she has a fun/outgoing personality. I am so eager to learn and want to be a great nurse. Unfortunately, my first day did NOT go as planned and I feel overwhelmed and completely foolish. I feel like they're already regretting their hiring decision with me. I did my school preceptorship (64 hours) in the ER back in June and then took NCLEX in August, so I've been out of the clinical setting for about 4 months. Everything that could have possibly gone wrong (with the exception of killing someone) went wrong. Mistake, after mistake, after mistake. Things I was comfortable with as a student. Here is a summary of my day. During all my experience in clinicals, I never left upset. I was crying the entire way home and cried for a good hour after getting home. I'm so overwhelmed and I feel like I'm letting the department down. I also feel like they just expect me to know how to do everything, and I don't. I just really need to get these feelings out. 1. Foley: My hands were sweating so bad, I couldn't get my sterile gloves on. I finally got them, but it took forever. Then, I was blank on what to do with antiseptic and even blank on what the syringe of lubricant was! I hadn't seen a foley kit since first year (I had done lots of straight caths throughout clinicals--just not foleys). I finally got the catheter in, but I was embarrassed. 2. I couldn't start an IV if my life depended on it! During my preceptorship, I was able to start them and take blood without assistance. It's like I completely forgot how to even do the steps. Plus, the person I'm with does things completely different than the person I precepted with over the summer which is frustrating. 3. Glucometer. Yeah, doesn't get much easier than doing a glucose reading...wrong. She asked me to find out what his blood sugar was and I was so excited, like "finally! something I won't mess up and can look competent at while doing"...While the machine was reading the results, I pulled the strip out (not even thinking!!!!), so of course, got an error message. 4. Went to connect IV tubing to the IV....couldn't figure out why it wouldn't go on...oh yeah, because I forgot to take off the cap. She teased me on this one and I smiled, but I was feeling so stupid. 5. Almost forgot to swab the IV port with alcohol before doing a saline push, but the trainer caught it and tried handing me a alcohol pad...that I dropped on the floor, so she got me a new one. 6. Put like four of the stickers for ECG on incorrectly because I couldn't figure out how to count the intercostal spaces. I've never done these before. 7. Was asked to reconnect a patient to monitoring...forgot to hit start on blood pressure cuff and didn't hook up the leads. THIS IS ONE DAY!!!!!!! I FEEL SO FOOLISH. It looks even worst seeing it all written out. Any past experience you've had or hope you can share would be so greatly appreciated right now. I hate feeling this way. Plus, I have ACLS training next week and I'm terrified of that as well. Did I mention I'm 6 months pregnant? Yeah, I'm just a wreck, lol.

I passed NCLEX in August and I'll be starting my first job as an RN in the ER in a couple weeks. I did my 64 hour preceptor at the ER over the summer, so I have a good idea of the routines, documentations, etc. There was a lot of tips and tricks offered by my preceptor, but SO MANY that it's impossible to remember them all. I wanted to make a little cheat sheet to keep in a binder to help me during my first few months, so any tips you would like to share would be very helpful. For example, I know there are certain drugs that are very painful to administer, so diluting them can ease discomfort. I know the orders never called for the drug to be diluted, but the nurse always knew which ones and the steps to follow--not something we're taught in school. Plus, approved ways to minimize pain during debridements or stitch removal (other than morphine prior to the procedure). Just anything you learned and would like to share which new (or even tenured) nurses would be of great help. Thank you and have a great day!!!

My husband is looking for a job right now, so there was no way I could wait. I have a 4-year-old and his list to Santa grows more and more each day. :-)

I got the job!!! I'm an ER nurse. :-)

It is definitely stressful walking into an interview pregnant. Especially when I'm 23 weeks and look like I'm 8 months, lol. They were really chatty about the pregnancy, mainly talking about how they take good care of their pregnant nurses. My preceptor in the ER (she was a reference) and one of the nurses at the interview knew I was pregnant when I was precepting, so I'm hoping they already knew about the baby when they called me for an interview.