bvalerio23

I have been a tech for about 2 years and work as a scribe (fancy transcriptionist) in the ED. I started my RN program last semester and have been catching a lot of crap about my previous work history. With the scribe position, I know a good deal of medical terminology and see physicians work everyday so I am familiar with care plans and procedures. As a tech I know how to deal with problem patients and have my own bedside manner that is evident in clinicals. I was just wondering if any other students that have worked in the medical field previously have dealt with this issue in their RN program. The biggest issue I face is answering questions in class. By no means am I a straight A student but I often know the answer to a question that professors ask the class. If no one answers the question, the instructors often look to me and the other techs in the class to answer. I can't tell you the amount of times someone would chime in with "of course you'd know" or "why even study for the NCLEX, you could take it right now".

I've worked in a Level 1 and a Level 3 trauma center for a few years now and love it. Some pros would be the fast paced environment will never leave you bored at work, you generally have help with high volume days (meaning you aren't like a floor tech with 10+ pts), you get to see a wide variety of techniques, procedures, and people. Some negatives of the job is that most places at 12-hr shifts so you need to get used to that, you are faced with many patients that are rude/drug seekers, and you deal with loss more than the floor techs. I mean that in the sense that you will see a higher number of critically ill patients that will die while you are taking care of them than the floor would see (typically). I reccomend the ED for a tech position to people who want a fast paced work environment, have a good sense of humor (sometimes dark humor), and do not get emotional very easily. You will connect with patients but not like you can on the floors. We aim to get pts in and out in the shortest amount of time so there is a lot of fake bedside manner that you have to master.

Agreed with shana - 95% of my tasks were on the job training. EMTs are always welcome and encouraged to apply in my hospitals; they are especially needed in Trauma I facilities. If you REALLY want to, taking a a phleb class (time and money permitting) wouldn't hurt but I was trained on my facility's equipment.

In my time in the ED it seems like PCTs are more likely to become RNs. I have a few suggestions as to why or why this might not be true. 1. Techs works with nurses for 12 hr shifts, we see the duties and complete spetrum of patients that an RN might deal with on a daily basis. I believe this is helping me learn real world vs textbook healthcare. 2. Techs have a higher amount of patients on a shift and are able to practice IV starts, blood draws, and get the basic skills down quickly. 3. EMTs have a hard time transitioning to the ED floor from the field. Very few of our ED RNs are past EMTs except the first responder die-hard trauma junkies that work 100+ hr/wk and work for the fire dept, EMS, and RN. I mean no disrespect as I believe EMTs and medics make wonderful RNs and PCTs but there are two very different work environments for the two careers. If you are aiming towards obtaining your RN, I suggest work in the environment.

I've worked in the ED just about a year now and it's the best thing I've done in my persuit of my RN. My hospital is great about teaching and letting me put my classroom skills to work. I was not an EMT before hand and I don't think it hindered me. My facaility is a 21 bed ED but is 45 minutes from another ED so we have many high acuity patients as well as seeing 140% of our anticipated patient flow. Depending on the facility, some places offer an extensive on-boarding process and preceptorship while others throw you into the deep end. I would suggest keeping communication between you and your nurses as open as possible, being clear about what tasks you are and are not comfortable doing, and keeping an open mind about your job responsiblities. There are a TON of things that are considered "other duties as assigned" that snowball and quickly become standard of care by a tech or PCT. I learned most of my skills on the job, learned what was complete BS that was taught in school vs. the real world. My biggest suggestion would be to not be afraid to tackle the ED floor. I was hesitant to learn IV starts and blood draws especially after sticking an artery on my first IV start. Do not be intimidated by 'experienced' nurses and remember everyone will be stressed to the max when census is high. Do not take what stressed out nurses say to heart if you make a mistake! Take a breath, try to remedy the situation as best as you can, and move on. There should always be another tech to help you out or a friendly nurse to take a few extra minutes to help clean up a patient or draw blood when you can't find a vein to save your life. Good luck with the job, I suggest it to any of my friends that are interested in Critical Care nursing.

I couldn't agree with RoseQueen more. There are differences in career paths for US vs international students. For the US the most common certification that "makes you a nurse" is the RN (Registered Nurse) certification that comes after passing the NCLEX and a 2- or 4-year degree program in a university or community college. There are also Nurse Assistant programs out there of various levels. CNA (Certified Nurse Assistant) or Technician is a common position in most hospitals and setting youself apart from other students is the best way to succeed in getting into either program. Male nurses are welcomed into the nursing community. I tend to say that we are not "sought out" as many people believe but I we are not ostracized as many believe either. Peds nursing is a highly competitive field so keep an open mind about where you might want to end up. You will change your mind many times during your health care education so keep an open mind and consider possibilities of other units (ED, Oncology, ect.). As for starting your education path ask your school counselor or look for volunteer positions at your nearest hospital or clinic. Most internships require education or enrollment in programs so read the fine print on those positions. The most important thing I would tell you is to complete your education as soon as possible. Most people that wait for one reason or another end up delaying their education too long and struggle to complete it. In the US courses are only valid for a short period of time (Organic Chemistry is only valid for 5 years) at my school. If you are taking a course that requires Organic Chemistry as a pre-requisite and you took O-Chem 5+ years ago, you must retake the course in order to move on. This is the same for math, grammar, etc. courses. If you are in the US, message me if you are wanting to know more about college applications and program details. I worked for 4 years in my undergraduate admissions office and have tons of info and tips on getting into program and researching which program is best for you. Best of luck!

Depending on the size of the facility, try speaking with HR or "people services" type offices. If you haven't gotten to move to PRN make it clear that it is in your best interest and check your contract for any parts that state time retainers or competition clauses.

I 100% agree with Redhead. Both large medical centers in my city are quickly replacing LPNs with Techs. We are allowed to do everything LPNs can do, MOST techs are younger with more availability and cheaper. Techs range anywhere from $9/hr-$20/hr depending on experience, educations, and status (FT/PT/PRN). It is very sad to see the older LPNs that pour their heart and soul into their job get replaced for financial reasons, however it is happening and I think schools should be more open with LPN program job outlooks and recruit more for tech programs.

PCTs move around often so rest assured there will most likely be openings in many departments. Some facilities use LPNs only, some facilities only use medics in the ED as techs, it all depends on what floor/areas you'd like to work. I'd suggest looking for a PCT position where you would like to eventually end up. This interest will change and that should not discourage you. Additionally, just because you might not like the PCT position on a specific unit, do not dismiss the possiblity of being an RN on that floor in the future. PCTs often get the grunt work but do not let this get you down. As for getting the PCT position, look in Express Care/Prompt Care facilities, they often hire techs for a wide range of tasks from taking vitals on each patient to assisting in procedures/radiology. Its a great way to look into many possible fields rather than seeing one unit. In an ideal world look for ED positions - they see the most variety of patients and the docs have a wide range of knowledge. A phrase that has stuck with me about Emergency physcians is "I know a little about a lot of things, but not a crap-load on any one particular thing". Additionally get certified in as much as possible such as BLS or phleb.

The ACCL programs in my regions are extrememly competitive meaning only students with between 3.5 and 4.0 GPAs are accepted. Additionally the programs are very high paced and remove you from the program if you earn below a 2.5 on any course. NOW, with the negatives out of the way, your GPA is appealing. With my experience (previous BS in Biology and minor in Chemistry, mediocore GPA but TONS of clubs and hospital work I was accepted into 3 of 5 ACCL programs in which I applied, the other 2 were waitlists as the programs had a cohort of between 5 and 15. If you have the time, I highly suggest the traditional BSN program and see what courses transfer so you can shave some time off of meanial classes like organic chem and stats, etc. My GPA alone was the factor that hindered 100% admission so on that front you have no problem. The time constraint did not work for me as I work full time and was getting married. I would end by telling you to to look into an NP program or at least do an ACCL BSN and glide into an NP program. Same level of care as a PA, just different education. Some docs will tell you they prefer PAs but all of the mid-level providers in my hospitals are NPs and so are the associates to a very repsected Cardiac institution that services the region. Good luck!

If you can work nights, do it. MUCH more down time to do homework/study no matter which department. I personally love the night shifts for the exerperience and personality types of the night shifters. As a student I am working nights as much as possible 2-3/wk. Another perk of doing school work AT work is that other RNs can give you advice and you can learn another prospective. BUT keep in mind that what you instructor tests on is not always what your fellow nurses/techs will tell you. I would say 30% of what I learned on the floor contradicticted what my textbook/instructors wanted to test me on. From an experience perspective, this was great - learning various IV methods or seeing other techniques is invaluable but make sure to learn the methods you'll be tested over.

Coming from a tech-- Not all techs are good, some are meant for the floor, some are natually built for critical care. If you have a feeling your tech is not going to be satisfactory, address is professionally and within the correct channels. Telling other RNs that so-and-so tech isn't qualified or isn't good just turns ALL techs against you. We can make your shift a breeze, or we can **** off a patient before you even get in an assessment, loose blood, etc. Another point to make is that most techs are not offended if you ask us to do something/ask us to stop doing something. Some RNs don't want techs starting IVs, and that is okay - its a preference thing. Some RNs rely on techs to an absurd amount to the point that it comes off as laziness. Just as RNs have their favorite Nurse Managers or Charges, techs have their favorite RNs and some they resent to work.

I was in the same situation a few months ago when I started working in my ED. The dept was/is notorious for not training or doing very well on orientations. I was nervous because the pace of the ED is unlike any other floor and I did not want to upset my RNs by screwing up their flow. What worked for me was working various shifts (mornings, mids, nights, etc.) and working with as many RNs as possible. I mentally kept notes on what each RN would generally expect of me and make sure I did it for the next RN. Besides being being very aware of what routine tasks take the longest for the RNs to do, I decided what was within the scope of my medical practice that saved the RN some time. My duties include your list minus call lights (our clerking staff relays msgs to RNs), starting/pulling IVs, all blood work, assisting in intubations, Foley's, I&O caths, 4P's, EKGs, collecting specimen cups/samples, alerting RNs of abnormal labs, glucose checks, vitals on arrival and Q(whatever), charting anything and everything I do, whatever is asked. Generally an RN will know what their tech can and cannot do so don't overthink the situation. If you EVER feel uncomfortable in completing a task, tell your RN or provider. I took my time in the ED as the best hands-on learning you could receive. Most BSN programs don't include enough clinical experience to make you feel comfortable when you get on the floor post degree. The ED is fast paced and you'll see everything from GI bleeds, CVA/TIA, MI, MVA, to cold and flu symptoms. I have gained a wealth of knowledge from my time in the ED and will seek a position in critical care. Most hospitals are understaffed so if you feel burnt out, ask management about floating. It's not the most glamorous job but sometimes it comes with a pay increase and you get experience with other clinical settings.

At both L1 Trauma centers and L2/L3 hospitals I have worked with, techs have started IVs. Depending on the level of intensity the ED runs, some places require us to go over procedure with the Phlebotomy dept, some throw us into the ocean and hope we can swim. I found it helped others in nursing school. Personally I was terrified to start IVs but after I mastered blood draws, IVs were just a few more steps, and similar skills. Depending on how your tech/RN relationship and workload is balanced, this usually takes a huge load off of the RN.

I'm in a very similar situation. I recently graduated with a BS in BioChem and am looking at a career in Trauma Nursing. I've worked at a few local hospitals (Truama Centers) in various roles and asked around about the accl. programs vs entry levels MSN. I've gotten a few mixed responses but here at the ones that have helped me out the most: -From an RN BSN MSN TNS Administrater: any hospital no matter the size will soon require a BSN. In sooner rather than later they'll just require the BSN regardless of how it was obtained. Once the marke gets even more saturated with new BSN/RNs hospitals are going to require BSN aquired during the RN process (or RN acquired during the BSN program). Upity hospitals will start this process sooner than rural or less strict hospitals. The generalist entry MSN program is great for students in certain positions -such as us- but not ideal for hospitals or ICU/Truama work. The MSN degree will fast track you to management at a desperate hospital. With no clinical experience, you will be holding a very expensive piece of paper with no eperience to show for it. Only people in dire situations or people who want to work in primary care/family medicine as an NP should take this route. (my addition): my hospital was very strict, always had the Magnet Status in mind. Something I saw a lot is the laying off of LPNs and only using RNs with experience. New grads were kind of up a creek and stuggle to find work in their desired areas. On average new grads took 2-3 years to get into their desired areas. - From a doctor who uses lots of NPs and PAs: Physician Assts are favored over NPs because PAs go to a school that is more similar to med school and the curriculum is usually more similar than a nursing school (NP school). NPs are generally used more in family practice, primary medicine, small emergency departments. In my EDs the NPs are given the grunt work (toothaches, headaches, drug seekers, etc.) while the docs see the more interesting cases and traumas. Unless you are very intrusive and ask to be involved in Trauma cases (if you have time), you will get stuck in headache/toothache land. I would say shadow, intern, work in truama centers to make sure that is what you want. PAs will see more action, but the nurses with full BSNs (and TNS) will see the most. The entry masters is very enticing but coming from professionals with experience, I am avoiding that path.