DeenieRN

Just remember you aren't supposed to know everything! The day you stop learning, is the day you should try doing something else. I get those pts that totally throw me off, and I love it, I keep learning, they are my challenge. That's what I love about the ER and the main reason I switch from CVSD to ED. I didn't want cookie-cutter diagnosis, I wanted to see more. Don't let anxiety get the better of you, turn that energy into enthusiasm, and learn. It'll make you are better nurse if you use this approach and you won't feel frazzled when faced with a new situation.

Level II facility - We have a pyxis in each trauma bay, it doesn't have everything, but its cuts a few trips out. Doesn't have the life saving Tetorifice shots because there's no fridge, heaven forbid!

thanks for the advice YoutubeTheNP

I have recently gotten into the yoga scrubs. I have been buying Healing Hands Yoga scrubs and they're fantastic. So soft, so stretchy and wash well. I wear navy so color fade is important to me, and this material eliminates that problem completely. Love them!

I've discovered that nursing is really just a journey, and you pick which road to take, there is no right way, just the way you choose. For your plan to get into flight nursing you will need ER and trauma experience. I thought I wanted to do flight nursing, but after doing a tour of the chopper and speaking with the staff that deliver the traumas to us, I found out that it's not for me. I love the ER and trauma, but I'll skip the flight side of things. I work with a lot of nurses that do flight nursing to the caribbean, I love their stories, it's exciting but also confirmed to me, that it isn't that path I want. Now back to you, if you feel uncomfortable transitioning straight to a trauma facility, why don't you get into the small ER at your current place of work, and do OT on your floor. Anyone going to the ER will feel overwhelmed at first, the process is different. Get into the smaller ER, get in your groove, then make the move to the trauma facility. Whatever you decide, there is no right or wrong answer, do what makes you happy and you'll end up where you want to be. Best of luck!

hahahhaa.... totally, Grey's Anatomy it is not...

Nurse326, I really feel for your situation. I could not have possibly coped with starting as a nurse grad in the ER. I totally respect that you took the leap and did that. Having been in the ER now, I have seen a handful of new grads start and go through exactly what you're talking about. Of those who have not made it, quit or been fired, I have noticed that they're the ones who seem cavalier, don't ask questions, over-delegate and don't have a solid go-to person. Find one of the nicer nurses, confide in them and make them your go-to person. That kind of support will get you through this stage. Bottom line is, if you get through this, you'll be a better nurse, your confidence will be solid and you'll be able to work anywhere, sadly this kind of attitude is prevalent and it shouldn't be. Best of luck to you! :)

bookmarking this thread because I'm interested. I'm an RN in the ER, in my 5 year plan I think I'm gonna start working on my NP, but I don't really get the difference between ERNP and FNP, I've only seen FNPs in the ER. If I got ERNP would it limit me? Seems like FNP are really everywhere, being so generalized does it help or hurt?

absolutely not! congrats on making the leap! you'll always have a job, its not an easy one, but it can be very gratifying. All the best! :)

I was thinking about doing this same thing. My manager at my current full time job is quite the handful, I would leave but I'm in a contract and don't want to pay 5k to get out of it right now, but I also want to get a local travel contract under my belt before taking the plunge and heading to cali for an assignment. I was planning on going part time and doing a contract 51 miles away, enough that I can commute and still function at my current job. Reading your post though makes me think that scheduling might make this a bit more difficult than expected.

Hey Argo, I want to take my first travel assignment early next year and was thinking about San Fran as my first location. I'm currently in South Florida working the ER. What's your thoughts on the hospitals there, or it as a potential location for a first timer?

Congrats first of all! Nursing school was tough, but now the real work begins, keep a hold of that enthusiasm! I agree with PixieRN, Sheehy's book is invaluable. Also know who your resources are, the seasoned nurses around you are your resources, no-one expects you to know everything or anything for that matter, so always always always ask! Everyone is going to look too busy, but when you approach a seasoned nurse and say, hey can you help me because I've never done this before, they will make time for you and you will learn. Not only that, as you grow everyone working with you will feel more comfortable because they know you know your stuff because they were there with you. Never feel like you cannot ask for help.

When I was a new grad, I rcvd a pt from the dayshift nurse and she informed me that the man was really grumpy and hadn't been very nice to her. I was prepared to meet this dude and assumed my shift wasn't gonna go smoothly, and would be immediately looking on the MAR for a sleeping pill lol. Anyway I went in to assess the pt and got into conversation with him, he was pleasant with me and told me he didn't want the dayshift nurse again tomorrow. On this occasion, I was intrigued and asked why? He told me when she wrote her name on the board in the morning, on the "goals" area she wrote "don't be SOB", he's like, why would she tell me not to be a son of a b***h, that's so rude. I burst out laughing and explained that she meant "don't be short of breath", I erased the board and wrote "be happy" with a big smiley face. We both had a good chuckle about it.

I couldn't agree more with TheCommuter! That is my exact outlook! I am loyal to my happiness only! I took a job on a post-CABG unit because I felt that it was a step up in my career, I was promised advanced education opportunities, support, advancement, etc. After 4 months, I realized this was all a lie. There was a severe lack of teamwork, no support from management, no option for education, and I found the post-CABG process to be monotonous. After four months and a very bad shift, I went home and applied for a huge list of jobs in my area at other hospitals. I went for an interview for a ED job with no experience in that area. The question was raised, why am I applying after only 4mo in my current job. Although you should never say anything negative in an interview, I thought I had nothing to lose, so I was honest. I told the manager, after 4 months, I don't see room to grow in my current job, and what I was promised isn't attainable there. She appreciated my honesty and offered me the job on the spot, with a sign-on bonus, as well as the higher pay and better benefits. It was a no-brainer. I didn't feel bad at all handing in my letter of resignation in person to my manager. It was such a shake up to the manager, the director got involved and offered me a lot of tempting offers to stay, but it wasn't enough, I was moving on and they would have to deal with how that looks on them, not on me. I'm not nursing for kicks and giggles, this is me making a living, advancing my knowledge and career. If I can't grow, it it's complicating my life, if I'm feeling miserable going to work - I'm outta there, I don't care about how it looks.

So I was watching this TV show about tiny houses (basically houses on trailers) and there was an episode about this travel nurse who was essentially heading around the country taking assignments with her tiny house. The concept sounds great, what do you guys think? Those of you who have travelled, have you ever heard of this? Think its functional? Worked with anyone who has done this?

Agreeing with all other posters: check order, check policy, confirm with Doc if necessary. Take note of pts CV status prior to transfusion. Always assess before transfusion - listen to your lung sounds! I had a young 20 something pt with no CV hx or hx of reactions, not present with SOB after starting transfusion, but at 15 min I recheck VS and listen to lung sounds again, and the bases were wet, even though the pt didn't complain of SOB?! It was good to catch it early.

I totally agree, instead of dealing with the stupidity of those involved in the incident, all staff are penalized by some sweeping rule. I feel like administration are so heavy handed sometimes. Safety issues raised are justified... why the hell is there a scalpel in a bag? That is the safety issue. That is what should be addressed. In the ED I work in, there is a big deal made about cell phones and drinks. We aren't allowed either. I keep my cell phone in my pocket regardless, but I don't get it out in the nursing station. The drinks are an issue because our break room is miles away from the ED by the entrance to the ED. When running around on the critical side, its a stretch to be able to break away and have someone cover you to go get a drink of water. Luckily I work nights and so sometimes I get away with hiding a bottle of water in a draw. The crazy things we deal with lol

Hi! Welcome! I have heard of many difficulties surrounding the accelerated programs. I understand why they work great in the US, but they cause problems when trying to go transcontinental. You won't have enough clinical hours to qualify in the UK. Similarly, because the UK offers an area specific nursing education model, transferring from UK to US, shows you as lacking in certain nursing areas (educationally), this is because in the UK you specify as a psych nurse, adult nurse, peds nurse etc. Whereas in the US you do it all and kind of pick whatever you want. If you plan on living in the UK, I suggest you just study there, taking into consideration, transferring from country to country you will need to prove a lot educationally, pay fees, take tests and have at least 1 year post graduate experience to qualify, if you study in the UK and plan to work and live there, you skip all that stuff. Then if you plan on going back to the US, you can cross that bridge when you get to it. I hope this gives you a better idea! Good luck!

I'd like to mention one thing to you: In the US, since you have a bachelor degree already, you will most likely qualify for an accelerated nursing degree, it is a fast track to a bachelor in nursing here and makes you very competitive when getting a job, BUT keep in mind if you plan on going back to the UK, you will likely not qualify as an RN via the NMC due to having too few clinical hours, even if you have gained experience post-graduation (others can attest to this, or correct me if I'm wrong). In this case, even though you have a bachelor degree, it would be better for you to enroll in a traditional nursing program. Regardless, once an RN, it is never easy to transition across countries, there will be transcripts, paperwork, fees, deadlines and sometimes testing. Just be prepared that it isn't easy, you can see many people post their stories on here, I sympathize with them, but each country has the right to protect the safety of their patients/citizens, so we just have to jump the hoops. Good luck!

In our ED we have "ATIs" I think it stands for active triage interventions or something along those lines. We've had over a year of education along with the integration of them. They are complaint based (theres maybe 5-6 categories), usually include just labs and xrays, and tylenol for fever and aspirin for chest pain, no CTs or ults. Most nurses will avoid the meds though, even if it is only tylenol. I like that my chest pain pts I can triage and order labs including cardiac enzymes, CXR, EKG all at once, often all of those have been done by the time the doc walks in.

Just make sure you have your A-E assessment down and you'll pass the practical portion. I found some of the questions on the written test vague to say the least, but our instructors gave us a study guide at the end of day one and I studied that all night and passed the 2nd day. You need the book for sure, and I would start reading 1 week before to get a good idea of the changes.

I work in a Level II trauma center and we have a T1 (Trauma nurse) for every shift. Our ER is split in triage levels so the Trauma bay is on the mid level triage area (belly pains, general complaints that aren't fast track suitable, vag bleed, earaches, headaches etc). That area takes the minimal complaints and the level II traumas. Level I traumas are taken solely by the T1 nurse, who when there are no traumas, is a float nurse/relief nurse. That section is also staffed by all nurses that are TNCC certified, so if a really heavy level I comes in, they give support to T1 on that pt. That's why they have the pts with minimal complaints, bc if they have to leave them a minute to be absorbed in a trauma, they're not leaving critical pts. I have found that this situation is great because when working on the more critical side of the ER (brain bleeds/CVA, STEMI, SOB, codes etc), if I have to hang TPA or prep a STEMI for cath lab, or have a intense 1-1 ICU pt, the T1 nurse will assist or take over that pt when there are no traumas. Also she will transport ICU pts to the floor so I don't have to leave my other pts. Overall I love our method, it isn't flawless, but it works most of the time, of course we have those freak nights like 2 weeks ago where we had 11 traumas (unrelated) and everyone got a trauma (insert Oprah's voice "a trauma for you, and you, and you" lol)

I'm planning on taking it at the end of summer. I have the Sheehy's book, Pass CEN book and the purple ENA practice book. I am currently in a ER skill course through my hospital which is 3 weeks long and I just took TNCC so I think I should have enough fresh knowledge in my head to pass. I've been in the ER for just over a year and was in cardiac stepdown for 2 years before that (incl. post open heart), so I'm hoping some experience will help. Does anyone rate the 2 day review class as worthwhile? I'm usually a self studier but I don't know if this would condense and bring it all together before sitting for the test?

Hi Everyone, I had to open a new acct bc my email got hacked, so I'm not really new to the board! Hello Hello Hello I have been looking into making the move to Oz several times over the last few years, and I seem to have come full circle and am looking into it again. The first time I looked I was a Tele/cardiac nurse, I am now an ER-trauma nurse. I'm thinking that if I make the move, I'll definitely want to stay in emergency nursing. That's why I would like to ask the question: What's some of the fundamental differences between a US ER and Aus A&E? :) Also does TNCC and CEN certifications mean anything there as far as hireability? Any insight would be great! Thanks!