questions about e.r. from s.n.

RN92 · Dec 4, 2004

For new grads, orientation to er shouldnt be less than 12wks. However, you would probably have an easier transition if you worked on the floor for a while first. Before coming to the ER, you need to already know how to prioritize, how to deal with stressful situations, be able to start iv's fairly easily. I have known new grads to come straight to er and do well after the initial shock!! good luck

CEN35 · Dec 5, 2004

hi, i am soon to be graduating - this semester and i spent one day at the e.r. for clinicals. i love it there! many of the nurses suggested that i should work at least 6months - 1yr before going to the e.r. due to stress. however, i'm thinking is that a hard to switch? reason: i might get comfortable there, new graduate, and the process of switching is that easy?
also would u happen to know how long the orientation or training at the e.r. would take? thanks.

Everybody has their own opinion, go to a floor first, don't go to a floor first etc etc. I came out of school as a new grad, straight into the ER. My only other training was as an EMT. That was why I went to nursing school, to work in the ER. They standardly give 12 weeks here. At one time, they would have extended it, (from what I have seen) up to 16-24 weeks. Also at the time I came in, they only hired one new grad per year into a unit or ER. However, that has changed. They hire many each year into the ER now (from what I hear), Which is a HUGE issue. It's a diservice to new grads, because the experienced nurses that are available to help are limited.

Here is how it went for me:

I started orientation, and after 8 weeks they said I was doing great. They said I cold go it on my own. I thought that was great! Gradually it became busier. Many times we had a number of high acuity patients in the ER at one time. This meant less help from others. At times I thought maybe it wasn't for me? I became extremely stressed, almost to my end a few times. I kept pluggin along. Like any new grad, you think they have taught it all to you. You realize, it's just the tip of the iceberg. Things slowly became better and eventually breezed through most things.

Bottom line? The first 6 months the learning curve is huge!!! The second 6 months, Big! The third 6 months mediocre. The 4th 6 months less than mediocraty.

Bottom line? 2 years to feel, you can handle anything. I hung out there 7 years, and did great. the docs even tried to hire me into their group to help assess, and work up people. As you maybe know malpractice these days is a huge issue, and it didnt work out. The ER had become the ER/nursing home. Half floor patients, half ER patients... and it appears to be a nationwide issue. Older aging population, and not enough hospitals or healthcare workers. Which includes floor beds, so the ER gets stuck. The bad side? Floor and ER nursing are completly different mindsets, its hard to mix and get everything done. That r/t a lot of political issues. So I left and went to PACU, and work with post op patients and anesthesia. That has been a whole entirely different area.

You have to decide what you want to do. It worked for me jumping into the fire, but I have seen it fail miserably first hand also.

GOOD LUCK!

veetach · Dec 7, 2004

Every new grad is different. If you had experience in the field of emergency medicine like CEN35 did, I would say go ahead and hop into the ER. But... if you dont have that background, it would be much easier on you to work in another area first. The ER is not a controlled environment, and we work with so many unstable patients that it can be overwhelming on a new nurse.

Our ED hired 4 new grad nurses last may, after graduation. One of them dropped out immediately and out of the other three only one has transitioned smoothly. That is after 16 weeks of intense orientation, precepted time and classroom instruction in emergency care...