Recent ER transfer w/ a question

Published

Hi. I transferred to the ER (oops...ED) 2 weeks ago. I have been an RN for 8 years, spending those years as a PCU/Tele RN and as a charge nurse for the past 3 years. For various reasons I started thinking a change was due, so several months ago I started picking up shifts in the ER (basically as floating help). I got familiar with the charting and flow and decided that this is something I like. Here's my question... My manager, whom I've known for some time now, gave me only three shifts of official orientation with a preceptor (and those shifts were so busy I ended up working on my own anyway). When asked about the short orientation period, she told me that, in review, my documentation was good and that those things that I'm unfamiliar with (trauma and peds come to mind......(we are not a trauma center)), that I would pick up that knowledge as I go. I work with a great group of nurses that are more than willing to answer any questions and lend a hand. The physicians are also, so far, very helpful to the newbie. But I can't shake this fear that there's going to come a time when I'm in over my head and my resources are going to be swamped elsewhere and I'm gonna be standing there like a dimwit. I know, it's probably my imagination running away.....I've handled worse up on the floor over and over. Can anyone recommend a cert course for an ER nurse. I have ACLS, doing PALS next week. Thanks for letting me blather on here....guess I was just wondering if I am being thrown to the wolves or what. On the upside, despite my current uneasiness, I'm confident that I'm going to succeed in the ER....I mean ED.

Up Vote Up Vote ×

One of the best classes for new to the ED nurses who work with trauma is TNCC. It is a good confidence builder, while it is basic, it really does build confidence in working with trauma- even minor trauma like fender bender type people.

and for peds they offer ENPC. PALS unfortunately doesn't teach much except airway...

I'd also encourage joining ENA.

Best Wishes and I will say welcome to what I consdier the best part of Nursing!!!

Up Vote Up Vote ×
Specializes in ICU,ER.

Just remember that nursing is nursing.... the critical thinking and skills you have are with you no matter where you are. It's only a matter of knowing where everything is located...which is kind of a deal, I know. Also, protocols are used a lot in most ER's. I know it sounds nerdy, but read and learn them..even make cheat sheets.... they help out immensely.

Good Luck to you and thanks for joining our ranks... goodness knows, we need the help.:)

Up Vote Up Vote ×

There are also some excellent reference books that should be in your ED. Core Curriculum of Emergency Nursing and Sheehee(sp) Principles of Emergency Nursing are wonderful books. I would also suggest that you become certified if you choose to remain in the ED.

Joining the ENA gives you a wonderful support group also. I work in a small rural ED with limited resources(no OB or pediatric services). Also develop a relationship with some of the ED nurses in larger hospitals that you transfer patients to. They can be a wealth of information and assistance.

Good Luck and Welcome to the forum and the crazy world of ED nursing

Up Vote Up Vote ×
Specializes in Cath Lab, OR, CPHN/SN, ER.

As a new grad, when I came off of orientation, I too feared I would be in over my head.

After getting a MICU patient within my first three days off orientation, I realized I had tons of help there, and I knew what to do and who to go to. Once I faced my fear, I felt so much more at ease (I don't have ACLS or PALS either).

If something is going terribly wrong, your resources will be able to unswamp themselves quickly. :) Drama can draw a crowd quickly.

I think the fear is totally realistic and normal though. I still have those fears with things I'm unfamiliar with. I feel like I do a good job of asking others "hey, I haven't done this yet. Can you answer a question or come help me?"

Up Vote Up Vote ×
Specializes in ER, Peds, Charge RN.

No matter how much time you've been in orientation, or how many certifications you have, there will be a time that you feel over your head.

You'll do great. You sound like an awesome, knowledgeable nurse. Part of the job in the ED is not knowing what to expect. If you have ACLS and PALS, the only thing I can think of taking would be TNCC, just in case. If you feel like there is something you are lacking, study it in your spare time. I still feel uncomfortable with acute MIs, and I try to read up on it as much as I can.

Good luck, I'm sure you'll do great!

Up Vote Up Vote ×
Specializes in Trauma, Teaching.

Another vote for TNCC. Welcome to ER! :yeahthat:

Up Vote Up Vote ×

Ditto to the TNCC course. Your background in nursing will definitely help you. Also, I second the thought of reviewing your protocols of common illnesses seen in the ER.

Up Vote Up Vote ×
Specializes in ER.
PALS unfortunately doesn't teach much except airway...

Your PALS course is obviously a poor one then!

We cover much more than airway - and have toned down the intubation of kids as the new studies show that it's not as important and could even be dangerous.

Chip

Up Vote Up Vote ×
+ Join the Discussion