Should I work in the ER?

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Hello, all! I graduated nursing school in August 2007. After graduating, I moved 3000 miles away from home and took a job in a small hospital on a post-surgical unit (it also served as the PCU, tele overflow, medical overflow). I received 6 weeks of training (which was really me just being thrown onto the unit with little guidance) and it was not a good time. I realize that this is true for most new nurses, regardless of which type of unit they work on.

I have relocated back home and have been given the opportunity to work in the ER (which is why I got into nursing). I am in the process of applying for endorsement, which apparently takes 4-8 weeks. The new grad (EDNIP) program at the hospital doesn't start until July, but the nurse manager offered to let me work as a Tech in the ER until then. The training program is 16 weeks long, both didactic and on the unit with a preceptor.

Most people seem to be of the opinion that one should have 1 year med/surg experience prior to entering the ER. I do have an opportunity to work on a med/surg unit and am torn. The nurse manager and I from the ER hit it off immediately, it just felt like a good fit. While I realize that year of med/surg is great for honing in on assessment, prioritization, and delegation, I feel this ER internship program is a fantastic opportunity. I also think it could be really hepful to work as a tech first (even though I am an RN), it'll give me a chance to see how everyone operates and how the unit flows. It will also give me a chance to really experience how an RN functions without the responsibility of being the RN. I feel that this would be excellent preparation prior to being in the training program.

Any thoughts? Input?

Thanks!:yeah:

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Specializes in Emergency & Trauma/Adult ICU.

Grab the opportunity.

Welcome to the ER! :nuke:

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Specializes in Emergency.

I went straight to ER after I graduated, and I have no regrets. Its been tough though, some days much better than others. If you have a strong backbone and are willing to learn, then go for it.

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Specializes in Med-Surg, ER.

There is no substitute for a solid orientation and preceptorship when moving into a new area of practice. My ED has made a strong commitment to hiring new grads and has a three month orientation program which is taken very seriously my ED management and preceptors. I think that the right person, who is willing and able to learn can do just fine without med-surg experience, *if* given a strong preceptorship with a qualified mentor. ED has a very different focus than med-surg. You would learn some pathophysiology, pharmacology, and procedures in med-surg, but you can learn those during a preceptorship just as easily, I think. I was an LPN on a surgical floor for a year before getting my RN license and moving to ED (as a new grad), and while I was able to apply some of what I learned on the floor, much of it is different because of the acute nature of nearly every case in the ED.

As for working as a tech, I think that you should consider it - it will be slightly awkward, but it sounds like you've found one of the progressive, supportive departments out there. You will learn a great deal, and since they will know that you are waiting for your license to arrive, you'll probably find some informal preceptorship happening as your new colleagues find opportunities to do some teaching.

Pay close attention to your scope of practice. As an RN, you will automatically want to do certain things that you know how to do, and you are capable of doing, but you can't do within the scope of an ED tech. You might also experience some pressure during a crisis with others asking you to do things that *they* know you are capable of as an RN. Practice your responses early to politely decline to do things that are out of scope. Read your new state's practice act, and compare it to the scope of an ED tech. Incorporate and accept the ED tech role.

Congratulations on your new opportunity. Let us know what you decide.

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Specializes in CNA, Surgical, Pediatrics, SDS, ER.

I worked med-surg 1 year and if I could have I would have went straight to ER to be trained. The ER is so different from med-surg in many ways and if you can get the training and experience now DO IT!

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I'd take the ER opportunity, but I would pass on working as a tech. I've seen a lot of techs become nurses, and then have trouble working with the other techs to recommend that. I think I would rather work in the M/S unit until July,if I had to make a choice about that.

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Specializes in ITU/Emergency.

It sounds like a good oppurtunity to me! I wouldn't hesitate. As for the tech job, I would be careful as you might be tempted to work outside your scope of practice or even do so without even thinking about it, which could put you in a vulnerable position if anything happens. So, in theory it would be nice to work as a tech, you need to look after your registration and look into the legal side of it.

Good luck whatever you decide!

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Specializes in ED, ICU, Heme/Onc.

If you are a RN, you can't work as anything other than an RN. Even if you were a tech - which would be unlikely because no facility would hire an RN to do a tech's job - you would still have the responsibility to be a nurse. Essentially, you have a legal responsibility to practice up to the parameters of your license. Besides, you would run the risk of being "pulled" as an RN to an unfamiliar job if they were short a nurse and realize that you are a RN functioning as a tech.

What you need is a solid orientation. Pick a job that provides that. In our ER, we do not throw anyone "to the wolves" and even after 3 solid years of ICU, I still had a six week orientation. My orientee is a new grad and he's had almost six months of orientation - which is the norm for new grads on my unit. The internship sounds like a great way to re-start your career as an RN.

There is nothing wrong with spending a shift or two with one of the techs. The techs in the ER are the eyes and ears of the place. It's a demanding, strenuous job, and the docs and nurses would not be able to function without them. But you are a nurse. It sounds like the internship offers a lot. I say take it and welcome to the ER! :yeah:

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I guess im a little confused, the boss of the ER said you could be a tech until July, even though you are an RN. Are they willing to pay you an RN salary. Trust me you do not want to get yourself into that situation, they will expect you to do RN jobs to help out but your duty is a tech. If something goes wrong with a pt. while doing a job outside the scope of a tech you could get in serious trouble with the hospital and let me tell you your manager and other nurses will not back you up. Why dont you work on the med surge floor until july and then transfer to the ER. Good Luck

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Specializes in Emergency & Trauma/Adult ICU.

If you are a RN you can't work as anything other than an RN. Even if you were a tech - which would be unlikely because no facility would hire an RN to do a tech's job - you would still have the responsibility to be a nurse. Essentially, you have a legal responsibility to practice up to the parameters of your license. Besides, you would run the risk of being "pulled" as an RN to an unfamiliar job if they were short a nurse and realize that you are a RN functioning as a tech.[/quote']

I guess im a little confused, the boss of the ER said you could be a tech until July, even though you are an RN. Are they willing to pay you an RN salary. Trust me you do not want to get yourself into that situation, they will expect you to do RN jobs to help out but your duty is a tech. If something goes wrong with a pt. while doing a job outside the scope of a tech you could get in serious trouble with the hospital and let me tell you your manager and other nurses will not back you up. Why dont you work on the med surge floor until july and then transfer to the ER. Good Luck

I think I can shed some light on the tech vs. RN issue ...

OP states that she is not yet licensed in the state where she is currently residing -- "applying for endorsement". So yes, I believe she can work as a tech and would encourage her to do so if the ER manager is willing to hire her now rather than wait until July when the new grad internship will begin. She'll get her foot in the door, learn the physical layout of the department & the hospital, learn people & names & faces & organizational structure of the hospital, and get in there and get her hands dirty. She will be way ahead of the game when July rolls around.

I know a number of now-ER nurses (including myself) who continued to work as techs until finding the right job.

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Specializes in med/surg/tele/neuro/rehab/corrections.

So yes, I believe she can work as a tech and would encourage her to do so if the ER manager is willing to hire her now rather than wait until July when the new grad internship will begin. She'll get her foot in the door, learn the physical layout of the department & the hospital, learn people & names & faces & organizational structure of the hospital, and get in there and get her hands dirty. She will be way ahead of the game when July rolls around.

I so agree. :yeahthat:

I work as a tech now in an ER because I want to work as a nurse in the ER when I get my license. I am learning so much and get to see and do a lot. Getting to know everyone is a big plus. Jump at this opportunity.

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