Starting out in ED vs. Med/Surge

pie123 · Jul 26, 2005

Hi all,
I'm new here......so much great information here. I will be graduating my LPN program in 3 weeks and am getting mixed signals as to where I should target my first employment.
My goal is to be an ED nurse. I have some nurses/instructors saying only med/surge for the experience and others saying that it is ok to start out in the ED as long as you have a good nurse to follow.
I am working on my resume and ready to head out and start seeking employment, just not sure where I should set my job target?
Chelle

I occasionally chatted with a new grad RN who went straight into ED. She loved it. When I told her that I was a nurse apprentice on Med. Surg. (at the time), she looked like she was going to be ill! She told me that I should, "At least try the ED." So, I guess...go for it. I too have heard about starting out in Med. Surg. (which I am doing), to 'get organizational skills.' But, I have to wonder, can't one learn organization on any unit?

While I question this, I am still going to Med. Surg. When I was a nurse apprentice, I worked Med. Surg., then transferred to an Intermediate Care (IMC) unit. I did find that having that Med. Surg. experience helped, not so much for organization, but for information/education. Good luck with whatever you decide.

Chelle2780 · Jul 26, 2005

Thanks for the info, my friend who is s BSN and an instructor says that she sees a few successful new grads in the ED and encourages me to do so but....the vast majority strongly warn me to start in med/surge. The nervous insecure new nurse in me says to follow the lead of the majority. Not that I don't have faith in my friend but I just dont' have that confidence I need as a nurse right now.

Maybe I'll change my mind 6 months into it :confused:

Chelle

ImaERtraumaRN · Jul 29, 2005

I am a new grad in the ED and I don't think there is a hard and fast rule about this. It depends on your personality and how you learn that can make the difference. ED is usually fast-paced and hands-on. I run after my preceptor all day but I get more hands-on experience in one day that I probably would not get on a med/surge floor in a week. I am growing every day and the day flies by. ***BUT*** I am well supported by the staff and my clinical coordinator, have 30 weeks of "orientation", new-grad skills class once a week for a month to get my competencies taken care of plus classes once a month for a year focusing on other things. Part of my dept. orientation was riding with EMS, going to an oncology unit to hang blood all day, a day with the IV team starting IVs, a day in the Cath Lab, a day in our sister-ED to learn how they work, a med class focusing on ED meds, a day w/ respiratory, a day with a phelbotomist drawing blood and doing labs and various other classes related to the ED. I have to be TNCC certified in October and then ACLS in December. I really think that FOR ME this training is invaluable and a good fit. I am LOVING every day. My preceptor calls me a "trauma junkie"

On the other hand if you like to be more laid back, learn at a slower pace where you can take more time then ED is not a good choice. A close friend of mine thinks I am crazy (probably right!) and took a med/surge job first. She likes it alot and it is a good fit.

My advice is to shadow an ED nurse for a day - or two if they let you. Ask LOTS of questions about orientation, how you will be supported, scheduling, learning opportunities, what skills or certifications you will have to have, etc. DO NOT take a job where you have not either done your clinicals or at least shadowed to see what kinds of people you will work with. Shadow on the shift you plan to work also before you accept a position - nights can be very different than days on any given unit.

Good Luck!!

Happy-ER-RN, RN · Aug 3, 2005

Definitely depends on the orientation. I started out with only 5 weeks of orientation. I got a few more weeks but still not enough. I am deeply regretting going into the ER as a new grad. I thought I could hack it since I did well in nursing school and like being busy. However, if I had a longer and better orientation it would probalby be a different story.

Chelle2780 · Aug 3, 2005

Thanks so much for the good advice everyone. I will definately check into the orientation period and I think I am going to stick to med/surge for now. I think I need to jump in and be comfortable being a "nurse" before I enter a fast paced environment like that. I like to stay very busy and love to move fast but.....

Thanks again!

Chelle

MrsWampthang, BSN, RN · Aug 3, 2005

Ok, this is my problem. In the ER you either get it or you don't. I think you know long before orientation is over if you are suited to the ER. In our ER, if the orientee doesn't seem to be catching on, then they are sent elsewhere. If you are at all nervous about entering the nursing field then please do yourself a favor and don't go to ER. They need aggressive, assertive staff members that can think on their feet. I don't think this skill is something you learn if you in the ER if you've never been in the nursing field before. Go to an inpatient unit first where you can learn and build your confidence at a slower pace. Sorry to be so negative. Also, I know our ER won't hire LPNs so that is something to consider too. Does the ERs where you live even hire LPNs, let alone new grad LPNs. Again, sorry to be so negative. Good luck where ever you chose to go!

Pam

MrsWampthang, BSN, RN · Aug 3, 2005

Definitely depends on the orientation. I started out with only 5 weeks of orientation. I got a few more weeks but still not enough. I am deeply regretting going into the ER as a new grad. I thought I could hack it since I did well in nursing school and like being busy. However, if I had a longer and better orientation it would probalby be a different story.

I can't believe your ER released you to work as a new grad in the ER with only 5 weeks orientation. Are they crazy?!?!?! As I said, I think you either get it in the ER or you don't. There's no shame in admitting you made a mistake going to an area you're not comfortable in. If you are regretting it then you need to transfer elsewhere. It isn't fair to you to make you work somewhere where you aren't comfortable. It plays on you self esteem and your confidence. If you did well in school then there are a lot of units out there who could use you. Talk to your manager; I can't imagine keeping someone in the ER that doesn't like it. Good luck.

Pam

Happy-ER-RN, RN · Aug 4, 2005

Yes 5 weeks, but we aren't allowed to take taumas yet and we have a resource person who will come with us when we have a critical pt. or one we are uncomfortable with. We still have uhhh, one week of trauma orientation before we can do that.....at least then there are 5 other people in the room to help though. I start working on my own after two more shifts. I think I have decided to tough it out for at least 6 months. I feel like I know enough to know when I need to ask, and I know enough to not kill anyone, so I guess I just need to try to relax and learn. I think part of my problem is I was used to always being the one who knew all the answers in nursing school, and now that it's real life and not a written test I am very uncomfortable with the fact that I don't know everything! I knew it would be hard and nerve racking, but I just had no idea how hard it was going to be and how very very much I really don't know.

However, I wouldn't say that I am completely not getting it, compared to some of the other new grads at least. For example, a new grad who just left a newborn in resp. distress alone in a room (no Oxygen) while working triage, the same person who was having a panic attack over a 0.6 cc dose of Lovenox--exclaimed "how am I supposed to give 0.6 cc! What am I supposed to do about the air bubble, I need the air bubble!" Sorry, I know that's mean and I shouldn't put others down to make myself feel better, but it helps a little to know I am at least not that far behind. :stone