Still a student, my heart set on ER...

[karleigh]

I'm a student, just starting the core curriculum and clinicals in January. I can't see myself working anywhere but the ER, in fact, we have a level 1 trauma center here, and that's where I want to be. I love the adrenaline rush, craziness, and always changing atmosphere. Much like my home life with three kids (four if you count hubby :-), I call it organized chaos! I was just hoping to get advice from experienced ER nurses as to what I can do during school to prepare myself best for the ER. Are there any additional classes or certifications I should look to do to better prepare? Is it likely that I can get a job right in the ER out of school, or will I have to work somewhere else for experience first? Any advice would be greatly appreciated.

Thanks!

[Larry77, RN]

How do you know you like the ED? Have you precepted there or do you just think that you want to do it? If not, definitely try to get a preceptorship down there to see what it's actually like on a day-to-day basis.

If there is an intern position at your hospital they often take new grads and the programs I'm aware of are 12 months long and give you all the extra training you need to be a functioning ED nurse.

Other ways would be to work med-surg or tele and get your ACLS and PALS training done and keep applying to the ED and get to know their manager as much as possible. Also helps to have an "in" with one of the nurses :)

Good luck!

[LoveMyBugs, BSN, CNA, RN]

I dont know how much longer you have in school, but have you tried working as a CNA in the ED to give you some experience there? I am a CNA and just got hired in the ED about 2 months ago and I love it. I was told by the ED director that once I am done with nursing school than I can pretty much count on a position in the ED. So working as a CNA or ED tech will most likley give you an in and an idea of how the department runs. Oh and I love working in the ED

[jackson145]

I'm hoping to work in the E/D when I finish with school, also. I can go right to work in the IS department but I'd miss working with patients. Our hospital is thinking about making it mandatory to work 6 months on Med/Surg before taking a position in a specialty area. However, most of the nurses in our E/D have never worked anywhere else. They just walked out of school and into either the E/D or ICU.

[SKQQTR]

I'm an ER Nurse now with about 11 years in the ER. First it's good that you want it. I spent 2 years in Tele, floated alot to ICU which is great experience but I must admit "I" didn't care for it much. If you are in a BSN program some hospital offer "Extern" programs for a 8 to 12 week stint in the summer between your 3 and fourth year so it's worth asking. I got that chance and not only was it a great experience but down the line my precepter became the ER Head Nurse so at first I filled in and when a full time slot came up (several years later) I had my foot in the door. That said, when I started there were a glut of Nurses and it was hard to get any job. I ended up at a tough inner city hospital, as I said first in Tele but after 2 years I got a shot at the ER and worked there for the next 5 years. We were not a Level I, but a Trauma Center (often refered to as the gun club) I've worked a bit of Level I, too, and it is great but one can usually get more hands on in a Trauma Center as often times there is only one Doctor so the ER responded to all hospital codes. The doctors felt we should learn how to intubate, as a house fire could easily overwhelm just one doctor so that was very cool. You might be lucky and just walk into an ER job but it's not the norm. Just keep an open mind, you will learn stuff wherever you are. I did not like working on the floor but I learned alot really especially how to organize time. Not everyone can cut it in the ER, it is a demanding, emotionally volatile, and potentially dangerous area, that said if you are an adreniline junkie, it's probably where you want to be.:welcome:

[JMBM]

Its wonderful that you are interested in ED work, and I absolutely encourage you. I also agree with the earlier respondent who wrote that you should look for opportunities to volunteer or somehow else become involved in an ER as soon as you can. Any of us in the ER have seen many, too many nurses start or transfer in to the ER, then leave in a few months because it is not at all what they thought it would be. One of the prime things you can have on your resume is prior exposure to ER work so you can honestly tell your prospective employer that you know what you're getting in to. (You might also learn that the real-life ER isn't quite your spot.) That being said, I think one of the unique things about ER work is that we see everyone and everything -the old, the young, the recently healthy, the terminally ill, the sober, the intoxicated, the sane and well,,, everyone else. Learn everything you possibly can in school. Especially learn critical care, pathophys, and pediatrics (kids are scary in the ER.) With the exception of care plans and nursing diagnosis', ER work will demand absolutely everything you can learn. So, when you're not taking extra coursework, go stock linen or something in your local ER. Best of luck

[andhow5, BSN, RN]

It sounds like you understand what a zoo you could be getting into!

There are 2 groups it seems to me:

Group 1 - Get experience first, then go to specialty

Group 2 - Go right into specialty - they'll train you

Both groups have excellent points. But the best answer you can get is the answer you give yourself after doing a brutally truthful self-assessment. If YOU feel that you perform well under pressure, can think quick, and have faith in yourself that you could recognize a situation that requires immediate attention; I'd say, "go for it", "go with your gut instincts", and "follow your dreams".

[SDS_RN, RN]

I knew before I graduated that I wanted to be in the ER but at the facility that I work in they want at least 1 year of experience. I did apply for a position when it came up but I did not get it because it went an ICU over myself who worked on surgical and pediatrics. Then 2 of the ER nurses got coordinator positions and their was another ER opening so I applied again and got it. I have been there for about 2 months now and just got off my 6 week orientation. I like the variety of patients that come through and the fact that I don't have to work on the floor with the same type of patients every day. This time of year is really busy for us on any floor but the ER comes with a whole different stress level than being on the floor. I am glad that I did get a year of experience in before I started but on the other hand if I could have started there from the get go I'd already know how things work and how to handle all the different things that come through the door. I like working in the ER and I'm looking forward to getting my ACLS and TNCC so I can be a better nurse and provide better care for those situations that require that type of care. If ER is what you want then you should try it if the facility allows for new grads.

[Itshamrtym]

hello:

i've been a nurse for 10.5 years. eight of those years doing mostly pediatric home care private duty. was an lpn for 8 years before getting my rn. have always wanted to do er. actually shock trauma. our trauma center requires 2 years of icu experience before they will hire you. have been doing or for the last 2 years. just got hired in the ed. . i'm so excited but also so scared. of all things iv insertion scares me to death. we don't insert iv's in the or, same day surgery and anes do this. any advice would be helpful:idea:. as far as new grad's working in the er/ed as someone else mentioned i think it should be on a case per case basis. i have talked to a lot of ed nurses and a lot of new grads and they do 'awsome' in the ed!!!! some have been running charge after only about 2 years. it is very doable..... if you have your heart set on ed..... go for it... keep us posted.............

[Freedom42]

Karleigh: I'm with you. I need adrenaline. Although I'm still a student, I think I'd like to work in the ER. So I asked my faculty advisers how to prepare. To a person, they all urged me not to do any practicum work in the ER because I wouldn't get a chance to practice, repeat and build skills. Too unpredictable, they said.

OK, that made sense to me, so I set out to get a volunteer position in an ER. Figured I could at least see on my own time whether it was what I truly wanted to do. For me, volunteering was the best option. It took me four months to get a volunteer position, as the medical center in my area typically doesn't use volunteers in the ER. But once I established myself as reliable, I had no problem getting nurses to let me shadow them and, where appropriate, they ask me to assist with procedures. Most are terrific about sharing their knowledge, and they're enthusiastic about it. I'm really grateful to the charge nurses who'll pull me out of a room to say that there's a procedure going on that I ought to see. I've had docs call me into rooms so they can show me unusual cases. When my classmates joke about the first time we'll have to put in Foley catheters, I think about how many times I've watched that procedure. (I always introduce myself to the patient and explain that I'm a student. I haven't had a person yet who's asked me to leave.)

It's been an incredible experience, and I think I've been better off as a volunteer than a CNA because I'm free to do whatever I want. That said, I heartily agree with the poster who suggested getting down to your local hospital and stocking the linen closet. When I started volunteering, I also shadowed aides. Once they showed me how to negotiate supply rooms, I was able to respond quickly when a nurse needed something or when a stretcher needed to be made up fast. It's simple, but willingness to perform simple tasks helps to establish your credibility and sincerity. Then the nurses are that much more likely to ask for your help and teach you something in the process.

[ERbunny]

jackson145 said that most the rns at their ed just walked into their positions without prior experience. I know it works for some, but can be really brutal when it doesn't. There is a thread in tis forum by a new grad, cwweeks, who has gone through quite a growth period. Many of us old timers did indeed start out in icu, or ED, but believe me the standard of care was quite primitive compared to today, and I shudder to think of what I would be facing if I was an inexperienced nurse today. Experience as a tech is immensely valuable, however many of our RNs who went through our residency program ,after being our techs while students, say that the difference in roles is mind boggling...as it should be. I am interested to know why you are so determined to be an ED nurse. It is definitely not glamorous. It is mentally , physically and emotionally challenging. Read the post about the RN who lost a pedi code to drowning his first day on the job. Like the old Army ads..you can be "all that you can be"...and still more will be required of you. The beauty of nursing is that we have an opportunity to do meaningful work in an infinite variety of ways. Good luck to you in your career, and keep an open mind. I have spent 38+ years and critical care, and am not going to change at this date, but my other great interest is the opposite end of the pt care continuum, rehab nursing. What could be more rewarding than to help the shattered people who survived their trauma thanks to the ED, get back their ADL skills ? Best wishes to you.