Stressing myself in the ER...do I suck or what??

[clairebearrn]

So, I have been an ER nurse for about 8 months, in a busy county ER...I still feel like am getting the hang of things...but I haven't gotten the confidence I would like...I feel like Im really slow, cuz sometimes I get patient after patients and discharge after discharge and I end up feeling like I missed something by not being able to think 100% regarding a pts dx....its very high paced...I always second guess myself and feel intimidated by some doctors, who can be nonchalant about a HR of 39, Bright red emesis, hgb of 4, etc...I tell them, "can you write me something for pain," and they just stare at me with a blank face...Like yesterday, I had a pt who came in for CP, ekg was normal and no cardiac enzymes had been drawned. the doctor sees the pt, but doesnt order anything...an hours goes by, while am busy with another CP/SOB, and still no new orders....nothing I ask the doctor if the pt can eat, since hes been asking me every 5 minutes...and then the doctor loudly says, "god, dont you know hes a r/o acs and may need a cath...so no he cant eat...." I was so embarrased, but in my head I was like, "you are so stupid, you havent even ordered anything, even cardiac enzymes, a d-dimer, anything, and yet you already plan a cath..." but all i did was walk away....

and then my heart starts racing when i have super critical pts:redbeathe:redbeathe...like I start thinking, "omg, what if he codes, i dont know how to cardiovert, etc, etc..."

Ive been noticing that other new grads were allowed to go into trauma bay area (we are a trauma hospital and receive super critical pts, like GSW, cardiac/traumatic arrests, all those tier 2 pts)...before me and they started after me...This really took a blow to my confidence and now I feel really bad, like my nursing skills must suck.....they must if everyone can work trauma, except me...

I dont know what to do, other nurses tell me am doing good and that I am very directable, that I focus on what I gotta do and do it...but I dont know why i feel this way...Ive noticed other nurses are so calm and collected, and joke around with the doctors, etc...and then there I am, like I dont fit in...so im frustrated and dont know what to do...I would really appreciate some advice..:cry::cry:

THANKS!!!!!!!!!!!:heartbeat

[crb613, BSN, RN]

About the North/South thing....I am in the South & we have protocols for everything from dog bites to cp!

[gonzo1, ASN, RN]

Mommyvicki,

It sounds like you are doing a very good job. And you are right, you don't know what you don't know. Don't be in such a hurry to jump into trauma. Spend time perfecting your skills in the area you are in.

You say you are scared when you get certain patients. Well, I still am sometimes too. Almost everyone is.

Remember, it's not just a "glamorous job" or a skills/competition game. We have these peoples lives in our hands and we owe it to them to be the best/smartest we can be.

Embrace the time you have in the area of the ER you are in and be a learning sponge. I believe God puts us where he wants us to be. You will have plenty of time to be in trauma later.

I worry that these people who jump into trauma are not ready to be there. And everyone I know says an overly confident/arrogant nurse is a scarey/unsafe nurse. (we all know these types)

Pace yourself and start getting certs like Loricatus suggested and before you know it you will be feeling more confident.