The Big Question

i would say take your acls,pals and tncc whenever you can, probably as soon as you can. in our er you have up to 3mos. to take acls & pals, and 6mos to take tncc before you get a nasty gram from the unit director. as far as cen/ccrn, i'd recommend you concentrate on the basics of being a new er nurse for at least 4-6mos. before you start getting into cen stuff, but that all depends on what type of er you are at, if it's a high volume er 50,000 visits a yr and much truama/cardiac or a slower er 15-20,000 per yr where you don't see as much of the "good stuff". as far as the ccrn, you need to get into a icu somewhere and spend much time tinkering with hemmodynamics,vent's,vassoactive gtts and other critical care concepts before you try to take the exam. I do know of a rn that took/passed the ccrn while they were working in the er (he just needed the certification to help him get into crna school) but he did have some previous icu yrs and even worked part-time/prn in some of the units here. i'd recomend getting the concepts of basic er nursing down first, good er a,b,c's...when you start handleing or being the primary rn on real low sick patinets, then it'll probably be a good time to start studying for cen, because you'll have past hands on exp., remmember the old maxim, "there is nothing like exp." I hope this helps, but i'm sure i did'nt tell you anything that any older rn in your dept could'nt have.

You need ACLS, PALS and TNCC (if your hospital is a trauma center) ASAP because you need that knowledge to function. The hospital also needs to be able to demonstrate to JCAHO, the state, and whatever other abc regulatory agencies that their staff are qualified to do their jobs in their assigned areas of the hospital.

Certification in a specialty area is different (CEN, CCRN, etc.). Certification is not necessary to perform your job but does (in an ideal world at least) indicate expert status. Unless you've been a medic, you'll want to wait at least a year to take the CEN exam. The content of the CCRN exam is heavily weighted toward hemodynamic monitoring. Unless your ER holds many unit patients for a long period of time and you are very comfortable with the finer points of hemodynamics, you'll want to put that one on hold for a while until you've mastered the ER basics and are routinely assigned the sickest patients.

Some trauma centers require CEN certification within so many years of employment. IMHO, it looks good when the surveyors come around.

I would imagine you're definitely going to need CPR, TNCC, PALS, and ACLS. As for when to take them, as Bullydawg said, probably will have to take them fairly soon, as in 3-6 mos. You're employer will tell you. Also, don't worry about your schedule. If they want you to take these classes (which most ER's mandate) they will either schedule you or give you the time off as long as you give them notice. Since you're new and on orientation, your manager is relying on you as a staff nurse yet so you schedule can be flexible. If the class interferes, either take another one or work a different night with a different preceptor. Sometimes working with someone else can work towards your advantage; seeing how they work and handle things. As for the other certs, in due time. You're going to need experience first. Good luck and welcome to the ER world :welcome: