To all the ER nurses...

Originally posted by I_Love_Donuts

I work in Onco/hemato ped. and in a few weeks I'm transfering to the ER. I want a new challenge and most of all I want to learn anything I can. But I'm scared...I'm not really good at starting IV (we only use central lines)...and I don't know that much about ER stuff...Do you guys have any advices that I could use during my orientation there? Should I start reading about it? If so, what books would you recommend?

Thank you...very very very much!

I have a book that is very good..I got it at Barnes and Noble

"Manual of Emergency Care" put out by Mosbys. As far as the IVs..you will get really really good at them since you will start them over and over and over every shift. I came from HH IV infusion and Onc also so most of my exp was with central lines, epidural lines and implanted pumps and ports. I was comfortable with starting IVs within the first month..you will be too!! Good luck, ER is fun!!!

I started out in ED at a level one trauma center, although I prefer cardiovascular/tele now. Relax. Soon, with practice, you'll be an expert at starting IV's. In ED, no matter what you're dealing with, remember the ABC's: Airway, Breathing, Circulation. Go now and have fun!

Thank you guys...it helps!!:)

keep your eyes and ears open and ask questions! If you arent sure.... ask!

Good luck, keep working on those IV skills, and let us know how it goes.

I really had to beef up on my cardiac rythms when I went to ER. You at least need to know the basics. I remember being sooo scared of iv's when I first got out of nsg school. They're all right - after about a month, it will be second nature.

good luck

We have a nurse that came from onc and she is doing awesome..it is great to have people who have diff. backgrounds such as yourself in ER..good luck!!

When I transferred to the ER from ICU I was terrified of starting IV's on children and babies. There were other skills that I wasn't that confident in either....NGT, foley caths, and believe it or not IM injections. We just didn't do a lot of those in the unit. They were already done in the ER. To build up my skill level, I went to all the nurses every shift I worked and requested to do all the skills I could get my hands on. It really paid off. I rarely miss an IV stick now and I just got my merit badge in blind foley caths...hehehehe

Welcome to ER. This greeting may be as good as it gets. I was born and raised in ER--right aoutta school 20 years ago. Pretty rough crowd. My "orientation" consisted of hanging around on days for two weeks and then going to nights, so I learned everything the hard way. At my first CP arrest code the pharmacist kept handing me syringes and saying, "push this." I felt completely bewildered, since I learned in school that if you don't know what it is, don't give it. I mentioned my concern to the pharmacist. 20 minutes later he handed me the abstracts on all ACLS drugs. That set the theme for my survival game plan--find every resource you can. Learn to watch and listen to how everybody does their job.

Please do not forget that you are bringing knowledge and experience with you. After you get both feet on the ground you'll be surprized to how much truly unique knowledge you have brought to the ER. Back in the old days, onc nurses didn't have so many central lines, so they were really good with IVs and blood draws. Think about how much more you know about central lines than many ER nurses.

I think everybody is afraid of IVs and I was no exception. But to this day if I find out there is a difficult phlebotomy case, I give 'er a couple of whirls if I see or FEEL anything that might save grandma from a central line. I tell those folks all the time that whoever does a groin stick on me will see me upstairs, and I will have a serious talk with them.

I never used a rubber arm, I just used the "watch one, do one, teach one" approach (this is much easier with an ER full of drunks--more members of my resource pool). I got to have Don an ex marine medic who had been a phlebotomist. Man, did I learn some tricks from him, like using a 16 long line anecubitally for "trashers."

Check on the ENA website for educational materials. You should join them ASAP to get their monthly journal and get a discount on their educational materials. There's a great medical book store near the big downtown medical center. I try to go in there 2-3X/yr and still get into a lot of trouble with my plastic. On-line stuff can be cheaper. Check out nursing websites--you'd be amazed at how much free education you can get from them.

Welcome to ER I've done it for 20 years and I love it. You will know within a year or two whether you should stay for the rest of your career or move on. Remember growth hurts and if I've learned near as much as I've been hurt, I must be a genius.

:kiss