Training time for the ER?

Congratulations on becoming an RN. You said you have a paramedic background - I know you probably had to do certain procedures without MD order (protocol). There really isnt much of a difference.

Once you have been there for a while - you will learn what different Doctors expect and you'll become more comfortable.

However, for people that dont have a medical background of some sort, really shouldnt be working in the ER. Yes, I know there are a lot of very smart new grads - but, some skills are only improved/perfected with time.

Orientation varies with each new employee. There should be at least a 12 wk period for new grads. Older, more seasoned nurses could probably get away with 6-8 wks.

Dont let them push you out on your own before you're ready. This is not an area to be taking shortcuts.

Hang in, there.

I was wondering what a good length of time is for a new RN to be released from training? I am a new nurse with a paramedic background and started working in the Emergency Room for almost a month now. I have a progress review meeting at the end of the week and was wondering what other ER's do? I feel confident in most aspects - patient care, charting, medications, etc. but still trying to get down ordering tests and x-rays without the doctor first seeing the patient. A nurse said to me yesterday, "you need to be more autonomous" but I just have a problem with ordering x-rays on someone prior to an initial exam by the doctor.

Sarah, When you say new nurse, are you a new graduate? In my ER new nurses(even ones with paramedic training) would be precepted for at least 3 months in they had no prior ER/critical care background as a nurse. Paramedic experience is good and helpful, but nursing a lot different from paramedic. We never throw anyone to the wolves until we are sure they are ready and capable of flying on their own, and even then Sarah-you are never alone, there will always be someone with a little more experience to ask. My preference would be that you ask before doing if you are unsure, this protects you, the patient, and your unit/facility. If any of the other nurses on your unit give you any grief about being unsure or asking questions then dammit they need to wake up, smell the coffee and remember that they too were once the new kid on the unit. I have worked for 19 yrs in the profession and have dealt with these primadonnas and have absolutely no problem in tearing them a new one. I love working with new nurses, experienced nurses and even student nurses, you can always learn something.

Currently I am one of the charge nurses on days in my 31 bed ER and fully believe in growing our own nurses since the amount of experienced ones aren't always there. Two of my friends on night shift are nurses and were paramedics first, and have never worked anywhere but the ER. Talk to your manager, director and preceptor about your status and let them know how you feel, and what you feel you may still need. If there is something you are not comfortable with, make that your next goal. At lunch and on break ask the other nurses how they do this or that and pick their brains. learn what you can, so you will feel confident and be safe in your practice and be an asset to your unit/facility/community. If you need any advice or want to talk or growl at someone or just pick my own little brain then feel free to contact me. My email is [email protected]. By the way I sent you a PM about a question you asked of me. Good luck and take care...flaerman( aka Paul)

amount of time to orient to ER? varies.

it depends many things: the unit, the docs, the other nurses, the personality of the grad.

a standard answer would be at least 3 months before you are expected to carry any patient load completely on your own. to feel comfortable in the ER? in my experience, i've been there 2 years in december (first as a tech and then a new grad RN). i'm just now comfortable when i get that trauma at 4:30 a.m. and our dept has gone down to 2 nurses.

When I started in the ER (as a new grad) it was 3 months as a standard. then they let me go, and the learinging curve is huge the first 2 years. Then it falls to almost nothing.

However, there were alot of people that had it extended 6 additional weeks at a time. For one person it was extended almot 7 months, she quit after 18 months.

I DON'T KNOW WABOUT NOW? I left 18 months agon, and went to PACU and surgery. Now they house so many INP's, there is way more to know.

The standard orientation period at my hospital, Thomas Memorial in South Charleston WV, is 27 weeks for new ER employees. The first four weeks are all in the classroom regardless of experience. The remainder can be extended as needed or shortened if appropriate for the individual. While on orientation a preceptor is coassigned and must sign off on all activities.

I had 17 years in EMS as a Paramedic and over ten years teaching ACLS, PALS, and BCLS and the orientation program was excellent in my opinion. Even seasoned ER LPNs who went back to nursing school had to go through the 27 week orientation.

From speaking with my fellow nursing school classmates, Thomas Hospital's orientation program is definately the exception and not the rule.