Useful student placement areas for future Emergency Nursing

[AntigenicShift]

Hi, I'm a new graduate entry Nursing student in Australia. I'm currently very interested in a career in Emergency Nursing, but obviously without any experience in the field to inform my decision.

I plan on preferencing placements in Emergency departments later on in my degree, when they become available. In the meantime I have placements in other medical wards and was wondering if there are any medical wards in particular that would be the most helpful in building skills and knowledge which may be useful in Emergency Nursing.

Wards that I'll be able to preference include Cardiology, Vascular, Respiratory, Infectious Diseases, Neurology, Internal and Thoracic Medicine, Rheumatology/Endocrinology, Geriatric Assessment and Rehabilitation, Extended Carem, Ophthalmology/Rheumatology/Immunology and Renal. Obviously I'll be learning very useful skills and knowledge where ever I end up being placed, I was just wondering if certain units would be more advantageous for a future career in Emergency Nursing.

Thanks for any help.

Cheers,

Cathy

[Double-Helix, BSN, RN]

Cardiology would be helpful. In the ED, you'll have many patients come in complaining of chest pain. You'll need to know how to recognize and treat a heart attack. You'll also see other cardiac conditions such as CHF, heart failure, and A-fib. A good background in cardiac assessment, medications and EKG rhythm strips will be a big help in the ED.

Respiratory would also be helpful, as you would probably see a lot of people come in with exacerbations of COPD, asthma, colds/flu, and pneumonia. Lung sounds can tell you a lot about a patient's condition, and respiratory will give you great practice with various lung sounds.

Also, you can shadow in the ED even before you are a student. I'd think about calling your local hospital and asking to shadow for a day. That way you can get a feel for what an ED nurse does and see if you really like it.

[AntigenicShift]

Thanks for that Ashley. I was thinking Cardiology and Respiratory too, so I'm glad that I'm on the right track. :)

I've actually found it difficult to find a shadowing place at the hospitals around here. They say I should just wait for a ED placement so I can use the University insurance. I shouldn't have to wait too long, I think I'll be able to preference ED placements next year.

[murphyle, BSN, RN]

Second the recommendations for Cardiology and Respiratory. I'd also tell you to focus on Neurology and Internal Medicine. Stroke care is one of the big "in" things in emergency as of late, and Int Med is going to be a big help in dealing with all the non-cardiac chest pain, belly pain, peripheral vascular and miscellaneous other "stuff" that comprises about 80% of your average ED's traffic.

If you can swing it, you might also want to have a crack at a placement in critical care someplace, whether it's surgical, medical or cardiothoracic. Learning how to deal with invasive monitoring, central access, and cardioactive and vasoactive drips are some of the biggest "scare factors" among new RNs in my department. If you can avail yourself of at least some exposure as an SN, you'll be well ahead of the game when that 85 y.o. septic train-wreck hits the doors (which is going to be at least once a week ) and your docs are calling for the whole EGDT package.*

Hope this helps, and best of luck to you!

* Early Goal-Directed Therapy, the premier evidence-based treatment package for sepsis/septicemia. Consists of early central access with CVP monitoring and/or ScvO2 if your hospital has it available (or serial MvO2 draws if not), A-line placement with continuous ABP monitoring, aggressive fluid resuscitation, vasopressors if indicated to maintain MAP >= 65, blood product transfusion if indicated for anemia or coagulopathy, early initiation of antimicrobial therapy, and serial lactate draws as a surrogate measure of tissue perfusion status. In this case, 'early' means we're doing all this stuff downstairs, long before the patient hits ICU. Fun!