Published Sep 24, 2013
BelleKRN
15 Posts
Hi all,
I've been a nurse for 2 years on a telemetry progressive care unit. Next month I'll be transferring to the ED. I could not be more excited!.....yet I am very nervous. I understand that the ED is a different world of nursing that I am not familair with. I have been reading a lot of old posts with great info, however, many of the threads are very old. Can we start a new thread for present and future new ED nurses??
How can I prepare?
Resources (sites, books, etc)?
Thanks so much all :-)
turnforthenurse, MSN, NP
3,364 Posts
Become familiar with peds and OB because in the ER, you will see and treat all sorts of ages, from the VERY young (a couple of weeks) to the very old and everything in between.
Books I suggest to help:
Sheehy's Manual of Emergency Care
Fast Facts for the ER Nurse
Emergency Nursing 5 Tier Triage Protocols
Armygirl7
188 Posts
Yes Sheehy's manual of ER Care.
Get to know your critical care drugs and drips - you probably already have a good handle on the cardiac drugs, but soon you will meet tPA, insulin drips, levophed, dopamine, etc.
You'll be doing conscious sedation and all the documentation that goes with it (know your Aldrete scores and how to attach the ETCO2 module to your monitor!).
You'll be straight cathing and putting foleys in day and night.
You'll be getting 24g IV access in the only available vein in the thumb of a dialysis patient.
You'll be responsible for door to balloon in
And you'll be juggling all these aforementioned things simultaneously. So what you really really need is to grow another set of arms and eyes in the back of your head!
It took me a solid year to stop feeling like a bumbling moron and now after 2-plus years it's just been leaps and bounds of improvement and competence - so stay with it! It is normal to feel overwhelmed at first - but you are never alone in the ER. Recognize your allies, and do not inhale the noxious gas emitted by bitter mean co-workers (there will be some in each field: MDs, PAs, RNs, PCAs, etc!).
Stay on orientation as long as they will let you. It's a true team effort in the ER and you will go through some heavy sh&t with your teammates but that builds this wonderful comaraderie that makes going to work and helping both your co-workers and the patients a joy.
I will defintely get that book. It was recommended by a couple of other people too. I definitely need to get better at "hard" sticks. I am pretty decent with IVs in people with moderately "good" viens. I will look for resources that can aid me in becoming better obtaining IV acess.
Thanks a thousand!! @turnforthenurseRM and @armygirl7
Belle, the great thing about the ER is you will do so many IV sticks in one shift that you will become an expert by doing. Your resource for tough sticks is the go-to RN who just has a knack (there's usually more than one on every ER shift). Learn from them, they all have little tricks and tips, and imitate their calm, serious, confident demeanor! You'll be popping lines in impossible places in no time.
But never beat yourself up. Learn from your failures without being defeated. Dust off and move on. Even the best IV nurse we had on our unit - she just retired :-( - used to tell me "Some days I can't hit the side of a barn!"
Best of luck!
Thanks armygirl7 that really helps :-)
melissa8321
17 Posts
Well for starters you did yourself a world of good by starting out on a telemetry floor because you have a good foundation of cardiac and respiratory, which by the way is the most important..."A,B,C's" :) The rest of the other stuff just falls into place. There is a really good book made by the ENA that I still use to this day to reference that helped me out a lot when I first became an ER nurse http://www.barnesandnoble.com/w/emergency-nursing-core-curriculum-ena/1100251404?ean=9781437726565 it's also a great book to use if you ever want to get your CEN. Don't ever be afraid to ask questions in the ER, no one knows everything, and if you are ever unsure of something always ask. Good luck to you I'm sure you will do great!!!! :)
Lunah, MSN, RN
14 Articles; 13,773 Posts
I love Sheehy's - fantastic resource. We used it heavily when I was a new nurse doing an ED nursing fellowship five years ago. A bit pricey but worth the investment!
Thanks so much everyone. I have the Sheely book. I start in one week......."biting nails"
EDFlyer
1 Post
I am also starting in a week in a new ER position! Should be a great experience.
Esme12, ASN, BSN, RN
20,908 Posts
Good Luck! remember you can come here and ask questions!
floridaRN38
186 Posts
Always ask questions. Even if u think it is a stupid one. I still ask and have been doing it for 5 years. Learn to prioritize your patients. Always ask if help if you are drowning. Make sure that all the techs in the ER love you. They are a big help