What was orientation like for the ER?

[northmississippi]

If a new grad is going to take a job in the ER, what will orientation be like and what will they be learning/doing, and is there a lot of shadowing first? Thanks.

[JKL33]

Based on various conversations here and "out there" - it totally runs the gamut.

You need to find out the orientation procedure for the specific facility in which you are interested. Generally speaking, you will be learning how to care for the various psychiatric, medical, surgical and trauma conditions which are associated with varying acuities from "nothing" to resuscitation-in-progress or imminently dying. If you are in a mixed ED, your patients will be all ages.

It is a big undertaking to learn the various roles, skills and knowledge associated with working in the ED. If you are personally considering this, do yourself a huge (and absolutely necessary) favor by finding out specific details. I favor a well-organized and fairly lengthy orientation that ramps up from clinic-type care to resuscitation, and one where knowledge and critical thinking are emphasized over learning tasks, careflows, and protocols.

Good luck ~

[amzyRN]

When I did my orientation at my first ER job (it was the same length for new grads and experienced non-ER nurses) it consisted of 10-12 weeks in the department with a preceptor. There were also modules to complete when not in the department. The knowledge you acquire in the ER is broad, across the life span. The work is very laborious at times. You will be doing more skilled activities than in other departments with more concise charting.

[PeakRN]

Our new grad ED program includes 5 months of classroom and bedside orientation. Most of our education is focused on preparing new nurses to take an adult ED pod, but we have them spend time in L&D, ICU, and Peds ED as well. They complete ENA learning modules in addition to TNCC and NIHSS, we require ACLS and PALS in order to apply.

At any point in their orientation nurses may decide that the ED is not for them. We do have a contract requirement if they complete the 5 month orientation but this is not required if they leave before the completion of their orientation. We have had a couple of new nurses who decide that the ED is not for them, we work with them to find another unit that will work well for them and have placed them in ICU, PCU, Peds, and Med/Surg in the past, though I would guesstimate this is less than ten percent of our ED new grads.

As others have pointed out many different systems offer very different orientation programs. I would look around and find one that will provide you a good training experience, and don't assume that a big name university affiliated system is the best. In my experience smaller hospitals often have better training programs, and after 1-2 years you can transfer to your dream hospital with better experience and better pay.