What does it take to be an ED nurse, and should a new grad even try?

Sensoria17 · Dec 18, 2007

Well, I don't know what it takes to be an ED nurse but my sister works at San Francisco General and they regularly hire new grads.

GilaRRT · Dec 19, 2007

Meh..not a big deal. You will have to learn the area like any other area. I never understood the 1 year on med/surge before moving to a specialty mentality. Regardless of where you go as a new grad, your first year will be rough and you will have to struggle to find your groove so to speak. If this whole you must have experience before specializing mentality actually works, does it work in reverse? I have several years of ER experience, so, I must be a top notch med/surge nurse since it is so below my abilities as a specialized nurse? I would not last a day on med/surge. Seven patients all to my self and no doctor within reach for instant orders, I can see how that would work out for old GilaRN.

All kinds of personalities work in the ER. Many will say type A; however, I have actually become much more relaxed and tend to go with the flow since I first started working ER. Now, that personality is really helping me after I took some time away from ER. I think an aggressive mind set with the ability to relax in the face of chaos would be the ticket.

Jump in and try ER, if you hate it or suck at it, not a problem. There are more areas of nursing than you can imagine. It may take a little time to find your nitch. In addition, do not be afraid to mix things up and try new areas as you grow as a nurse.

Medic/Nurse, BSN, RN · Dec 19, 2007

Congrats! Sounds like you are on track to being an ER Nurse!

Everyone starts somewhere. I think that "New Grads" can do fine in the ED with a good preceptor and strong clinical orientation.

Like the "old GilaRN" I'd not last a day on the med/surg side of the house. Also, he nails it - Med/Surg is a speciality as much as any other. I never understood the 1 year rule either.

Personality - well, it takes all kinds. ALL "Type A's" all working together apart can be like doing hard time without any chance for parole. Yikes!! I think that you need to be energetic, deliberate, honest, thorough, confident, organized and committed. Personally, I think the ability to think and act critically is the KEY!!!

I think folks tend to think that all ER folks are more Pit Bull than Poodle - and to some degree that may be right. Just due to the nature of the ED with the increased autonomy, acuity and endless clinical presentations of the patients we see - we tend to have to be very technical and strong patient advocates. (so that is why there is so much barking and growling, errr!!!)

Just remember ---

HOW do you eat an elephant? (if you were to do such a thing)

*** ONE bite at a time ***

Good Luck!

Practice SAFE!

RNcDreams · Dec 20, 2007

You must do what makes you happy, and what works for you. I graduated May '07, went straight to ER, and came off orientation last week... and yes, it works for me :)

If you are sensitive and can't handle a fast pace, you might not like it.

You have to think fast, be organized, and make it a personal goal to always go home and follow up on the new diagnosis, test result, or assessment you learned that day.

You have to learn to work with many, many different (often strong) personalities, and not take harsh behavior to heart.

You have to learn to assess your patients and open your mouth when you know something is wrong, even though the voice in your head says "I'm probably just checking XYZ wrong"..... you HAVE to be proactive and open to constructive criticism and change.

You have to be motivated to learn, flexible, and kind to others. ER is not a place to go if you don't play well with others... you will drown if you can't offer and accept help.

That being said... where else in nursing can you care for a psychotic elderly woman, a child with SVT, a man with a head injury, and a pregnant woman in the same shift?

ER is a wonderful place to grow and learn, so long as you learn to do it safely. EVERY single day, I learn or do something new. It feels wonderful to find the area in which you flourish... and mine is emergency :)

Best of luck, I bet you'll be fab

flychick08 · Dec 20, 2007

I am a nursing student who will be done with school in May. I have always been interested in ED nursing. I had a chance to do some shadowing during my summer internship and really liked it. However, I have not had any experience working in ED. Our clinicals have mainly been on med/surg floors. I was scheduled to precept on a cardiac ICU unit, but yesterday was informed of a new opening for a preceptorship in a ED. I took it, just because I really want to know if I love it or hate it. I was wondering if you could tell me what you think are qualities most ED nurses have, and whether it is possible for a new grad to succeed in this environment. I spent the summer interning on a med/surg floor. I went into nursing wanting to go into OB (like many others did) and find myself gravitating more towards the other specialty areas (ICU, ED etc). I am a 2nd career nurse (33 yr old) and feel I handle stress fairly well. However, I'm new and naive! How do you feel about new grads and what types of personalities do the best in the ED?

Hi. Hope I can be of some help to you. I've been a nurse for 16 yrs.,currently entering my 4th.year of ER nursing and LOVE IT! I too did a preceptorship in an ED back in the day and fell in love with the specialty. Been where you've been, so here's some friendly advice...

Go get yourself some 2-3 years of ICU experience. Yeah...I know you're thinking "Geez, why such a long wait to get in to the ED?" but trust me on this one. You will get your butt handed to you on a silver platter if you go in as a fresh-off-the-press nurse. I had years of CCU and ICU experience when I was hired into our ED and still had the "deer in the headlights"look on my face after every shift for months. You won't be doing yourself or your patients any favors without the critical experience under your belt. You gotta' do critical care medicine at warp-speed with family standing behind you screaming,crying,cursing,etc. Not very pretty. With that being said, keep that passion for emergency medicine and get the ICU experience. You'll be able to cherry pick what ER you want to work in, shifts you want there,etc. It's the best job and the worst job all at the same time every day. You'll love it;)

futurecnm · Dec 20, 2007

Thanks,

The one issue is that it is easier (at least where I am looking at to work) to get a job as a new grad in an ER than the ICU. I have been told it is really hard to get into an ICU as a new grad. And the ER is hiring new grads all the time. I see what you are saying, thanks for the advice.

flychick08 · Dec 20, 2007

Thanks,
The one issue is that it is easier (at least where I am looking at to work) to get a job as a new grad in an ER than the ICU. I have been told it is really hard to get into an ICU as a new grad. And the ER is hiring new grads all the time. I see what you are saying, thanks for the advice.

Yep...you're right. It is easier to get a job in an ER in most places. Why do you suppose that is? High turnover rate because they throw fresh-faced nurses into the lions den. If the trauma and general human misery of what rolls in daily doesn't get you, then the burned-out cynicism of your coworkers will. Get your feet wet first-then jump into the deep end of the pool.

futurecnm · Dec 20, 2007

Yep...you're right. It is easier to get a job in an ER in most places. Why do you suppose that is? High turnover rate because they throw fresh-faced nurses into the lions den. If the trauma and general human misery of what rolls in daily doesn't get you, then the burned-out cynicism of your coworkers will. Get your feet wet first-then jump into the deep end of the pool.

I take it that ED is not a fun place to work??? I really am clueless I just wanted to hear if anyone has gone into ED right away and the pros and cons. I guess if I'll just be thrown into the lion's den then maybe I'll stay away:uhoh3:

I am also considering float pool to get an idea of where I want to work. They always are looking for float nurses, even though that probably isn't ideal for a new grad also!

flychick08 · Dec 20, 2007

Actually, float pool is a VERY good idea! That way you can get an idea of what might be a good fit for you. Don't get me wrong.... I love being in the ED, but I would have been eaten alive if I hadn't had ICU experience first. If you really want to do it, by all means do it! But you can get some good experience behind you first:balloons:

SDS_RN, RN · Dec 20, 2007

I just graduated in 06 and I have worked on Surgical and Pediatrics for about a year and a few months and I just made the move to the ER and just had my first day off of orientation on Tues. One of the advantages of working on surg was that I got to know the docs in the facility and what they like so that also helped make the move easier for me. I am glad that I had the surg/peds experience before going to the ER, however I feel like I lost a lot of my nursing knowledge and skills because surgical and peds really are quite specialized. I have pulled my nursing books back out and have been on the internet looking stuff up like crazy because I like to know what I'm doing and I want to make sure I'm doing is right. I'm liking the ER but now I have to build my confidence back up again and I feel like I'm starting all over again. I guess that's how it is with any new job or task that you take on. I just try to keep a good attitude and ask questions when I don't know the answer.

I also had the strong drive to end up in the ER after graduation and I'm glad that I have fullfilled that goal. I am looking forward to my new journey learning to be a good ER nurse.

I think that to be a good nurse no matter what area you are in it takes the guts to stand up and ask questions if you don't know something and to admit the mistakes you make and learn from them. Take full advantage of your orientation and ask for more if you need :idea:it. Good luck to you and if the ER is where you want to be then you need to go for it.

futurecnm · Dec 20, 2007

Actually, float pool is a VERY good idea! That way you can get an idea of what might be a good fit for you. Don't get me wrong.... I love being in the ED, but I would have been eaten alive if I hadn't had ICU experience first. If you really want to do it, by all means do it! But you can get some good experience behind you first:balloons:

Maybe some of you who are more experienced can tell me what it means but getting "eaten alive"??? I guess I am super naive, but does that mean just people making a bad atmosphere for you at work? Or criticizing??? Just the phrase scares me if that is common for new nurses.