What's your best advice for a noob?

[donnasaur]

Hi everyone! I'm a second career but new grad RN, and my first position is in the ED at one of the smaller hospitals in our system. I'm done with orientation and hit the floor for precepting on Monday.

We have a Level I trauma center and Peds hospital a mile away, plus a hospital 5 miles away with the maternity center and cardiovascular institute.

That leaves for my ED: a lot of psych patients awaiting a bed at our inpatient facility, some chest pain, some GI/flu-like stuff, lots of urgent-care referrals, etc.

Regardless, I'm terrified. The department is in major transition (new NM and CNS, both ANM positions open, short-staffed on RNs) and I already feel like I'm going to be in the way.

I wanted this opportunity because there were no openings in my first choice (ICU) and I felt like this could be a good boot camp for learning how to intervene quickly and perform my skills under pressure. But now I feel like I'm starting nursing school all over again, except now the stakes include patient outcomes and my license.

Is this normal?

Were y'all scared too?

What should my self-talk be as I walk through the door on Monday?

What should I keep reminding myself of as my preceptorship unfolds?

[Candogirl]

Nursing school does not really prepare any nurse for the real world. The ED can be fast-paced, and let's face it, we were all scared or perhaps, terrified, when were done with orientation and were expected to be real nurses. Take a deep breath and know that, like many before you, you will survive. One piece of advice that is paramount to learning and surviving in the ED, or on any floor, is to ask questions. If you don't understand the reasoning behind an action, ask your preceptor. Some preceptors may assume that you know more than you do (like operating some of the equipment). If you don't know how to use something, don't be afraid to say so. Now is not the time to fake it. If you have a patient that presents with something you are unfamiliar with, go home and learn more about that particular disease process. You'll be glad you did, because I guarantee that you will see it again. Don't be afraid of the psych patients, many are just grateful for a kind word and a little attention. The most difficult part of being a nurse in the ED is working in an environment in which patients are very sick, but the cause of their illness is unknown. I like to think of the ED as the Sherlock Holmes of nursing. When you walk through the door, on Monday, remember that all of the nurses you will be working with were once in your shoes. Be friendly, open, and hard-working. As the preceptorship unfolds, remember that you will have great days and off days. You will experience things you have never experienced before. Absorb everything like a sponge and enjoy your new career! Welcome to the ED!