Will I ever be good at this?

[amzyRN]

I am a new ER nurse and I thought because I'm not a new grad and have been an awesome nurse in other areas, like tele and cardiac step down that the transition would be smooth.

It has kicked my butt and the learning curve is steep. The pace is fast and I find myself still stumbling with equipment, slower on IV starts that some of the more experienced ER nurses, difficulty seeing the "big picture" to keep the flow moving while assuring continuity of care.

I am still not that confident in code situations, feeling like everyone is doing things so much better than I am. When I'm under pressure, it's like I'm fumbling with things. Does this go away, or does this mean that I'm not suited for the ER?

[CrunchRN, ADN, RN]

Any new job takes 3 months to a year to get really competent. Stellar takes forever lol. Give yourself a break.

[DarknTwistyERRN]

Hang in there. It's a huge adjustment in terms of flow - flipping patients quickly (Treating and Streeting or Getting and Admitting), charting quick and keeping it to the essentials, learning all the standard protocols (I'm assuming y'all put in a lot of your own orders before the MDs see the patients), etc. You'll get there. It'll be at least 6 months before you feel ok and a year before you feel decent. At two years you'll have confidence but know that there's still so much more to know. The amazing thing about the ER is you're afforded the opportunity to learn and do something new often. Remember - ask for help if you're drowning and if you're not busy help someone else. Help someone before you chart. If you complain, they'll want to know two things: 1 - Did you ask for help? 2 - Did you tell your charge you needed help? Asking for help is not a sign of weakness in the ER. Being a leach and having everyone do your work because you're lazy is. :) BIG difference.

[Lunah, MSN, RN]

Don't kid yourself, it is difficult to go from stellar to novice. You are way outside your comfort zone and it will be uncomfortable for a while, but hang in there. One of these days you'll realize that everything has clicked. :)

[LadyFree28, BSN, LPN, RN]

Don't kid yourself, it is difficult to go from stellar to novice. You are way outside your comfort zone and it will be uncomfortable for a while, but hang in there. One of these days you'll realize that everything has clicked. :)

Agree.

My AHA!!! Moment came 6 months into working in the ED; I still mess up occasionally, but I keep swimming!

[Lev, MSN, RN, NP]

Finally feel like I am no longer a fish out of water after 1.5 years. I too was a "star" on the floor (Post surgical).

[TSBSNRN]

Learning a new job, regardless of how much experience you have in other areas, is still challenging. You're used to a certain pace, certain types of patients, and a certain routine. In the ER, all of that goes out the window. You never know what is going to arrive, or what is going to happen. During nursing school, I did a practicum, in a busy ER, and in the beginning I was WAY overwhelmed. But towards the end of my practicum, I was starting to get used to the flow, the unexpected cases, and the chaotic "routine" of the ER. Give yourself a chance, and some time to get aquatinted with things. It takes a LONG time, years even, for nurses to really get comfortable with their job, duties, responsibilities, etc. Learning a new craft, or a new department, is the same way. It may not take as long as a new grad, or an inexperienced nurse, but you will get there. JUST BE PATIENT! DON'T BEAT YOURSELF UP!!! Also, if you're not sure of something, never be afraid to ask. Ask for more education if you feel you need it. If you're a reader, look for books that are directed towards the ER, as there are so many different things that an ER nurse must know. Good luck with everything!

[rhkenji]

Been on the ER grind for the past 4 months as a new grad.

I still feel anxious whenever I come in for a shift because I never know what's waiting for me but I just keep on swimming. Taking things one shift at a time, sometimes, surviving an hour at a time.

There were times I wanted to just drop everything, give up and quit but I'm still here.

It's a steep learning curve but my ER crew is amazing. They are very supportive. They always tell me "You are one of best nurses that can ever there be because you work here. You'll be able to handle a simple cough up to the full arrest and you'll be great at it. You'll be steps ahead than your peers because you're here and in no other unit. You're an urgent care, telemetry, med-surg, and ICU nurse all at once.". And I come, I learn, It's hard but I know i'll be good at it.

Summarize your shift, and re-read what you see. It's hard but when **** goes down, you know you have your team's backing you up.

[Roy Fokker, BSN, RN]

Dude(tte), it took me a good, solid 2 some years before I could go into work and not worry about killing someone on my shift!

Not feeling like a rockstar - just merely relaxing enough to the point where I was reasonably sure I wasn't going to kill anyone.

Still working on the rockstar part... but I think I'm getting there! ;-)

I was a kickass ortho/neuro/step-down nurse before the ED.

You didn't mention what kind of ER and how long you've been an ER nurse :-)

The ED is a very peculiar and unique branch of nursing. As I like to joke about it, (thanks to EMTALA): "Even hookers get to say 'No!' but we can't!" Chronic to acute, from stubbed toe and med refill to cardiac arrest and trauma - we see it all. It takes a special breed of nurse to not only work but thrive here.

And that sorta thing just isn't gained easily!

Eyes and ears open. Ask LOTSA questions. Plug away at it.

Re-eval yourself in a year's time - see what you think then.

cheers,