Will start my first hospital role in ED next month. Want advices from experienced ED nurses as of what I can prepare ahead of time e.g. reading some procedures, diagnosis etc. because I don’t want to be a burden to my team. Thanks!
The OBVIOUS answers are going to be: know the charting system and where supplies are, know the roles of each provider (who is on call at what time - depending on the size of your hospital) and who to call upon first (ie: NP on until 1am and MD all night but don't bother him/her unless you have to), what and where your standard protocols are (pt comes in with chest pain - draw a rainbow of labs when you start that IV and give MONA, do your own EKG and find where the heck is RT because you are about to need them STAT, etc before you wake up the doctor!!!). But MY advice, no matter your level of experience or expertise is to KNOW YOUR ROLE in a CODE. I rock codes, bc I like to assume team lead when it is not my patient. I can look, watch and record every person, every role, and every time something occurs plus shout out who is in charge of getting the chart ready for transport to icu, who is my runner (hopefully you get 2 bc some MD's like weird stuff like a towel behind the neck to help intubation), make sure you run TO the code with 10 flushes in case nobody can find one - you will look so smart and prepared, and look at the bed!!! Is it flat and did someone make sure the plug in cord is not wrapped around the headboard in case some idiot stole the backboard off your crash cart and you now look like an idiot not having it under the patient when Rapid and the ICU arrive to help you save this life. True stories. FB or email me - many stories to tell. Lastly, now what nurse in the ED or the department closest has OB experience bc you will eventually deliver a precipitous baby and likely the ER MD hasn't done that since med school. Lastly, read everyone's advice. Weed out what your brain says, um, nope, and follow the rest. Good luck to you. You will love this experience! D, RN.
Ask and you shall receive. That is not meant to be a Biblical quote, but one of the many codes among great nurses, no matter their field of expertise.
I forgot one very important thing. Know your hospital's normal lab values bc some of us have gone from the standard troponins to a new value system, and so many RN's do know how to interpret blood gases. Do your best to know at least what part of them is critical to call the provider for, no matter what RT says to you. It's your license. IE: a known COPD / CP pt with a critical low O2 may not be all bad if they are a CO2 retainer and everything else is near normal. Use your common "cents" and put your college money where your brain is. It is difficult to go wrong in an emergency in the ED, bc without you, they would die and you have a team that helps each other to prevent that. Know who to ask, why and when to ask, and you will ROCK the ED.
Surviving in the ER/ED really boils down to a few hard and fast rules you can count on. Time management, assessment/triage, assessment and more triage, and be prepared and focused the minute you walk into the unit. You shouldn't be surprised, judgemental about anything, and remember that you are there for rapid treatment, compassion, nerves of steel and a sense of humor. But foremost have a good support system. When it's bad, it's really bad. When it's good you'll have stories of a lifetime for your grandkids.
Paperwork
You got hired as a new grad in the ED! That's awesome!
First bit of advice, don't start considering yourself a burden on your team right out of the gate. As I stated above, you are a newly graduated nurse in the ED who has yet to earn his/her bones.
Second bit of advice, take it easy. You have until the age of retirement to learn everything there is to know about WORKING as an ER nurse, and even when you do reach retirement, there will be new developments in healthcare that you never would have anticipated anyway. In other words, when you think you know everything, you know NOTHING. You'll learn about new procedures and diagnoses with time. You know the basic diagnoses and how they're managed, e.g. heart failure, copd, asthma, etc. You will encounter them in the ED.
Last but not least, just be a sponge. You're gonna learn something new every day anyway, so just go with the flow. This is good advice that should last you well into your golden years as a nurse also.
