I have just finished my first DDNN rotation in the small-town hospital Emergency Department.
WOW. I don't know anything about nursing! In nursing school, they try to give you a lot of theory and practical information so that you know how to help and work with people on the floors. They teach you how to do assessments, what general diseases are out there, and how to do various nursing skills. They also give you experience on the floors so that you feel comfortable giving injections, doing basic wound care, personal care, working with IV's, talking to patients, etc.
In the emergency department, there are SO MANY MORE THINGS TO LEARN. I need to learn the flow of a patient through the department. I need to know what is a standing order, and what I need to get an order to do (which the ED nurses know already, and just get started on things, but I feel clueless!). Overall, I feel stupid most of the time, and try to ask a lot of non-stupid questions. I used to be proud that I felt comfortable doing nursing, and that I was looking foward to increasing my learning and the acuity of my patients. Well I feel i'm on a sharp steep hill, struggling to stay upright. I hope it gets easier, and so far, every day has seemed a bit easier, because now I know where things are, and I sort of know how the flow goes.
There are also a lot of skills that ED nurses complete, yet as a student nurse I won't be able to do until after I pass and work as an RN and complete the competancies or testing within the hospital. Examples of things I won't be able to do as a student include: taking verbal orders, give meds below the drip chamber, and triage (i can observe but that's it until i have worked in the ED for over a year). I'm sure there are other things that as a student I should not be doing, but that is the list so far. I also do not know how to read ECG's, but I am proud to say that now I know how to use the machine to get one!
This emerg also has paediatrics, so I need to be on top of my paediatric assessment skills, something I am not good at, and I am still intimidated by those little people.
After reading ED nursing blogs for almost 8 months now, I have thrived in the stories and felt that I could really like working in Emerg. Now I can kind of relate to their stories about not having enough space, about people waiting for a room, seeing drug-seekers first hand, holding patients in the ER because they have no beds available in the hospital (our lack of beds right now is due to a norwalk-outbreak). I also, unfortunately, know what it's like to work 12 hours without a break, because the ED was so busy.
Overall, so far, I REALLY LIKE IT. I like the fast pace, and I like the learning. I can see myself working in Emerg after I graduate, and so far it looks like they need nurses badly so I could probably get a job there!
Hello, I am Elaine, and I AM AN EMERGENCY STUDENT NURSE!