Congratulations! You’ve chosen one of the most exciting nursing specialties. So what should you do?
If you’re a nursing student, take every opportunity to gain acute care and emergency nursing experience through clinical rotations or work-study programs or by working as a part-time patient care assistant during vacation or days off. If you’re a graduate nurse, consider gaining experience in medical-
surgical or intensive care units for a year
Although emergency departments (EDs) do hire some new graduates, the more preparation you have, the better you will look to an ED nurse manager. Most ED nurse managers prefer that you have an arrhythmia course (about 15 or 18 hours broken into four or five sessions), which will help you pass the Advanced Cardiac Life Support (ACLS) certification.
Will becoming a Certified Emergency Nurse with BCEN certification make you a better candidate? Yes, it will, but remember, experience counts. You may take the certification examination without having ED experience, but you probably shouldn’t. Work in an ED for 2 years or so first. Then, when you take the examination, you’ll be able to draw on your ED experience, just as new graduates draw on their clinical experience when they take the boards.
Standardized emergency care courses, such as Trauma Nursing Core Course (TNCC) can be valuable, but you’ll get much more out of some courses if you take them after you have at least 6 month’s ED experience. Most nurses who have never worked in an ED struggle with these courses because they have never seen the kinds of patient presentations discussed in the courses.
To learn about educational opportunities, go to the website of the Emergency Nurses Association (ENA): www.ena.org. Join ENA and contact your ENA state president to introduce yourself and learn about local chapter and state council meetings. At these meetings, you’ll meet and network with ED staff nurses, ED nurse educators, and ED nurse managers, and find out about state and regional meetings and courses.
Which type of ED is for you?
Small rural EDs often offer a chance to work with a tight-knit group of people who know each other, their patients, and the local police and pre-hospital personnel. In this setting, you may have more responsibility because of a smaller staff.
Large, tertiary-care teaching hospitals offer the stimulation and challenges of education, research, and practice. You’ll see many acutely sick and injured patients, and you’ll see many staff members coming and going. These settings also provide initiatives and teaching and learning opportunities.
Community hospitals may offer the best of both worlds.
City and county public hospital EDs offer the challenges of caring for sick and injured patients who have few resources. Don’t discount these EDs because of a concern about security. You might find some of the best, most consistent security protection in these settings—not to mention some of the most challenging and gratifying emergency nursing, a good sense of teamwork, and a place to learn and do a great deal.
Zeroing in on a specific position
Before you accept an ED job, talk to the nursing director or nurse manager. What are his or her philosophy and values? Are they similar to yours? Is excellent, compassionate nursing care the top priority? Can the director or manager rally resources to support the staff? Does the staff have experienced senior ED nurses to provide mentoring? Ask, too, about the turnover rate in the ED.
Find out about orientation and internships. Are nurses new to the ED given the information and support they need? What is the average length and depth of the orientation?
And ask about security. Does the ED have professional, well-trained security personnel with backup close by?
If you don’t hear from the hospital’s human resources (HR) department, don’t be discouraged. Just pick up the phone and cordially keep in touch. Remember, some HR departments are overwhelmingly busy. Also, follow up with the nurse manager, and remind him or her why you’d be a valuable addition to the ED staff.