Working in the ED

MagicTyler

MagicTyler

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Been a while since I posted on here, but I just got offered a part time job at a level on trauma center in the ED. I'm very excited to finally be working as an EMT (after a year of beeing certified). I start my first 12 hour shift on monday and am a little nervous. I'm getting a lot of new skills to do and am excited to learn a bunch of new stuff. Anyone else have any ED experience?
 
Congratulations on your new position, I'm assuming you are going to be working as an ER Tech. You should be proud knowing that you were chosen over many other applicants, we often get hundreds of applications every time we have a tech position open up. I have been a tech at one of our local level one trauma centers for five years, the last two as a children's emergency room technician. I still pull shifts on the adult side but peds is my home base and where I prefer to work.

I really enjoy the job and have learned so much during my time in the ER. One thing you will notice right from the start is that there is always an opportunity to learn something new, all you have to do is ask. The educating never stops and you will find that if you choose to move up the ladder that your time as a tech will prove invaluable. One of the first things you will notice is that things work differently on the inside and you will be assisting with and preforming procedures well above what you would do in the field. You will not be restricted to some local EMS systems protocols or have to ask a higher level field provider mommy may I before you make a move. You will learn your ER's boundaries and will be expected to always stay within them. If your facility is anything like mine you will be working under a charge RN and either a PA or MD, once you have proven yourself and have some time in you will be surprised at what you might find yourself involved in. During your orientation you will learn what is expected of you and it will be up to you to work hard, prove yourself and over time gain the respect of your ER peers.

I have helped train new techs and I can give you a few pointers that will give you a good head start. Always arrive 30 minutes early, I like to get changed have some coffee and get the feel for how things are going in the department and be prepared before I hit the floor. You will want to ask questions even if you think they are dumb, you are new to the department and are not expected to not know more than your basic EMT skills. Be the first to jump when a new patient arrives, showing that you have critical thinking skills and are one step ahead of your RN's will prove very beneficial in the future . Try and always stay busy, I still will not sit down for more than a minute or two for an entire 12 hour shift (maybe lunch) just because there is always something to do. Don't gossip with the staff or the outside crews it will turn around and bite you in the arse, I have seen two many new techs that start down this road and it never ends up good. You have been offered a very unique networking opportunity but it can work against you if you get a bad reputation. If we want to know what you have done or where you have been we will ask so don't bore the staff with endless chatter about your experience, until you have proven yourself we don't care. If you have time to sit and BS at least during your first year your not doing what needs to be done. Be respectful to all your fellow co-workers whether it be housekeeping or trauma surgeons everyone deserves to be treated like a valuable member of the team. The housekeepers can especially make your night miserable so show them some love by helping them out if they get behind and they will kick arse and keep your rooms turned. The last and most important is don't be a tool, your future reputation in the health care community no matter if its medic,RN,PA or MD starts the day you hit the ER floor and will follow you no matter where you go. There is so much more but I think this will get you off to a good start, if you have any questions please feel free to ask. Welcome to the tech world, your going to love it!
 
Mark you stuff, and get weird colors. So your stethoscope ideally should have your name on it and your trauma shears should be pink or green or something that when someone borrows them they notice "hey, I didn't have pink shears before." (Also track your stuff down right away, otherwise it disapears. Surgeons are always borrowing stethoscopes.

I'd also invest in a pair of decent clear safety glasses. They're great for dealing with people who are spitting, splashing blood around etc. I like them a lot better than the ones that come on a mask.
 
I was an ED tech at a major trauma center for three years. You'll get a lot of invaluable experience seeing what happens to patients *after* EMS has dropped them off and left the building. When you do go on to a service down the road, you will have an edge to knowing what that patient really needs versus just running through the protocols. Also, if you befriend the ED physicians and RNs because you've shown that you can work hard, care about the patient, and want to learn, you will also pick up invaluable gems of knowledge that will help immensely down the road. Although I was as busy as a one-legged dog with fleas working as a tech, I would never trade that experience for anything.

My opinion may be a bit contrary to others, but for the sake of the nurses and patients in your area, don't always be the first trauma monkey. I've worked with techs who felt their only purpose in life there was to pick their butts off the chair only when EMS arrived with a critical patient. Anything else was below them, because by God, they are a certified EMT-B, I, or P. Bedpans are for nurses (in their opinion).

That left me with the bedpans, the stocking of equipment, the crash cart inventory, the call lights, the transports of the patients upstairs, the blood draws, the ECGs, the bed cleaning (our housekeeping staff left much to be desired), and on and on... you get the point. Well, the nurses notice. The docs notice. Even the DON noticed.

When it came time for layoffs, I had a job. When I wanted to learn more about the patient's condition, the physician would sit with me for far longer than he should to explain it --- and he was busy to begin with! The nurses would stand up for me, and were a blessing when I finally applied to the 9-1-1 service. For the others, they were not that lucky. You reap what you sow.

Just remember as a tech, you are not one onto yourself. You are not something so special you must be revered by all who do not know the ways of the prehospital provider :ph34r:. You are working with nurses and physicians to meet one end goal: help all of the patients under your care. Keep that in mind, and you'll gain experience that could never be bound in a textbook.
 
Aliakey said:
I was an ED tech at a major trauma center for three years. You'll get a lot of invaluable experience seeing what happens to patients *after* EMS has dropped them off and left the building. When you do go on to a service down the road, you will have an edge to knowing what that patient really needs versus just running through the protocols. Also, if you befriend the ED physicians and RNs because you've shown that you can work hard, care about the patient, and want to learn, you will also pick up invaluable gems of knowledge that will help immensely down the road. Although I was as busy as a one-legged dog with fleas working as a tech, I would never trade that experience for anything.

My opinion may be a bit contrary to others, but for the sake of the nurses and patients in your area, don't always be the first trauma monkey. I've worked with techs who felt their only purpose in life there was to pick their butts off the chair only when EMS arrived with a critical patient. Anything else was below them, because by God, they are a certified EMT-B, I, or P. Bedpans are for nurses (in their opinion).

That left me with the bedpans, the stocking of equipment, the crash cart inventory, the call lights, the transports of the patients upstairs, the blood draws, the ECGs, the bed cleaning (our housekeeping staff left much to be desired), and on and on... you get the point. Well, the nurses notice. The docs notice. Even the DON noticed.

When it came time for layoffs, I had a job. When I wanted to learn more about the patient's condition, the physician would sit with me for far longer than he should to explain it --- and he was busy to begin with! The nurses would stand up for me, and were a blessing when I finally applied to the 9-1-1 service. For the others, they were not that lucky. You reap what you sow.

Just remember as a tech, you are not one onto yourself. You are not something so special you must be revered by all who do not know the ways of the prehospital provider :ph34r:. You are working with nurses and physicians to meet one end goal: help all of the patients under your care. Keep that in mind, and you'll gain experience that could never be bound in a textbook.
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Very well said!!! Ditto!
 
Level1pedstech said:
...There is so much more but I think this will get you off to a good start, if you have any questions please feel free to ask. Welcome to the tech world, your going to love it!
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I love that support like this comes from this site!
 
Aliakey said:
My opinion may be a bit contrary to others, but for the sake of the nurses and patients in your area, don't always be the first trauma monkey.
Just remember as a tech, you are not one onto yourself. You are not something so special you must be revered by all who do not know the ways of the prehospital provider :ph34r:. You are working with nurses and physicians to meet one end goal: help all of the patients under your care. Keep that in mind, and you'll gain experience that could never be bound in a textbook.
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...and this!
 
I've worked two shifts now and absolutly love it! I think being a tech is going to make me an amazing care provider and I'm already learning so much. All of the staff is willing to teach and everyone is really nice. I can't wait to get some more training so I can start lines and draw labs. SO MUCH more to learn, don't think I'll ever stop:rolleyes:. This is deffinatly the place I need to be working and am so lucky I found the perfect job for me!:)
 
GREAT

Good, It always makes a difference when you LOVE the place your are working for!! Never stop learning, keep an open mind. Even if you dont think you can benefit from something, still do it; cause there are always hidden bonuses.
 
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you will love it. i am very happy that i took a job at one of our local hospital and i love it more than being on an ambulance i dont know about your area but when i work at the hospital i work under the dr and i got to learn some really good skills that really help me in my medics class but good luck and have fun.
 
claytondirk said:
i dont know about your area but when i work at the hospital i work under the dr
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In the hospital situation everybody involved in patient care is essentially working under a doctor or more specifically their Medical Director. The Medical Director of that department determines and supervises what procedures each professional and technician directly in that area will be allowed to do within their scope of practice and impliments the polices to reflect that. Each unit or area such as the ICUs and the ED as well as individual departments (Lab, Radiology, RT, OT/PT/SLP) will have their own medical director. The doctors in the various departments also follow the P&Ps of that medical director. In some situations, conflicts arise in certain protocols or policies. One doctor may write an order or request a procedure that directly conflicts with the policies of the Medical Director of that department. That is where the licensed or unlicensed professional/technician can consult with his/her medical director to handle conflicts at the MD level. There are also some moonlighting ED MDs who take it upon themselves to extend "privileges" to the ED staff which are clearly not within the policies of that ED's medical director.
 
Some of the best experience I have gotten over the years I have gotten in the ED. I have never officially been an ED tech but I always made a point to spend time helping in the department so when I called for orders outside my SO's they trusted me. I have always introduced myself to the Doc's I did not know and spent a little time talking with them.

I remember back in the early eighties a Doc walked me through doing a chest tube in the field over the radio, using an ET tube. I was scared to death but have not forgotten how patient he was.

Good luck on your new job.
 
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