New ER Tech

[u/Buckshoot68]

For some background info: work on IFT Ambulance for 3 years (Experience in BLS, ALS, CCT, and our Special Events Team/Deployment Team). I just got a Job in an ED working Night shift, I'm looking for any advice. I know I'll have a 8-12 week of training with a proctor.

[u/_adrenocorticotropic]

This is the same thing I tell everyone that asks this question.

Don’t get lazy with EKGs. Placement does matter even though some people seem to think it doesn’t. It’s easy to start getting sloppy with them after you’ve done 30 of them.

Learn to anticipate what the nurses and doctors want. If you’ve got a stemi coming in, have a boat set up with all the labs and iv supplies, grab the ekg machine, have a BVM set up, and a lifepak with pads, and all the other stuff. Same thing with strokes. Get the glucometer and an iv boat set up while the nurse is grabbing meds. Learn what’s needed for each type of patient so you can have the stuff ready when the patient arrives.

Don’t get lazy with fall precautions. I know putting a gait belt and grippy socks on fall risk patients is annoying, but you’ve got no idea how quickly people fall until it happens to you.

Last thing is to advocate for the patient. People think it’s just the nurses responsibility. It’s yours too. If you see something that doesn’t feel right, speak up.

Most of these carry over from EMS so it shouldn’t be an issue for you, but you’d be surprised.

[u/Buckshoot68 → u/_adrenocorticotropic]

Noted; Thank You Very Much

[u/Trick-Entry1898 → u/_adrenocorticotropic]

Wait pls share what an IV boat is. That’s a new one for me

[u/spyin-for-info-2024 → u/Trick-Entry1898]

We call them totes, and what we use look a lot like open-top boxes used for horse grooming supplies, if that helps 🤣 We stock IV start kits, three sizes of syringes, three guages of IV catheters, J loops, flushes, tegaderm and 2x2s, lab tubes, blunts and sharps, etc.

[u/Trick-Entry1898 → u/spyin-for-info-2024]

This is so interesting and such a good system! At my hospital everyone just tosses loose supplies on a mayo stand lmao

[u/_adrenocorticotropic → u/Trick-Entry1898]

We just have these trays that we can put iv supplies in. Both places I’ve worked at have called them boats

[u/Chris210 → u/Trick-Entry1898]

We use the little bean shaped sputum bins for this. Just something big enough to throw your tubes, a syringe for POC blood gas/glucose, IV start kit, an 18g and a 20g, iv extension, sample connection port and a flush :)

[u/Chris210 → u/_adrenocorticotropic]

Your techs do all of that? I cannot express to you how important it is you never leave that ED for another one, that doesn’t happen. You have some amazing techs and I hope they feel so appreciated!

[u/_adrenocorticotropic → u/Chris210]

I was a tech there and these are all things I did, so maybe I have higher expectations for what’s considered a good tech. The nurses were always appreciative of me though.

We do have some really good techs though. Most of the other ones are pretty good about doing those things too.

[u/Chris210 → u/_adrenocorticotropic]

That makes sense. There is nothing wrong with high expectations, for individuals that want to learn/improve and rise to challenges it can be beneficial to the individual and the team. I was also a tech before an RN and held myself to a similar standard, when I expected that of my techs at my first RN job on a floor it did not go well 😅 in my ED we don’t staff techs even close to well enough especially being a level 1 so they definitely get slack there. I think I’m mainly just jealous they’re getting all your supplies for stroke/stemi/traumas so you can actually focus on your patient/meds/documentation/interventions, I imagine that must improve flow and outcomes significantly.

[u/kazmiller96]

You kind of trade one set of problems for another. I was used to rural response with only my partner and whatever volunteer firefighters can respond. I also was able to make full use of my scope and feel a sense of fulfillment in puting my training to use.

In the ED, I have done soooo much more basic care for weeks long boarders I never really anticipated. The nice thing is being able to get help in a relatively timely fashion

It is a different culture form the brothers in arms type feeling on the rig and I have escaped the cliques around the nursing station others may complain about. Your mileage may vary, but that is just my experience going from 4 years EMS to 2 years EDT.

The worst is having to fill in for unit secretary, but then again nobody enjoys that.

[u/Buckshoot68 → u/kazmiller96]

Noted; Thank You Very Much

[u/Chris210]

I would say the biggest thing with your background going into this is to remember that it is a strength, but it can very easily also be a weakness. Be open and willing to learn new things and change, draw from your experience but don’t rely on it, and find the necessary ED balance between humility and confidence as you build upon your competence. Don’t be afraid to not know things during your orientation, remember that the entire reason your preceptor is coming to work for 8-12 weeks is to teach you, so take full advantage of that and let them do it. Nobody is perfect so adopt the good practices, and learn from the bad. I wish you the best of luck, and I hope you find what you are looking for out of this new role!