Sorry, JonZ,
didn't see this post until now. Most emergency nursing knowledge comes from being immersed in the ED environment. In our department, we require the nurses to hold a few certifications and maintain them. Required are ACLS, TNCC, ENPC and/or PALS & Hemodynamics. I'm certain other departments are similar and some different. These classes are absolutely helpful, but you really have to take the information and apply it in the care of all of the different kinds of patients that come in our doors. You're absolutely right, it is a large spectrum of information. You're talking any age group with any complaint. We give our new grads an 8-12 weeks orientation and don't allow them to even entertain the thought of working in our critical care/trauma area for one year. Every time we even remotely think we've seen it all, we're proved wrong.

Typically, during the orientation period for the new grad (which usually ends around week 10) they will attend a few days of general hospital orientation, Basic Dysrhythmia (4days), Hemodynamics (1day) and then being immersed in the ER learning the job for the rest of the time. In the summers, which we may have around 6-9 new grads and about half-a-dozen externs, I put together 2 days of ER specific education which they attend also. I'll schedule them for the rest of the required certs after they are put into staffing. The suits would always like orientations to be shorter because it's kinder to the budget. I sit down with all of our new teammates every 2 weeks throughout their orientation to discuss their progress and needs. We put them into staffing when they're ready, not before. If they don't get it by week 12, we discuss other options in the hospital.