ED nursing tasks/responsibilities:

  1. 0
    What tasks/responsibilities make up most of your shift (and do you work at a small community ED, level 1 trauma center, etc)? I am really drawn to the ED and want to get a better idea of the more mundane, day to day/hour to hour tasks in between major emergencies-- I realize its not all excitement, drama, and trauma. Thanks!

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  2. 13 Comments...

  3. 4
    1) Cleaning up incontinent patients with C-Diff diarrhea. A lot. Often.
    2) Unhooking completely hooked up patients (to monitors and IV fluids/meds) to help them to bedside commode. Help patient back to bed, rehook (unless you have to leave all leads on, then it is a new challenge). Collect stool/urine/emesis sample.
    3) Assist in pelvic exams
    4) Medicate for pain. Repeatedly. Or medicate for other complaints. Collect samples for newly ordered tests (blood tubes, swabs)
    5) Convince male patient who is high fall risk that no, he cannot stand up to use urinal.
    6) Insert foleys, NG tubes, perform enemas, draw blood cultures, etc
    7) Order/Bring food for patients and family
    8) Educate on discharge
    9) Documentation (really 90% of your time), including Vital Signs, actions performed, med administration, discharge, etc.
    10) Handover report to floor nurse. Making copies for transfer. Organizing transfer (if out of facility). Filling out more paperwork. Making more copies. Transporting patient to new floor.
    11) Cleaning rooms, restocking rooms
    12) EKGs, IV starts
    13) Handle family members

    Level II Emergency Department, suburb of big city
  4. 0
    * Vital signs, assessments. In the ER, however, our assessments are focused based on the patient's chief complaint.
    * IV starts
    * Specimen collection - drawing blood/blood cultures, urine/stool/sputum samples, wound cultures, rapid strep, RSV...a lot of "data collecting."
    * Obtaining 12-lead EKGs.
    * Foley/NG insertion, if ordered.
    * Assisting the provider with procedures...these can range from a pelvic exam to a spinal tap to central line/chest tube insertion and everything in between.
    * Conscious sedation
    * Splinting
    * Medication administration, and A LOT of it, especially for pain.
    * Tell patients that if they cannot produce a urine specimen within 30 minutes, they will have to be straight cathed. It depends on the provider, however. Some don't care and will wait...others will want the straight cath to be done.
    * Bring snacks/cold water/hot coffee for patients and family members.
    * Assisting patients to the bathroom, whether it's to the actual bathroom or the bedpan...or cleaning up incontinent patients. And this includes unhooking everything and then having to rehook everything back up.
    * A LOT of documentation.
    * A lot of patient education.
    * Reporting off to either an oncoming nurse, a nurse who is covering your patients or to the floor nurse if your patient is being admitted.
    * Mixing medications. I came from the floor and was spoiled with pharmacy mixing all of our antibiotics but where I work, we mix pretty much everything. There are some medications, however, that pharmacy will always make for us.
    * Obtaining fetal heart tones.
    * Assessing visual acuity.
  5. 0
    Quote from turnforthenurseRN
    * Tell patients that if they cannot produce a urine specimen within 30 minutes, they will have to be straight cathed. It depends on the provider, however. Some don't care and will wait...others will want the straight cath to be done.
    They would strait cath A&Ox3 pts just for a urine sample? I can't imagine strait cathing a patient just because they can't produce a urine sample within my time frame unless they are neurogenic bladder or something. As a pt, you can bet I would refuse.
  6. 0
    It sounds exciting. Can't wait till I become a nurse😊
  7. 3
    Quote from ChristineN
    They would strait cath A&Ox3 pts just for a urine sample? I can't imagine strait cathing a patient just because they can't produce a urine sample within my time frame unless they are neurogenic bladder or something. As a pt, you can bet I would refuse.
    If I have a patient who keeps saying " I don't have to go right now" and it's been over an hour and I've offered fluids, I walk into the room with the straight cath and say "ok well since you can't pee, im going to use this small tube to get some urine from you"... Normally the pt is magically able to give up some urine with the right motivation... And don't knock people who want to get all the labs knocked out quickly, I hate walking in and having a pt who has been there for 4 hours yet still hasn't had a urine sent off, it's a necessary lab test for many patients.
  8. 1
    All of the above. Also triage patients to determine their acuity and what room best suits there complaint. I also frequently am in charge and that means playing musical beds with patients and moving around stretchers to make room for incoming patients that cannot wait in the waiting room. Also when in charge, constantly harping on the providers to get them dispo patients faster and improve throughput through the department. And let us not forget, soothing all the ruffled feathers of family members and patients who don't understand why they have to wait just because someone came in with complaints of chest pain (we all know people just say that to move to the front of the line.)
    turnforthenurseRN likes this.
  9. 1
    Quote from ChristineN
    They would strait cath A&Ox3 pts just for a urine sample? I can't imagine strait cathing a patient just because they can't produce a urine sample within my time frame unless they are neurogenic bladder or something. As a pt, you can bet I would refuse.
    As I stated, some providers will wait on the urine, others have it a "standing order" to have a straight cath done if a patient cannot void within 30 minutes of coming back to the main ER. Can the patient refuse? Absolutely. I'm not going to force a tube into their urethra.

    99% of the time, however, when I come in with that straight cath kit, they can magically produce a urine specimen
    psu_213 likes this.
  10. 0
    Quote from ChristineN
    They would strait cath A&Ox3 pts just for a urine sample? I can't imagine strait cathing a patient just because they can't produce a urine sample within my time frame unless they are neurogenic bladder or something. As a pt, you can bet I would refuse.
    Usually it scares them telling them u need to catch them and then "oh I can pee right now". Then once in a while u get a weirdo who prefers to be cathed!!
  11. 1
    Quote from ChristineN
    They would strait cath A&Ox3 pts just for a urine sample? I can't imagine strait cathing a patient just because they can't produce a urine sample within my time frame unless they are neurogenic bladder or something. As a pt, you can bet I would refuse.
    ER docs are not always the most patient types when it comes to urine, particularly when the pt has a fever and/or a white count with no other explanation for such. An A&O pt always has the right to refuse, but usually just showing them the cath scares the you-know-what out of them, and, well, there's your sample.
    turnforthenurseRN likes this.


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