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Thick skin, a large bladder, and a small stomach! LOL...just kidding!
You need to be able think on your feet, and think fast. ER nurses are more autonomous than floor nurses for the most part. It is not uncommon for me to suggest and order for the doc. Also you need to be able to care for any type of patient. This could be a 3 day old infant or a 103 year old. Any diagnosis as well. Say you don't want to work with peds- then the ER is not gonna work out for you. Hope this helps a bit! I'm sure some more good answers will come along.
Not only fast under pressure like the PP stated, but calm under pressure is important. To be level headed.
To have a sort of detachment when things are really emotional, I'm not saying relating emotionally is a bad thing, its definatly a good thing, but it can get the best of you when you are trying to make good decisions quickly.
And none of these things are anything that you need to have prior to coming on, but they can be developed. If ER nursing is something you want to do, try it, and if you don't feel you like it after a little while (say before 6 months or so) then try something else.
Hi king, Im from philly same as yours and im new at ED..I just started my rotation since monday and i gotta say it's overwhelming..I mainly observed the flow of nurses and know all the protocols in my hospital..I gotta say that Im loving the ED Environment..Well goodluck, Hope you will soon become an ER nurse. My advise would be, you should know the protocols of the ED first before engaging in a warzone area..hehe.. =)
I agree with the prior posts. You have to be able to think on your feet and take things into your own hands sometimes when the doctor just cannot be there at the bedside at that moment. I had a patient recently who went into vfib on my zoll (he was off the hardline monitor because we were preparing to transport him). We started ACLS-did a quick shock, and he regained rhythm and pulse with the shock before the doctor made it in- Since shocking someone should be done ASAP in witnessed cardiac arrest, you need to be on your toes and confident-that you know your rhthms, your equipment, how to assess responsiveness, your shock energy, and your cpr/airway management. You have to be confident in yourself and in your assessment skills. You have to be able to prioritize correctly. You have to be okay with knowing you're not always providing the most personalized BEST care to all patients. This was hard for me. Sometimes patients feel ignored when you cannot get them a cup of water when you are helping someone in respiratory distress who just came through the door--which can sometimes take a while to get them settled down-heck you might have to assist with getting them tubed. Sometimes you can't clean someone up right that second after they've soiled themselves or you can't get the pain medicine for someone that second. Or maybe you come off rough when you're trying to dress a patient quickly. You might get complaints lodged against you from these patients-which can be stressful-not being able to please everyone. -not that I get many complaints-but it happens. I guess this just depends on how well staffed your ER is. A lot of times patients understand that you have a load of patients you're balancing and if they understand that, they will be more patient waiting for you. And, about the thinking on your feet and confidence, it comes in time. I know our ER keeps new ER nurses in less acute areas for about a year to help them develop their prioritization and speed skills and become familiar with policies and procedures. This has its drawbacks, though, because then when a "less acute" patient goes south, the nurse isn't as experienced to recognize the downhill turns (we can move the patient to the higher acuity section, but this down turn has to be recognized). Good luck!
One of the qualities that I learned early on in my ER nursing career was not to get too excited. Adrenaline in an emergent situation can only get in your way, you have to learn to think fast, know what you are going to do before you do it, and not let your rush
of adrenaline affect what you are doing.. Even if something horrible happens right in front of you try to keep a level head and act. dont be forced to react.
another thing that is a must... a good sense of humor. You will be spit on, pooped on, peed on, puked on, kicked, scratched, lied to, screamed at, cussed at and abused in more ways than you can imagine. Dont let it get to you.
Prioritize, prioritize, prioritize. Delegate, delegate, delegate! Trust your gut! Be a sponge, absorb any wisdom experienced nurses can give you. Us old timers only do things that work. Oh yeah, and you have to be supersticious (did I spell that right?) Never, ever say the "B" word or the "Q" word! Bored or quiet, kiss of death! Don't speak of a specific patient or they'll show up!