What being an ED nurse is all about

  1. I had an elderly woman come to the ER this morning 6ish, she was struggling to breathe, I took her into room one and started undressing her while directing everyone else to bring me this and that and order this and that. She reminded me of my friend's mom although this woman was older. The steamy weather down here is kind to our faces and she didnt look her stated age of 81. She looked at me when I was starting her IV and said "please don't let me die, I'm not ready yet". I assured her that I would not let anything happen to her, not while I was taking care of her anyway. We did this and that and soon she was feeling better and the morphine we gave her helped her to rest some and her oxygen saturation went form the low eighties to the mid 90's. When I left this morning, day shift was just about to take her to the CCU, I went in to tell her bye. She said, "you said you wouldnt let me die and I didn't, thank you" and smiled at me and held my hand.
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  2. 8 Comments

  3. by   CATHYW
    LilgirlRN, I am so happy for you and your little lady! The way you handled her is the way to go-be DOING something the whole time you are getting them in the room and undressed. All that time saved by delegating things on the critical folks during triage can make the difference between life and death.

    On a sad note, though, I learned the hard way NEVER to tell a person that I wouldn't let them die. I promised that to a dear man one night, and, after his transfer to ICU, he expired (no fault of the ICU nurses-it was his sorry Doc). I learned 2 BIG lessons that night:
    ***When someone says, "please don't let me die," they aren't just talking. They usually will expire, or at least, CODE. I think it is the body's early warning system, or something. I always took it VERY seriously, and was never wrong to do so.
    ***My response to that statement, after my first bad experience, was, "I'll do everything I can to see that doesn't happen to you. We want to take good care of you. Plus, it just doesn't look good when that happens!" Usually, I'd get a little chuckle with the last statement, but believe me, from the second they made that statement until they were safely off my unit, my antennae were up and twitching, mightily! Every sense I had was on overload, trying to pick up the intuition that something was fixing to go south. I was worn out when they left my ER! LOL!
  4. by   traumaRUs
    I love being an ER nurse and couldn't imagine anything else!!! You guys are the best!!
  5. by   Amy ER Nurse
    You are right to tell them not to say they won't let someone die. It has not happened to me, but a nurse I work with told me a man grabbed him by the arm and begged him "Larry, don't let me die!". Well the man had a massive MI, and died. It is true what we were taught in nursing school about pts having the "impending doom" feeling, and they know when things are gravely wrong. Always let that clue you that things are very serious.
  6. by   LilgirlRN
    I must be very fortunate. I've never lost one that I told I wouldn't let them die. I know that in nursing school they tell you not to say that. I've been out of nursing school for 15 years. I can count on 2 hands the number of patients that have died while in my care that were not terminal or that I considered to be viable. I spent 2 years in the CCU and 13 in the ED so I considerable experience in the areas of emergent/intensive care settings. We are a level II trauma center so we don't see a lot of trauma and I am sure that has helped to keep the numbers down. I am not saying that patients that I took care of didn't eventually go on to die while in the hospital, just that they didn't die while I was caring for them. We have very few codes, the people that I work with have years of experience just like I do for the most part and we try to take care of the situation before it becomes a code situation. Sometimes codes are inevitable, sometimes they can be prevented. I always look at it like this, if the patient dies, then their number was up, if they didn't die it was because it wasn't their time. When I speak of viability... a patient that was found down for indeterminate amount of time and they've been working on him/her in the field for 30 minutes and they are flat line and have been the entire time, that's not a viable patient. Then sometimes we have patients that might be viable but they have DNR status and we have to let them go. We got a lil old lady in from the nursing home recently. Tiny, malnourished appearing. had casts on both arms and a leg. She had been hit by a car 3 weeks before. NH sent her in because she had altered mental status...yeah on O2 sat of 78 will do that to you. She was Cheynne-Stoking so we just let her go. Had we done chest compressions we would have popped her ribs, Seemed senseless to prolong her agony. Her casts had feces in them, she was very dehydrated, really emaciated looking. So sad that people can take such poor care of their patients in a nursing home.
  7. by   Brownms46
    Originally posted by LilgirlRN
    I went in to tell her bye. She said, "you said you wouldnt let me die and I didn't, thank you" and smiled at me and held my hand.
    Now this really got to me
  8. by   LilgirlRN
    It got to me too
  9. by   Tiiki
    Wow...I'm relatively new in the ER, coming from an acute medical floor. I often said to pts who told me.."don't let me die" that I never let such things happen on my shift..besides, it would totally ruin my day! I am lucky to say it never did happen. Now, would I do it in the ER? From what I've seen so far, I don't think so, pts condition can turn on a dime. I think my best response would be, "I am doing all I can for you now." None of us like to fail.

    JO-ANNE
  10. by   teeituptom
    Howdy Yall
    From deep in the heart of texas

    I always look at ER as a place to come and eat PIZZA, and set up golf games.

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