What did you do in the ER today?

Specialties Emergency

Published

I am a nursing student and will soon be starting my last year before graduating. I am interested in the ER, but it is really hard to pin down exactly what the job consists of.

I have looked at a lot of old posts that talk about how a lot of the work is determining priority. But it is hard to understand what is usually seen or done in the ER because "no day in the ER is the same".

So, in order to get a better understanding of the variety of situations an ER nurse encounters, I was hoping you guys could answer my question:

ER nurses, what did you do in the ER today?

I would appreciate any answers!

Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.
Told a pt with a concussion they were in the ER after a car accident 400 times. Fortunately, no serious injuries.

I had a patient who fell from a horse whose brain seemed to "reset" every 2 to 3 minutes. I finally just wrote her a note about what happened, put it on a clipboard, and put the clipboard in her hands. When I saw the "where am I?" panic set in, I would direct her to the clipboard. It was a challenge getting her to complete her CT scan, she would reset just as we were getting ready to scan her and we would have to explain over and over why she needed a CT! Lol

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Specializes in Med-Tele; ED; ICU.

- I started an IV in the hand of a 4-mo old child from an MVC then followed same child to CT where I gave pentobarbital in order to get the kid to hold still for the CT and then hand-pushed the contrast medium.

- I lined and labbed a guy with a kidney stone and managed his symptoms with morphine and zofran.

- I did q2h turns and pericare on a demented, contracted old lady from a SNF w/ a UTI. I straight-cathed her for urine and started a 20ga in her R forearm and drew blood cultures from a second peripheral stick. I gave her fluids and IV antibiotics.

- I started a heparin drip on a 43-yo guy having a NSTEMI... and talked him out of leaving AMA.

- I put the second line into a trauma patient... 16ga L forearm.

- I irrigated the numerous bite wounds on a guy who didn't have the good sense to surrender when the officer said, "I'm going to send in the dog."

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Specializes in Med-Tele; ED; ICU.
There's still a lot of "little" ERs that don't have SANEs.
Some big ones, too.

Neither my 76-bed department nor my 34-bed department do forensic exams. In both cases, the patients are treated as needed then medically cleared for discharge with a law enforcement escort to clinics where the exams are done.

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Specializes in Urgent Care, Emergency Department.

IV starts and EKGs!

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.
Some big ones, too.

Neither my 76-bed department nor my 34-bed department do forensic exams. In both cases, the patients are treated as needed then medically cleared for discharge with a law enforcement escort to clinics where the exams are done.

That was the model I was used to in Virginia. Of course in the Army, we had to have our own SANE program due to frequency as well as a mandate from some general somewhere who had no idea how difficult it is to staff a SANE program long-term.

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I am a tech in the ER! My day went like this:

-Sat and monitored a PEC patient for two hours.

-Did an EKG that detected a STEMI which of course led to a STEMI code.

-Did at least 20 more EKGs.

-Brought a stretcher outside to Air Med as they arrived with a pt for a different unit.

-Inserted 2 foley caths and 3 straight caths.

-Listened to an EMS pt arrival scream Bible scriptures while withdrawing from meth.

-Collected many urine samples and sent to lab.

-Assisted several patients in getting to the restroom.

-Answered a few phone calls when the secretary was swamped.

-Connected countless patients cardiac monitor.

Never a dull day. :)

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Oooo i like this topic, we should do this for all types of nurses!

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Some big ones, too.

Neither my 76-bed department nor my 34-bed department do forensic exams. In both cases, the patients are treated as needed then medically cleared for discharge with a law enforcement escort to clinics where the exams are done.

Well, that makes a heck of a lot of sense, seriously. But I, too, knew a hospital system where they were accused of being unethical by sending people "elsewhere" following the MSE. So, despite it being 100% nonsensical, ED nurses were told to put on the "forensic examiner" hat.

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Last night I was in our behavioral area. I had 7 patients who were not going to be going anywhere anytime soon.

I did my assessments, my room checks for the shift, pulled what seemed like 100 pills for my patients, had two patients refuse their meds, wasted said meds, had to give IM haldol to my little lady in the hall (who about got her leg up around my neck because we were all focused on holding her hands). We tried and failed to shuffle my patients around to make room for three more behavioral patients that showed up in the lobby in and amongst all that stuff that happened in my first 4 hours.

After that it was cruising...checks, documenting hourly rounds, redirecting people back to their rooms, their was a straight cath on my hall lady when a room briefly opened up that we could do it in and change her in, then another IM injection, then just a lot of helping my coworkers with minor stuff (IVs, getting EMS patients settled, etc).

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Specializes in ED.

I'm not a SANE but did most of the training. My ER only has one SANE and she is PRN so not available very often. I get called in for these patients when she is not available. Only part of the kit I cannot do on my own is a pelvic exam. I can do the entire SAFE exam on a male patient by myself.

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Specializes in Med-Tele; ED; ICU.

Today I started multiple IVs... 1 stick each, thank you very much.

I did q2h turns on a debilitated guy with a documented sacral ulcer.

I stood at the bedside of the same guy with his sats in the mid- to low-80's deciding on my list of escalating interventions.

I gave a lactulose enema with great results.

I gave three insulin injections and one heparin injection.

I did one ABG.

At the very end of my shift, after reporting off, I did some meticulous peri-care on a butt, scrotum, and perineum that sorely (literally) needed it.

I did a mobility assessment.

I hung a few liters of fluid.

I documented I&Os on a CHFer getting diuresed.

I did two throat cultures.

I gave some PO doxy.

I did an IM Rocephin shot... after lobbying and getting an order for some lido for reconstituting.

I dropped an NG tube... after lobbying for and getting an order for some viscous lido and some benzocaine spray.

I put a Foley into an old guy... after lobbying for and getting an order for UroJet... and giving it time to work before I put in the Foley.

No codes, no traumas, no strokes, no sepsis, no intubations, no restraints... just a pretty low-key, easy-peasy shift... almost like stealing at $97/hr

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I love this thread! I'm trying not to preemptively pick a specialty before I do my clinicals, but I feel like my heart might belong to the ED.

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