WHY are ER nurses like "that"

Specialties Emergency

Published

l had my yearly eval today...went very well. Ended up getting into a discussion with my NM about new ER nurses from different areas of nursing and some new grads aclimating(sp) to the ER culture.

Does anyone else out there think ER is a unique subculture of the hospital and nursing?...l definately do, andl am fascinated by this topic.

l lecture in our ER residency program that we hold bi-annually, many are ER nurse wannabe's, or new nurses in local ER's. l have seen several with tremendous potential that do not make it, not because they were incapable or screwed up, but because ER veterans are not very good at identifying the problems these nurses are having and simply write it off as "not ER material".

For the most part, the veterans are not of the "nurse eating mentality"....although it seems like it to the newbes sometimes.

l am interested in other's perceptions of ER nurses and the sub culture. l don't want this to be an us vs them, but some honest perceptions that are held and why. l am hoping to use the info to mentor new RN's in the ER. lt is hard to be new anywhere, but for me, ER was the hardest place l have ever had to prove myself.

One of my perceptions after having worked ER a few yrs now is that the nurses have a "lead, follow or get out of my way mentality" l can feel when l am slipping into this and honestly sometimes it is absolutely nec. when pt's crash and the ER is crazy. ER nurses are REQUIRED to make snap decisions...again necessary ....and , any ER nurse that denies being a bit of an adrenalin junkie is in denial;)

Your thoughts experiences appreciated..........LR

Specializes in geriatrics.

I worked in the ER for 3 yrs, 2 of them as a HUC then as a nurse intern and then as a GN. I left the ER to work on a med-surg floor because the pace was so hectic. As a HUC(ward clerk), I loved it asn was quite good at what I did. But as a nurse, I still need work on my time management skills and I wanted to be more familar with disease processes. Many people connot believe I gave up the "glamour of ER" for the boredom of mes-surg. I don't believe that a new nurse, unless they are very exceptional (and I graduated with honors) can work that kind of pace without some kind of burn-out. Many kudos to all you Er nurses, you are definately a special breed!

Hi, l.rae

The thread I referred to is Need Encouragement, was started last January. I thought that the author, Lilith, described her impression of ER nurses quite well.

Most of the responses were, fortunately, quite encouraging. I wrote at least a chapter there, of my own!

Hopefully, you can use some of the information contributed by all.

Happy Hunting !!

Great topic l.rae! It's been 3 months since I got out of orientation and I still do not regret leaving a medsurg floor for the ER. However, working on a medsurg floor DID help with the transition to the ER. The juggling act of working med surg makes one get organized and learn to prioritize. It is hard to "get" the ER mentality, but I think some of that comes with experience. Some nights are hard and I dream of the day my contract is up and I can leave the ER, but then other nights are so amazing I'm impressed with myself for being an ER nurse. And that comment about crawling home............indeed indeed! There is so much more to say, but I gotta crawl under the covers and hide from the sun now :)

l.Rae

Loved your question as the ER has been my home for the past 7 yrs..

I think it is definitely a subculture all it's own..I attended the Emergency Nurses convention in New Orleans last year and overheard a nurse pose a question....What is the difference between an ER nurse and a pitbull dog????Everyone sort of looked at each other and shrugged...She replied.....LIP GLOSS!...I had to giggle to myself and then realized that this is probably the interpretation of some people..

I want to throw out a thank you to all the med-surg/ICU/CCU nurses that I transfer my patients to.....I have heard many ER nurses grumble and mumble when a bed upstairs or in the unit is not available yet and respond with "I wish we had the opportunity not to accept patients because we don't have beds"....You guys on the med-surg floors and other units have the hardest jobs in the world (just MY opinion)...and thank you for all you do...With nurse/patient ratios through the roof, we all need a pat on the back....Keep up the good work guys!

The next time an ER nurse gives you a hard time, think LIP GLOSS!:chuckle

Hey, baseline!

You're one of us and you know it! Fortunately, nothing has burned out your sense of Yuma! :chuckle

I started out as a "newbie" in the Er as a new grad 2 years ago and am now one of the "seasoned" nurses training the new "newbies" lol I have definitely discovered that it does take a certain kind of person to work in the ER, you have to be able to handle pressure, prioritize, organize, multitask, and be able to identify those that can go downhill super fast...and it is possible to learn all that, but I think you have to be able to take it all in and absorb what is going on in the ER enviornment...and the instinct to know when someone is sick is something you have to be able to develop and fast! Not everyone is able to acclimate to that fast paced/stressful enviornment no matter how smart they are or how good their assessment skills are. But I'm grateful that "newbies" are able to try, otherwise I wouldn't be in the ER, and I love it!

Specializes in Emergency.

Thanks Angelgirl and Tara.

You've inspired me to definitely go for it as a new grad in the ER.

During one of my ER clinical rotations, I was with triage. It was neat. Then the nurse told me, "we got one coming in unresponsive, go with her" she sent me in the direction of another nurse. This nurse that I went with says, "ok, she's coming in unresponsive, what are you gonna do?" I just opened my mouth and let all of my assessment pieces flow, and when the patient came in I was prepared. The nurse was a little bit "short" with me, but she stood by me the entire time. Which I appreciate and admire. I definitely want to work in the ER.

Jenni

to graduate ADN june 13, 2003

Specializes in Med-Surg, Tele, ER, Psych.

One of the best things that happened to me in my first month in the Er was having a preceptor that was to be my "partner" in our schedule rotation, so she was essentially training me to be able to work with her. We went over the top diagnoses that would be coming in the door and took our actions step by step, verbally and on paper, so that it would be rote to me about what I would do when a patient with X walked in. Last week, all hell broke loose and we had beds in the xray hall and inside the ambulance bay, and then one walked in with chest pain. I knew that my assessment and triage process depended a lot on what I saw on the monitor, so I climbed over the group prepping a patient for the helicopter to take him away and got the Datascope and dragged it into the triage room and hooked him up. It doesn't take long to identify an elevated ST segment, and you can guarantee I flew out of the triage room and grapped the nearest doc, then the charge nurse so I could kick someone out of a bed quickly and raised the alarm, so to speak that I needed to get him out of a chair in triage.

I called the nurse who trained me when I first came to ER to tell her that her method of step by step assessment then action really made a difference in the life of a patient in a totally different hospital....a long time down the road. She just popped into my mind after the dust settled....her voice coming out clear in my mind that first things first will save a life one day.

Specializes in Med-Surg, Tele, ER, Psych.

One of the best things that happened to me in my first month in the Er was having a preceptor that was to be my "partner" in our schedule rotation, so she was essentially training me to be able to work with her. We went over the top diagnoses that would be coming in the door and took our actions step by step, verbally and on paper, so that it would be rote to me about what I would do when a patient with X walked in. Last week, all hell broke loose and we had beds in the xray hall and inside the ambulance bay, and then one walked in with chest pain. I knew that my assessment and triage process depended a lot on what I saw on the monitor, so I climbed over the group prepping a patient for the helicopter to take him away and got the Datascope and dragged it into the triage room and hooked him up. It doesn't take long to identify an elevated ST segment, and you can guarantee I flew out of the triage room and grapped the nearest doc, then the charge nurse so I could kick someone out of a bed quickly and raised the alarm, so to speak that I needed to get him out of a chair in triage.

I called the nurse who trained me when I first came to ER to tell her that her method of step by step assessment then action really made a difference in the life of a patient in a totally different hospital....a long time down the road. She just popped into my mind after the dust settled....her voice coming out clear in my mind that first things first will save a life one day.

As I've gotten more experienced, I'm grateful to the ER nurses. It's rare when I will ask them to "hold" a patient for 15 minutes ... unless a patient has just been discharged and the room needs to be cleaned. Thank you for what you do.

And yes, there are many subcultures in nursing ... but the more we think we are unique ... the more we are truly the same.

:D

As I've gotten more experienced, I'm grateful to the ER nurses. It's rare when I will ask them to "hold" a patient for 15 minutes ... unless a patient has just been discharged and the room needs to be cleaned. Thank you for what you do.

And yes, there are many subcultures in nursing ... but the more we think we are unique ... the more we are truly the same.

:D

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