That Day in the ER
I reported to clinical on time, and then went down to the ER to check in with the nurses. I had been here before, and knew most of my time would be spent walking patients to the bathroom, gathering urine samples, maybe passing a med or two, taking a lot of vitals, and repeating to patients "I'm sorry, I can't tell you what is happening next door. I can't tell you anything due to the privacy laws." That was fine. I didn't mind doing what needed to be done because I was in the ER and loving it.
The beginning started out just as I had expected until about an hour into my clinical.
One nurse grabbed me and told me to go to Trauma Room 1. I assumed I was just to observe, so I quietly stood out of the way of the trauma team and let them work.
According to the Paramedics that brought the patient in, she was fine when they arrived. She was talking to them and telling them that she had had a pacer put in several months ago, and she said she hadn't "felt right" since the surgery. The paramedic also went on to say she didn't feel good while she was eating dinner, so she called them. They got her loaded and on the trip in, she lost consciousness. The doctor suspected respiratory failure, a stroke, and a PE.
I think I stood there for about five seconds taking in the report from the paramedics and watching the doctor. Then the big moment came....the doctor asked me to put the patient on oxygen. I unhooked the hose from the tank, and replaced it on the oxygen coming out of the wall. As I finished and started to move back to my observation place, one of the nurses came in and dropped a Foley kit at the bottom of the gurney.
Not thinking, I grabbed the kit, and stuck the Foley in. I'd had a bit of trouble with female patients when inserting Foleys in both clinicals and in my job as a Patient Care Tech, but this one went in quickly and with no problems. The nurse returned a few minutes later with the intention of inserting the Foley, and asked where it was. I told her I had put it in. She smiled and thanked me, and asked me to get a glucometer reading.
Fifteen minutes later, it was all over.
As I cleaned up the trauma bay, I took a step back. I hadn't just observed. I actually had participated. I had done Critical Care!
After all of the nightmares I had and had heard about how horrible Critical Care is, I was surprised that I had actually enjoyed it. In my current job, I had been floated to the stepdown unit a number of times and I had hated it. Those experiences had told me for sure that I was not cut out to be a Critical Care Nurse.
At the beginning of my clinicals, I had been so set on avoiding the Critical Care situations as much as possible. If my classmates were sent up to ICU to observe, I would stay on the floor and do whatever I could to avoid going. My instructor kept wondering why I wouldn't volunteer to go, when I routinely volunteered for other areas. I didn't have the heart to tell him I didn't want to be trained in Critical Care nursing.
After my rotation in the ER, I realized that I was cutting myself short, and I did enjoy it. I really loved my ER rotation. I'd love to work there. I had great precepting nurses and a Paramedic who worked there that really knew her stuff. She was wonderful at explaining things and answering questions.
One ER nurse was a former teacher at my school and told me that she held my school's students to a higher level than the other students that rotated through the ER. On my last day, she took me aside and told me I did a wonderful job.
Critical Care wasn't the nightmare I had expected it to be. I'm so glad I had the chance to do this rotation because it has left me wanting and aching for more.Last edit by Ms Kylee on May 9, '08
About Ms Kylee, BSN, RN
From '1 W. 161st St. Bronx, NY'; Joined Oct '06; Posts: 845; Likes: 683.May 11, '08When managed properly, the ED can be a wonderful place....just be ready for the ones that aren't....12.5 hr days, no breaks, no lunch and don't have an opinion that is different than the NM and the goodie two shoes who care only about making themselves look better at the expense of the nursing staff. Budget means everything and you will work shorthanded from the RN that called out, the tech that was never replaced and so on..
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