Real life in the ER
There's never a dull shift for emergency room nurses
By Roy Wood
Post staff reporter
They each have their memories.
University Hospital nursing supervisor Joyce Zehler remembers the night a man got his arm caught in a meat slicer.
He came into the emergency room with the slicer still hanging from his arm -- and the ER staff had to call a hospital maintenance man to help take the machine apart so doctors could put the man back together.
ER nurse Annette Asbury remembers the day a woman got her ponytail caught in a piece of industrial machinery. The machine pulled the woman's scalp off.
Asbury and emergency room nurse Jennifer Parkhurst both remember the night a woman was vacuuming in her attic and fell through the floor and was impaled on her vacuum. The hose attachment went through her diaphragm.
Then there was the night the cabbie came in with a large knife sticking in his head. He recovered.
"We know the news before everyone else does," Parkhurst said. "Everything you see on the news is here."
"Here" is technically known as the University Hospital Center for Emergency Care, a 43-bed floor that sees upwards of 240 patients a day.
Over the past few months, University Hospital's emergency department has been implementing procedures to shorten waiting times for ER patients and improve overall emergency care.
One step involved re-implementing a newer triage system, in which a nurse assess patients within a few minutes after they arrive to help make sure the sickest or most critically injured patients are seen first.
Now, hospital officials want to add eight emergency nursing positions in order to improve the nurse-to-patient ratio in the ER at University.
Currently, there are 70 registered nurses, plus nurse managers and patient care assistants. Even though Zehler, Asbury and Parkhurst said the work sometimes can be stressful -- even scary -- they said they would never leave the ER.
The ER is where the action is.
"I love the quiet days, but I love (treating) the trauma; I love the clientele," Parkhurst said.
"Every single day is different. There's nothing monotonous about emergency room nursing."
Asbury, who has been a nurse 19 years -- the last four in the ER -- said there's a special teamwork in the ER that she didn't feel when she worked in other departments.
Unlike on other floors, that kinship extends to doctors and residents, she said.
"When you work on the floors, you see the docs come in, they write their orders, and they leave. And you might not see them for the rest of the day," she said. "Down here, we're with each other all day long.
"You work so closely together," she said.
Because of the situations they find themselves in, they share a lot of emotions, Zehler said, recounting an incident several years ago.
"I'll never forget the lady that came in and was delivering the baby that was breech," she said. "We were having trouble getting it out, and there were probably 15 of us around her.
"It was real quiet because people were so involved and so wanted it to be OK. I just remember when that baby came out, you would have thought that it was our baby."
Other times it is collective grief that suddenly quiets the ER, the nurses said.
The morning firefighter Oscar Armstrong died fighting a house fire last year was one of those silent times, as was the night in December 1997 when Cincinnati police officers Daniel Pope and Ronald Jeter were killed in the line of duty while trying to arrest a domestic violence suspect.
"I'll never forget the policeman lying there with his tennis shoes on," Zehler said. "He looked like a little boy: jeans and tennis shoes because he was undercover. It was very quiet -- very quiet."
Sometimes they simply need to step away to wipe a tear. Other times simply being quiet helps.
All three engage in hobbies to unwind.
Asbury has a booth at a flea market. Zehler runs. And Parkhurst confesses with a laugh that she's a Pottery Barn addict.
All three women are married.
As the nurses spoke, one patient was being treated for chest pains, an HIV patient was having a neurological problem, and a cancer patient was in extreme pain, said Dr. Alexander Trott, a University of Cincinnati professor of emergency medicine.
The ER was also handling its usual array of broken bones, asthma attacks, a psychiatric emergency and a minor head injury.
However, the ER's four trauma beds -- where victims of serious car crashes and gunshot wounds and the like are treated -- were empty.
By ER standards, it was quiet.
To be effective, ER nurses have to be able to perform in "organized chaos," Parkhurst said.
They also have to be adaptive and able to prioritize tasks, Asbury added.
For all the stress, ER nursing is extremely rewarding, the women said.
"I can focus on the patients and make a difference in their day and in the things they're going through. I can reassure them with confidence that we can make them feel better, or during the times when we know we can't -- when there isn't much hope -- to be able to comfort them," Zehler said.
"I can't imagine doing anything else in nursing. I will never leave it."
"Every day at the end of your shift," she said, "you know you helped at least one person that day."
Publication Date: 05-17-2004