Are ER nurses burnt out or just uncaring??

Well-Seasoned · Jul 14, 2010

In the ED you generally see people at their worst. You get the chronic beligerant drunks and methheads, You get the people who have no healthcare who use the ED (because of cobra laws) to go in for every little sniffle and sore throat and clog up the "throughput" which means extended waits and frayed tempers. You get the drug seekers, who can actually be teachers or other professionals who overtly lie. You get child abuse cases that hurt you to the core. Into this mix you get the genuinly ill person who needs a kind and empathetic nurse to take care of them.

To answer your question I beleive many ED nurses do get jaded. I have always rotated myself fairly often out of the ED because of this. However I have more cards from pts thanking me from when I was working ED. I do see the side of things you saw. It is hard to tell a nurse that maybe its time he or she moved onto another facet of nursing for awhile.

NocturneRN · Jul 14, 2010

oh my goodness i am so sorry!! the way i worded my post was stupid..i wasnt trying to accuse ALL nurses of being burnt out/uncaring, i was just wondering what all the ER nurses thought about my situation...for example, if that was the norm or was i treated badly...i didnt mean to start a big fuss or anything...to all the ER nurses that may have been offended by my thread--- I am TERRIBLY sorry. I appreciate and admire all the work you do. Perhaps I should've waited until i had cooled off from the terrible experience. My apologies!!!

This ER nurse thinks you have no need to apologize. Any one of us would be pretty upset if we were stuck on a backboard for four hours, especially if there was no explanation for the delay. Not only is that uncomfortable and frustrating for the patient, it also places him or her at serious risk for skin breakdown.

Sometimes nurses are busier than they look, and that's not always apparent to a casual observer. But I also think we forget that, when we're joking (even briefly) with a coworker at the nurses' station, it's easy for visitors to misinterpret it, and assume that we're not taking our jobs seriously. Whatever was going on with the staff at that hospital, they should have been aiming to get you off that backboard as quickly as possible, and been more diligent about letting you know what was going on and why. If there's anything worse than being strapped to a backboard for hours, it's being strapped to a backboard without any idea how long it's going to take to be cleared from it.

futurenurseheather · Jul 14, 2010

It's very weird to be left on a backboard after the secondary trauma survey. I would not have been surprised that a C-collar was left on, of course. In fact I would have been surprised if it hadn't- given your symptomatic neck pain. However, and granted I don't work in ER, but have been on the 2nd trauma team many, many times, not to mention the TNCC cert. The practice that I am familiar with- and believe to be correct is to logroll the pt. off the backboard to assess the spine. I don't recall any patients being placed back on to the backboard- even if full spinal precautions (holding c-spine, logroll, etc.) are indicated.

i was in a C-collar the whole time, but for some reason, i still strapped to the board with no other complains of pain anywhere except my upper neck, right below my head (idk the medical term for that! )..then they had the nerve to ask me for a urine sample!!! LOL i just stared at the (nurse, intern, cna?? idk who she was) and was just like "wow. are you serious? i cant even move much less give you a urine sample!!!"

BrnEyedGirl, BSN, MSN, RN, APRN · Jul 14, 2010

I'm an ER nurse who isn't burnt out or uncaring,..however I have been accused a time or two. 4 hours on a back board is unacceptable. I work in a large trauma center and often receive pts from other hospitals who have been on boards for hours. The board is for transport only and there is no medical reason to leave a pt on a board. Our pt are usually removed within minutes of arriving in the department (there are exceptions,.the very large pt or a pt who is confused or altered and unable to hold still),..the C Spine doesn't need to be cleared to remove the board! They screwed up and shouldn't have left you on the board.

However,.I must respectfully say that you have no idea what was going on in the dept by looking around and hearing staff talk and laugh. Humor is a huge stress reliever for most of us and even in the most dire circumstances a bit of humor will relax all involved including the pt and family.

I can't make excuses for your care,.I wasn't there. Send a note to the hospital listing your concerns. Our ER usually sees those letters and we often learn something! Best of Luck to you!

PatMac10,RN, RN · Jul 14, 2010

oh my goodness i am so sorry!! the way i worded my post was stupid..i wasnt trying to accuse ALL nurses of being burnt out/uncaring, i was just wondering what all the ER nurses thought about my situation...for example, if that was the norm or was i treated badly...i didnt mean to start a big fuss or anything...to all the ER nurses that may have been offended by my thread--- I am TERRIBLY sorry. I appreciate and admire all the work you do. Perhaps I should've waited until i had cooled off from the terrible experience. My apologies!!!

Sug you ain't got to a apologize to me. I'm in the same boat as you, I understand what your saying. The posters here seem to be taking your post well and seem to be understanding you meant no offense. I just wanted to warn you from my own experiences on here with nurses who didn't take so kindly to what I posted, even though I didn't mean to offend them by any means.

Jennifer, RN · Jul 16, 2010

Where I work, if you come in on a backboard with a c-collar on, it is standard practice to take the patient off the backboard immediately even before a physician is present and leave the c-collar on. Unless they are a trauma or are complaining of severe back or neck pain. Then we, the nurses, go get the doctor to get the pt off the board. Being on a backboard for 4 hours is completely unacceptable, and almost unbelieable.

gld rn · Jul 17, 2010

I hope I can provide some insight. First of all, I am sorry that you had a bad experience. I work in an extremely busy ER, have been a nurse there for over 8 years. I can tell you from experience that most often you can not tell by appearences whether an ER is busy or not. Things can be going on that the patients/family members are unaware of, and naturally we will not discuss this due to HIPPA. I also can tell you that ER staff very often laugh, joke, etc., just to get through what is very often a grueling job, but this does not mean that they aren't working; you may hear me laugh, joke, or make a comment about something (not inappropriately) while I am triaging, documenting a patient assessment, admitting or dishcharging a patient, or trying to transfer a patient to another facility. For example, 2 nights ago, I had an family member question me about why her brother was still in the waiting room. I explained to her the best I could that we were busy and he would be brought back ASAP, and she boldly told me "it's not even busy in here." At that time, all beds were full, 2 patients were on ventilators and required one on one care, we had multiple other unstable patients, a sexual assault, a CPS case, and other situations that were time sensitive, not to mention stressful. These things are not evident to onlookers, so please do not assume that we are not busy.

Across the nation Emergency Departments are overwhelmed with patient volume and not enough staff. The large number of people that use ER's for there main source of medical care for non-emergent problems is staggering, which largely adds to the problem.

ER nurses for the most part work 12 hour shifts, rarely get a scheduled break much less get to sit and eat lunch. Our job is demanding physically, mentally, and emotionally. We do our job with very little appreciation or so much as a thank you. But it is very commen for us to hear complaints. We are also called names, verbally abused, threatened with physical violence, and are at high risk for injury due to the type of setting we are in. To add insult to injury we are expected to do this with a smile on our face and worry about customer service before our personal safety or consideration for how we are treated.

I cannot say that the above coincides with the ER that you visited, so if it does not, again i am sorry that you had such a bad experience. I can only speak from the MANY ER nurses I know from all areas who walk in the same shoes that I do for 12 hours. I can't imagine that ER nurses are uncaring, because none of us would put up with the things that we do if we didn't care.

Editorial Team / Moderator · Jul 17, 2010

I have to say I'm proud everyone for handling this discussion in such a positive, constructive manner. You all rock. :) And I'm sorry to the OP for such a horrible experience ... 4 hours on a backboard is terrible treatment. As an ED RN, I pester pester pester (or advocate, whatever you want to call it! ) until my patient is a) cleared from the backboard, or b) off to radiology to have the studies that will allow backboard clearance. Depends on what else is going on in the ED at the time, of course, but we're all highly aware of the negative effects of remaining on backboards. If possible, we'll clear the backboard and substitute a thin "slider" board under the patients. Not super-comfortable, but slightly better. Our x-ray department has protocols about c-spine studies -- they prefer the patients are in a c-collar and on a board of some sort, be it a backboard or slider.

futurenurseheather · Jul 17, 2010

thank you all so much for your insight...i should've known better than to judge the ER staff just from hearing them laughing outside my door, but i was just so confused at the time, i had no idea what was going on, and i was just concerned about my pain management, and when the heck i could get off that backboard!!! lol anyways, THANK YOU again to everyone who posted, and i'm super glad i didnt offend anyone because that was not my intention...i just realized that i should NOT have chosen "are er nurses burnt out.." as the title..stupid me

happy2learn · Jul 17, 2010

Wow. I volunteer at a Level 1 Trauma center and our ER nurses may sit and chat for maybe 10 minutes, but our patients get in and treated pretty quick. And if I interrupt their chat for a question, they are as nice as can be. They would never leave someone in that position for 4 hours. They get our patients in beds pretty quick. They also care very deeply about patient and family satisfaction.

TxnRN · Jul 21, 2010

:mad:I hope you didn't developed bed sore for being on that backboard for such a long period of time.

gld rn · Jan 18, 2011

you don't have to apologize! sites like this are for exchanging information, comparing situations, and venting....it's a good tool! I hope your next visit (hopefully a long time from now, lol) is better, or maybe it will have an effect on your clinical outlook for your own patients. as long as some good comes of it. you should never apologize for expressing a concern or asking a question!