ED Nurse Project for Nursing School

MedicVeronica · Mar 24, 2009

I'll try to answer these....

1. How many years have you been a nurse? Just had my first year review as an ED RN - and started in the ED straight out of nursing school a year ago.

2. What is your educational background and/or specialty certifications do you hold? BS from Villanova in general science with minor in Math, MBA in Info Systems Mgt, Nationally Registered EMT-Paramedic, BSN from Georgetown U. and RN. Have ACLS, PALS and am a AHA BLS CPR instructor. Also am an EMS Lieutenant for my local VFD.

3. What is the most rewarding aspect of your job as an ED nurse? Getting to help patients that appreciate it. The team work that occurs in the ED.

4. What situations are the most challenging for you as a nurse in this department? Dealing with patients that have poor attitudes, ones refuse to do anything for themselves, family members that don't have a clue about how truly sick or NOT sick their relative is.

5. Why did you choose to go into emergency medicine as a nurse? Loved being a volunteer paramedic but needed a new career that paid better and did not want to be a firefighter.

6. Has there ever been a time when you wish you wern't an ED nurse?

Some of those first 12.5 hour shifts were killers - especially the night shifts.

7. Is there a memorable experiance that stands out as you think back as your experiance as an ED nurse? Every day is a different adventure and there's something memorable or unique about each shift.

8. What would you tell a new nurse as they begin their experiance? Don't let the amount of information they throw at you bog you down. Be patient. Ask lots of questions - but not in front of the patients. LISTEN TO THE PARAMEDICS AND EMT'S THAT BRING YOU YOUR PATIENTS! Read the EMS protocols for your state so you know what to expect the EMT's/Medics to have done and what they can and cannot do in the field. Be nice to everyone in the ED - the unit clerks, the housekeeping staff, the security guys, the EMT techs - if you get to know their names, and are polite and kind - they will really help you out.

bkMT · Mar 24, 2009

Thank you so much for your time and insight!! I really liked your comment on the last question regarding listening to the medics/EMTs....very true! I'm a EMT-B myself and can attest to the importance of that! Thanks again : )

Myscrubs · Mar 24, 2009

1. How many years have you been a nurse? 20 yrs

2. What is your educational background and/or specialty certifications do you hold? BSN, MSN; boardcertified in pediatric nursing by ANCC, board certified emergency nurse & board certified pediatric emergency nurse by BCEN/PNCB, board certified pediatric nurse practitioner by PNCB; has BLS, ACLS, PALS, NRP; TNCC & ENPC providers

3. What is the most rewarding aspect of your job as an ED nurse? That I am part of the team that saves someone else's life...

4. What situations are the most challenging for you as a nurse in this department? Violent behaviors of patients/parents/visitors... the different human behaviors that you need to deal with all the time

5. Why did you choose to go into emergency medicine as a nurse? I like the drama, the action and most importantly, emergency nursing gave me that skills in quick decision-making, prioritization, good assessment skills.

6. Has there ever been a time when you wish you wern't an ED nurse? NO. I enjoyed every single moment that I've worked in the ER.

7. Is there a memorable experience that stands out as you think back as your experience as an ED nurse? The human drama always fascinates me. Everyday is always a new experience.

8. What would you tell a new nurse as they begin their experience? Don't pretend that you know everything. Always ask. Keep enthusiasm, curiosity, eagerness in your pocket at all times. Volunteer, hands-on experience is the best teacher. Observe all the time. Do not kill time by just sitting down, read about new cases/procedures... Do scavenger hunt- go around and open cabinets and storage rooms. Above all, be yourself, respect others, and be professional.

MIA-RN · Mar 24, 2009

1. how many years have you been a nurse? a few months short of 3 years. i have been a nurse in the ed for just over a year.

2. what is your educational background and/or specialty certifications do you hold? i have an aas in nursing.

3. what is the most rewarding aspect of your job as an ed nurse? the fact that we do things in the here and now to help an immediate problem. when i send people home, they often feel better than when they got there. i feel like i make a real difference, which i didn't feel when i was a floor nurse.

4. what situations are the most challenging for you as a nurse in this department? the biggest challenge is trying to manage the care of more and more patients without a similar increase in resources. we seem to have more patients who are more acute. also, the people who aren't truly sick take away the time and resources from those that really need it.

5. why did you choose to go into emergency medicine as a nurse? i got very tired of working on the floor, and seeing the same patients day in and day out and not feeling i was making a difference. i like the fast pace and the (relatively) fast turnover. i like seeing a little of everything every day.

6. has there ever been a time when you wish you wern't an ed nurse? no.

7. is there a memorable experiance that stands out as you think back as your experiance as an ed nurse? it's hard to say without violating hippa...when people tell me i really helped them, it stands out to me. (and it is often not related to their actual medical/nursing care) one time i had a patient who came in with mostly anxiety-related symptoms. i took the time to ask her what was going on, and it turns out she was recently diagnosed with cancer, she did not speak much english, and she didn't really even understand her illness or the treatments. i was familiar through my experiences with the type of cancer that she had, as well as with the medication she was taking. i explained the basic mechanisms of her illness, and told her about the medication side effects. she explained that the medicine was very expensive, that she didn't have the funds. i was able to find the name of the drug manufacturer's program for reduced-cost medication, and i was also able to give her information on a local support community for her type of cancer. this young woman came in feeling alone and scared and left with a plan and a new sense of hope. she cried and hugged me when i discharged her, thanking me for giving her hope. this is not the kind of 'blood and guts' experience or even one of the most moderate heroics, but its one that impacted me strongly.

what would i tell a new nurse? well, the standard stuff about comfy shoes. but seriously, keep your eyes open and ask questions. always ask if you don't know. trust your instincts; if you find something in your patient that doesn't seem right, bring it the attention of your preceptor, your doctor, or another nurse. your instincts will sharpen the longer you do this job. if you begin to feel overwhelmed, ask for help. teamwork is huge in an ed and most people will help you out. you need to remember to reciprocate as well. grow some armour too--you will see things that will affect you on many levels. it is okay to use therapeutic use of self but if you get too emotionally involved you will burn out. not all outcomes are good and you have to be prepared for that. its okay to cry with your patients.

ERjodiRN · Mar 24, 2009

1. How many years have you been a nurse? i have been a nurse for 3.5yrs

2. What is your educational background and/or specialty certifications do you hold? graduated from a parochial university in napa valley called Pacific Union College with a BSN. i have bls, acls, pals, am a certified pals instructor as well as the pediatric resource RN to my ED. i also have my micn certification (mobile intensive care nurse), as well as a ccrn.

3. What is the most rewarding aspect of your job as an ED nurse? one of the greatest things about the ed is the raw emotion you experience with the other staff memebers and families/patients involved. whether it's finding horrible news like cancer, or good news like telling someone they are pregnant....the raw emotion happens in the ED. when you're on the floor, chances are the diagnosis has already been established and the patient and family already know. being able to help, or be a part of that initial reaction is inredibly challenging...not everyone can do it! another great thing is the fact that we are ALWAYS learning something new. everything comes through us!

4. What situations are the most challenging for you as a nurse in this department? the heartbreak......again, part of that raw emotion thing.

5. Why did you choose to go into emergency medicine as a nurse? i thrive in stressful situations that get my adrenaline pumping. i like being able to work fast and efficiently, so it's perfect.....and always ever-changing!

6. Has there ever been a time when you wish you wern't an ED nurse? never

7. Is there a memorable experiance that stands out as you think back as your experiance as an ED nurse? i was 3 months off orientation and had a an altered female pt. we suspected a seizure but weren't sure. all vitals were normal outside of slight st in 120's. i take her to ct and she starts seizing so i call the doc to give another nurse an order for ativan and have them bring it over. as i'm talking to the nurse i notice that even while seizing, the HR on the monitor is bradying down, with very little artifact so i have him give the phone back to the dr who tells me just to stop the scan and bring her back. as soon as i hang up and walk over to her she goes limp and totally coded.....vfib on the monitor. i had the ct tech call a code and debated whether i should shock before the doc got there. decided to do so and right after the shock the team got there and started compressions, etc. got her back to the main ed, shocked her 2 more times and finally got a rhythm back. we did the hypothermic protocol on her and she ended up being discharged 1.5wks later with no brain damage. the doctor wrote a letter to my director commending me for my work, and i will never forget that. i was absolutely terrified the entire time and thought i was the worst nurse in the world (remember....3 months off orientation). to get that from a doctor was amazing.

8. What would you tell a new nurse as they begin their experiance? prepare to be nervous, unsure, and absolutely terrified for a solid 6 months, no matter where you start. you may feel sick before every shift. always always always ask questions! while you're afraid you're showing a lack of knowledge or confidence, you're showing your coworkers that you're wanting to know things that enable you to take better care of your patients. that includes getting a diagnosis you've never heard of before, even if everyone else seems to know what it is. ask. we don't care that you didn't know. we DO care if you're treating someone with a diagnosis you don't understand the patho to. don't expect to not get emotionally involved with your patients. you will. you will cry, you will get angry. eventually you will develop a slightly thicker skin. most importantly, don't let more experienced (and often bitter and burned out) nurses change your view on nursing.

cookienay · Mar 27, 2009

Hope this helps you in your endeavors...

1. I have been a nurse for almost 17 years. ED for almost 10.

2. ASN originally, BSN 2002. No specialty certs, though a few of my colleagues have CEN.

3. Instant gratification... seeing someone come in very sick and turn around before your eyes. Or actually saving someone's life. that is always good.

4. The human element such as the drama, behavior, threat of violence. This coupled with the incessant demands placed upon you from all directions really creates most of the challenges.

5. I like fast paced, chaos, and see answer to #3. Plus, to be honest, it is sort of an ego rush to know that you have a part in all that.

6. Yes. When I have to comfort the mother of the dead 4 year old as she is still strapped to the backboard and is being airlifted to the nearest trauma center due to her injuries. Also, when my overactive imagination comes to life and I picture all the ways my kids could be hurt or killed. THat is when I hate being an ER nurse

7. Yes, several. I love the comraderie(sp) with my colleagues- we have a great team for the most part. There is one incident when I had a patient with a lower GI bleed who started bleeding out and was circling the drain. Within one hour he had 4 units of rbcs, some ffp and GI on the way and it was all documented as it occurred. As he was being wheeled to endo, one of the other nurses looked at me and said, "I wonder if he realizes we just saved his life?". It made me realize that what we do becomes everyday routine. Very rewarding.

8. Ask questions. ask the docs, ask the other nurses. Please be prepared to still be stupid after 6 months- we ALL were. Observe and take it all in. Learn to take criticism from everybody- even the uneducated, unwashed, and unlovable. Develop boundaries. You cannot please all people. There will be days when patients, family members, and/or coworkers will be angry with you and vice/versa. Plan how you will deal with that. Please also help out your teammates. If you are caught up, see if there is anything you can do to help. believe me, that will payoff later.

nurse4ukate · Mar 30, 2009

1. I have now been a nurse for 3 months. I graduated in December and started right out into the ED.

2. I graduated from Baker University in which I did my pre-nursing and nursing schooling through in 3.5 years. I will be taking the emergency nursing certification hopefully at this end of this year. Right now I am just getting all of my certifications completed for my job (e.g. ACLS, TNCC, ENPC, PALS, etc.)

3. It is so rewarding to have thank you cards sent back to my director from a patient that I took care of and how appreciative they are to have me try and make them feel as if they are my only patient (when I usually have 2 of 3 others). It's also rewarding to have a career in which I am continually learning either new medical knowledge or just a simple life lesson. I don't believe that in any other career can you get the satisfaction of knowing that you have touched someone's life and also know that you are bettering yourself through your career.

4. It's difficult to see and have to talk to families when their family member is critically injured/ill or has died. It has also been difficult dealing with patients with mental health issues who are off their meds and ,then in many cases, dealing with some type of injuring which involves much pain on top of that.

5. I have always been a person who needed to go-go-go. I hate to sit still and I hate things constantly being the same. I love that the ER is ever-changing. You never know what is coming through the door. I also love the fact that the ER makes you think critically and always being thinking ahead of even the doctor. Just in 3 months, I have felt that I have learned more in the ER than what I learned in school. It's amazing to me though how much sense all that stuff I learned in school makes now!

6. Even though I've only been there 3 months, never I have wished that I would have started out anywhere else.

7. Well, again, since I'm just 3 months into it I'm still experiencing a lot. But what comes to my mind is when my preceptor and I were assigned to our critical rooms that day. We had been pounded on the entire shift. My preceptor and another nurse began to work on another patient as I was receiving a patient having an MI. It was the first that I had had to deal with while they were actively infarcting. The entire ER was slammed at that time and hall beds were everywhere. Luckily, another orientee (a newbie like me) came and helped me and we got the man to the cath lab in about 20 minutes. It was a good day! :)

8. It may look intimidating and heck, it is. You are going to be stressed. You are going to feel like you don't know anything at times. That's what your co-workers are there for. They have all been in your shoes and they know exactly how you feel. Ask questions- even the dumb ones. Try to get in on as many procedures as you can. I usually follow my doc in after I have already assessed my patient just to see what all he assesses and the questions he asks. Some docs don't like it but too bad, it's your patient also. Most docs like it when you ask them questions. They develop a deeper respect for you because they can tell that you are wanting to learn. Don't stand back for things- jump in there. You are going to make mistakes but that's how you learn. Trust me, you'll remember to not do it the next time! Don't take it personally when a patient or co-worker yells at you during a crisis time. Everyone's emotions will get the best of them sometimes. Shake it off- that didn't mean it usually. Write down questions that you have as you go through your day. Don't know for sure about what a certain lab is for- either ask someone or look it up later. Once your out of school it's amazing how things will leave your head. Look it up when you've had a patient with it. It makes it much easier to remember and it will make more sense. Be prepared to have a different mind set. I'm not saying to become cynical or jaded but you'll find that you develop a thicker skin. You'll begin to be able to tell some certain complaints from another...work a little while and you will find out what I mean.

I love the ER and there isn't any other place I would want to work. It gets crazy, stressful, scary, emotional, and sometimes boring. It makes you think constantly and you will NEVER stop learning.

I hope all of this helps! Good luck on your last semster and enjoy your nursing career...there's no other job quite like it!