ED RN in Australia

sparticus2008 · Sep 29, 2018

Medications: You are not going to be prescribing medications in ED, or other nursing areas, unless you become a nurse practitioner, however, most ED nurses (and again in any nursing area) will find after a while that you know what the common medications are for common presentations, so you probably ask the doctor for the medications that you want in certain situations.

Performing first aid/Checking vital signs/other procedures e.g IV's, blood transfusions (giving not prescribing) - yes you wil be doing things like this. Fixing broken bones = doctor's job.

You will have a good understanding of the results of blood test, ECG/EKG's etc HOWEVER you will not be making the main treatment decisions/give the official diagnosis, its more so that you know how sick/critical your patient is and how quickly you need to track down that doctor and advocate for them .

Yes exciting things happen in emergency departments, but most of ED isn't adrenalin racing, someone is about to die, they're doing open heart surgery in the ED department TV kind of ED. There is a lot more just run of the mill abdo pain, back pain, nausea & vomiting. Lots and Lots and Lots of Elderly falls patients.

Also I have yet to see a TV ED show that includes the 2-3 mental health patient who are currently in crisis, who have been sitting there for two+ days waiting for a mental health bed to become available, whilst their mental health steadily worsens because EDs (Loud, bright artifical light, lack of privacy, rarely any outdoor windows etc) are possibly the worse place for a person in a mental health crisis to be.

TV shows also fail to show how multi-disciplinary ED care is. Like rarely ever do TV shows include physiotherapist, but actually there may well be a physiotherapy team that is working with the falls patients (once medically cleared that they haven't broken a hip etc) to work out whether the patient is safe to go home , or whether they need transfer to the ward for further rehab/falls prevention.

Or the social workers who are trying to sort out the very tangled domestic situation of a patient who wants to discharge and so on .

Sometimes babies are born in ED, but if the hospital has an maternity section they will generally call them to attend :)

But what you will see will also depend on the hospital set up. So for example: in my state there is one State Trauma Centre, so the majorty of major trauma is funnelled to that hospital, so ED's at the other tertiary hospitals rarely ever see major trauma.

One of the other teriarys is the state burns centre, so the other tertiaries rarely see massive burn injuries.

One of the tertiaries jokes about being the states hip fracture unit, because their catchment pool has a lot of older adults, so they see a larger percentage of broken hips.

An ED located in a CBD will see a lot more homeless/no fixed address clients than a hospital in the suburbs.

But essentially: there will be way more mental health & major surgery than what you are used to seeing on TV :)

K+MgSO4, BSN · Sep 30, 2018

And lots of gen med secondary to non compliance. Not taking diuretics, not adhering to fluid restrictions, not taking immunosuppressive meds and having flares of UC or chrons, continuing to drink with liver failure, not using bipap with respiratory failure. Major mental health issues but not enough inpatient beds for them resulting in sending people back to the community who desperately need admissions.

I liken ED to a sorting office. Speciality wards are often more intense e.g. uncontrolled GI bleeds, airway compromise on a head and neck patient post op. Emergencies don't just happen at presentation. Sick patients who are admitted continue to be sick, some getting worse requiring surgery or ICU or cath lab or endoscopy intervention.

Mary3010 · Oct 2, 2018

Sparticus2008 and K+MgS04:

Thank you for your comments!!!! Would you say that the description of my interests is closest to that of an Emergency Registered Nurse?

Could an advanced nurse fix broken bones/dislocated shoulders etc. maybe then?

Some of the things that you both have mentioned, I didn't think of but makes perfect sense. For instance the fact that an ED located in a CBD will see more people who are homeless than elsewhere. Wow I didn't realise how many elderly fall patients and mental health patients there would be. I didn't realise...I only thought that those who suffer mentally would go to emergency if they have physically hurt themselves (self harming). That's really sad that not that much can be done to help them!!

Have you ever had to deliver a baby in the ED?

sparticus2008 · Oct 2, 2018

So as a nurse practitioner you may diagnose & strap a simple broken toe or finger, but legs, arms, wrists, dislocations etc are a Dr's job.

Again, if you are rural/remote you typically have a larger scope of practice, for example, you may do simple suturing as a nurse in a remote hospital ED.

Mary3010 · Oct 3, 2018

Thank you for your comment! What would be the difference in duties between working as a doctor and nurse in Australia? From my understanding the doctors will give the orders and the nurses carry out the bedside tasks. Though I think ED and anaesthesia doctors do some bedside tasks too.