Emergency Nursing Areas

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I am trying to work out what work I could do in emergency nursing. I thought I would ask people who work in this area since you would know best.

1) What area of emergency nursing do you work in? 

2) What are your duties and what is it like?(e.g hours/days, working conditions etc.)?  

Specializes in Peds ED.

I work in a peds ER. We see patients up to 20 years old, but have been taking more adult patients to help out with COVID.

When I have a patient assignment:

Get report, check my rooms quickly for emergency equipment and say hi to patients. Then repeating cycles of prioritize, task, reassess. New patient? Say hello, get quick history of why they're here, do focused assessment, try to set realistic expectations for when the doctor will come in to see them. Give tylenol and motrin, start IVs and do straight caths, set up for and monitor sedations. Give zofran, so much zofran. Recheck vitals, get patients to CT, ultrasound, give fluids. Call report on admitted patients, help coworker hold for a workup. Restock my carts as I go and do a bigger restock when things slow down around 4am. Cosign wastes with coworkers, answer junior staff member questions. Talk to the residents, talk to the attendings when I feel like the residents are not on the ball. Jump in when there's a sick patient needing a lot of help or hang back and task for other patients while other staff is tied up. Lots of education and reassurance. 

When I have an orientee: various levels of doing all of the above to hovering while they do to sitting at the RN station watching them from afar and checking the charts to make sure they're not missing new orders or documentation points.

When I'm in triage: Check my stock and restock quickly (usually just need more disposable pulse ox probes and temp probe covers). Get initial vitals, history of complaint, medical overview of walk in and ambulance patients and assign acuity. Basic wound care if needed, start safety watches if needed, call charge nurse for a room right away if needed. Keep eye on patients waiting in waiting room for signs of decompensation. Give vague and unsatisfactory updates on wait time when people ask (it's so hard to explain that wait times have too many variables and can change moment to moment depending on what's happening in the department and what's come in through the door in the last few minutes) and 10 years of success in NOT saying "Oh I'm sorry, what time was your appointment?" sarcastically to the people who complain the most about the shortest wait times. When the flow is slow I walk patients to their rooms, when I have a backup to triage I let the charge nurse delegate getting patients to assigned rooms.

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That sounds really interesting!! As an emergency nurse do you have a designated role or do you jump tasks from being the triage nurse to working in trauma for instance?

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Specializes in Emergency Room, CEN, TCRN.

we have different assignments in my ED; charge nurses are in charge, triage nurses triage pts in the waiting area, some nurses work a a "zone" (three rooms that they're responsible for), flow nurses break nurses from their zones, assist people with heavy pt loads, or respond to traumas/codes/strokes/whatever comes in so the nurses in the zones can focus on getting pts admitted or discharged.  

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Specializes in Peds ED.
19 hours ago, Mary3010 said:

That sounds really interesting!! As an emergency nurse do you have a designated role or do you jump tasks from being the triage nurse to working in trauma for instance?

We make assignments in 4 hour blocks. Generally you're in whatever assignment you start in for your full shift but as staffing decreased you might move around. I might start in triage but at 3am there's not staffing to have a dedicated triage nurse so I take over an assignment from someone who leaves at 3am. I might start in the acute section and move to our less acute area that we tend to staff first when we're low staff due to logistics. Our staffing model has us losing a lot of staff at 3am which *usually* coincides with a sharp drop in census so the assignment generally shifts at least a little at that point. The trauma responder is assigned the same way, usually has another roll, ideally as a floating helper nurse instead of having an assignment during bigger trauma hours.

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Does working in the urgent care section of emergency mean that the nurse interprets scans and performs first aid duties such as managing wounds etc.? 

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Specializes in Emergency Department.
On 1/9/2021 at 7:36 PM, Mary3010 said:

Does working in the urgent care section of emergency mean that the nurse interprets scans and performs first aid duties such as managing wounds etc.? 

Official interpretation of scans/tests/etc. is the purview of the advanced practice providers (NPs and PAs) or the physicians in my ED. Obviously, we RNs look at the tests and scans and will know what's going on before the APP/MD/DO makes an official diagnosis. But officially diagnosing and then deciding on a plan of treatment is not in our RN scope of practice. 

First aid is often started by EMS or triage. Yes, we do wound care and splints and other things like that.

It sounds like you would benefit from shadowing an ED RN in your area. You won't really understand what we do until you see it in action, partially because it can change drastically from minute to minute. And a RN in a big Trauma 1 may have a very different average shift than a RN in a rural ED in a critical access hospital. 

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How would you be able to do that? 

My interests are to perform first aid duties, understand and give scans, give medication, check vitals, help those in a mental health crisis situation etc. I understand what you mean though. Maybe what I am after is a nurse practitioner position which I assume would require a masters or pHd degree.  

 

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Specializes in Nursing Student.

You might also be interested in being a wound/ostomy/continence nurse if you're into wound care.

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Specializes in Emergency Department.
On 1/15/2021 at 1:17 AM, Mary3010 said:

How would you be able to do that? 

My interests are to perform first aid duties, understand and give scans, give medication, check vitals, help those in a mental health crisis situation etc. I understand what you mean though. Maybe what I am after is a nurse practitioner position which I assume would require a masters or pHd degree.  

 

You could probably contact the nurse manager of any local ED and ask if you could shadow one of their nurses for a bit. Explain that you're interested in the field and want a better idea of what we do. Are you a nurse? Nursing student? Pre-nursing? 

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On 2/23/2021 at 2:34 PM, Raven Sierra said:

You could probably contact the nurse manager of any local ED and ask if you could shadow one of their nurses for a bit. Explain that you're interested in the field and want a better idea of what we do. Are you a nurse? Nursing student? Pre-nursing? 

I didn't know you could do that (I just assumed that only students on their placements could). I have studied nursing but I am on a break at the moment. 

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