How do you know if you've got what it takes to be an ER nurse?

alicenbp · Jan 6, 2006

I just graduated in May 05 and my local hospital allows you to go directly into the ER provided you worked there as an extern for your last year of Nursing school first - then you have a preceptor for almost a year - I think it varies by hospital policy and state law how long you have to wait before going into the ER.

MMARN, BSN, RN · Jan 6, 2006

There are always going to be some bad things. Here are some that I have had to deal with and how I dealt with them. Not that I cry all the time, just when I feel it is warranted.
I have had to tell a man his wife died in a car accident he walked away from with just scratches. I had a patient who arrested in CT while I was praying with him.
I had a patient confess murder to me. The police were in the room and missed the entire confession. Yes, I had to go to court and yes, he went to prison on my testimony. That was a real party.
How did I cope with these things? Well, I cried with the man whose wife died, literally for hours. I talked with him about her and called his family for him. Then when I went home, I cried some more.
The man who arrested in CT--I cried while we coded him. I cried as I wrote my notes. I cried when I talked with his family and told them he and I prayed before he died. I cried some more when I got home.
The man who confessed murder--well, I talked with my doctor and coped by taking Xanax. There is only so much you can do on your own. I also talked to a counselor. The Xanax worked better. My colleagues were, for the most part, very supportive. The administration, on the other hand, was less so. I was advised not to talk to ANYONE about the confession. That is why the Xanax was so wonderful.
The very best advice people here have given is to have a sense of humor. OK, so it isn't funny when someone dies, but when you are in the middle of a code and someone does or says something funny, well you just laugh. It cuts the tension. Like the time I told someone to go towards the light. Or the time I thumped this guy on the chest when he went into V-tach (hey, it worked). Or the time the ED doc thumped an LOL on the chest and she told him to not do that again because it hurt.
It isn't fun trying to change wet linens from underneath an obese patient, but it is funny when she farts when you roll her over and the nurse who is helping you totally loses it and tries not to let the patient know she is laughing hysterically.
It is very funny trying to walk a 6' 4" drunk to the bathroom when he doesn't have a steady gait. He is also wearing clothes he has urinated in and is leaning on you because he is incredibly drunk. His last name was Shannon and I dubbed his drunken walk the "Shannon Shuffle". This same guy had also been in prison for armed robbery. I pointed out to him that, of course, he was an armed robber because he still had both of his. He loved my joke.
If you have a sick sense of humor, can see humor in other people's misfortune, can work with some of the bossiest/most aggressive/most assertive nurses ever, function semi-independently, and still maintain compassion for all mankind, then you can be an ED nurse. If you don't think you can measure up to any of that, don't bother. The ED nurses can be extremely tough. I know, I used to be one (though I wasn't necessarily tough, just extremely distrustful of new people). The reason for this is because they are trying to save lives. If you need to have your hand held during these times, the ED is not the place for you.
Please don't get me wrong, I loved the ED. The fact I didn't have to live with the same patient for days on end was definitely a plus. Not having to float to other units helped, too. Good luck to everyone who wants to work in the ED. It is a great place to work.
Thanks for letting me go on for so long. I can be a bit long-winded.:zzzzz

You know what? I really think this is the type of nurse I will be. I'm going to be an emotional nurse, but very capable to do the job. I know myself and I know I won't take everything too badly that I will need zanax (sp?) to sleep. I just think I will be this way. Thank you for the post.

It really opened my eyes to how full of reality it can be.

AtlantaRN, RN · Jan 6, 2006

when I was younger I LOVED the fast pace of ER. the folks you work with are great, and with the new charting "emstat," is great! click, click, click, nothing narrative...

linda

PCA RN · Jan 7, 2006

I have been an ER RN for almost 10 years now. Here's the qualities I think are important for ER RNs:
1. Sense of humor.
2. Excellent and quick assessment skills.
3. Great people skills - you must like people.
4. Sense of humor.
5. Ability to move quickly...out of the way of vomit and other things.
6. Adrenaline junkie.
7. Great pathophysio and A&P knowledge. You simply have to know the why's of care.
8. Organized.
9. Realistic - you will see things that literally tear your heart out - you must keep going and be able to prioritize care.
10. Sense of humor.

sounds like every other kind of nursing!!

Beth_audrey · Jan 8, 2006

thanks those stories were inspiring. loved to here more!

Sara, RN · Jan 12, 2006

I agree a sense of humor is needed...many times it is not a pc sense of humor either. A coping mechanism.

You will see the worst and the best there is to offer. No 2 days are the same. You must enjoy organized chaos! Realize that if you get hot food, chances are you will be eating it when its cold, hours later (always have grazing food on hand).

Great assessment and pathophys needed, plus confidence. Many times you need to do a visual assessment in less than 5-10 seconds to decide who's triaged back first. Need to be able to speak 1:1 with MD, act autonomously.

And, realize that you will see a whole different side of the human population!

chip193 · Jan 12, 2006

I agree a sense of humor is needed...many times it is not a pc sense of humor either. A coping mechanism.
You will see the worst and the best there is to offer. No 2 days are the same. You must enjoy organized chaos! Realize that if you get hot food, chances are you will be eating it when its cold, hours later (always have grazing food on hand).
Great assessment and pathophys needed, plus confidence. Many times you need to do a visual assessment in less than 5-10 seconds to decide who's triaged back first. Need to be able to speak 1:1 with MD, act autonomously.
And, realize that you will see a whole different side of the human population!

Very true...PC doesn't always work in the ER!

And you need to earn the respect of the docs...that's probably the most important thing to make your life easier.

Chip

Beth_audrey · Jan 14, 2006

do you think er doctors are easy to work with?

Sara, RN · Jan 14, 2006

I do think ER docs are fairly easy to work with...like any RN/MD relationship their must be a mutual respect and trust thing. But, overall, yes and I love the autonomy I have in the ED. I feel more of a team approach with most of the MD's than on the units.

chip193 · Jan 16, 2006

The vast majority of the ER docs that I work with are wonderful. There are a couple who are not. But that's true of any profession!

Chip

bopps · Jan 16, 2006

i am still in nursing school but i am a emt and i have worked in a ghetto er for over a year now. that' not very long buts its long enough to see about ten new grads start and only have of them stay. either you have what it takes or you don't start working and see how it goes. you probably won't even have to make the decision of can i do this or not. if ya ain't cut out for it your superfizer will let you know ina a professional way probably while you are still in orientation. there are other cool fields of nursing out there too so don't worry about it. give it a try er is great

eudemon · Feb 11, 2006

plus you need a lot of ATP reserves..