Funny, but we have two RNs in our ER now that were both Law Enforcement, and they are great nurses.
Anyway, a day in the life of an ER nurse, hmmmmmm, besides putting up with frequent flyers, temperamental ER docs, and snippy coworkers, life is just peachy!!!!!!
Seriously though, in our ER our nurses can order certain xrays on their own, but we can't initiate any kind of treatments except for fever reducers, before the doc sees the patient. Well, we can start IVs and draw blood, and order EKGs on chest pains before the doc sees them, but that is about it. Once the docs give the orders, they don't stand over us to see if they are carried out, it is expected that we do what we're there to do and take care of the patient.
Our patient to nurse load is 4:1 which is great compared to some ERs I've read about here. Anyway, with that many patients, things can get a little hectic, especially when you have two doctors throwing orders at you. And that doesn't even count the times that specialty docs come in and throw orders at you.
Things move rather quickly in the ER and we are expected to tell the doc of any changes with the patient. If we are in triage, we are expected to be able to tell at a glance which patients are critical and which can wait to be seen. (this isn't as easy as it seems).
We are expected to do what needs to be done in a timely fashion. This means that we don't usually have time to have a long friendly chat with patients. We can't take an extroidinary (sic?) length of time getting an IV in place and getting medications given. It is ok to talk to the patients and comfort them, but sometimes you just don't have a lot of time to do so if you have a couple of other patients that also need something.
Which leads us to another big thing; prioritizing. Would it be quicker to check that back pain in and then start an IV on the belly pain down the hall? Or can you get that IV quickly, give meds and get that patient to xray without delaying check in of that back pain? Which patients need your attention more? The little old lady that needs a bedpan for the fifth time or the back pain who wants their pain med NOW, who is in the ER at least once a week with the same complaint.
ER is where the rubber meets the road, critical thinking skills are essential to quickly assessing patients. That's my story, and I'm sticking to it! :chuckle