Wanting to know about life in the e.r!

rjflyn, ASN, RN · Apr 16, 2005

Well in my 16 years of life in and around the ER - worked about half the time as an ED based paramedic. Size of the ED is getting to be not so much of a issue anymore- there all busy. Most of the time one has 3, 4 or 5 things one needs to be doing with just as many patients. The key is teamwork, you need to have a good team. As well as a good protocol set that lets you as a nurse start treatment on certain kinds of patients, all though these vary so much as well ie some let you give meds others dont. Things also vary depending on who the ED physician is ie some dont want you doing much more than the basic protocol set says. Others want you to go ahead and do things more advanced, that varys from doctor to doctor and nurse to nurse.

rj

:rolleyes:

PennyLane, RN · Apr 16, 2005

I'm a new nurse in the ER and I love it. No, it's not like on tv, but it is very, very busy! If you enjoy seeing everything from abdominal pain to acute MIs and everything in-between, ER is the place for you! I work with a great group. My ER is not a trauma center, but it is a very busy urban hospital. We often have patients in the hallways being treated, or being treated in triage. I put all of my prioritization and hands-on skills to the test every day in the ER.

britishwannabenurse · Apr 16, 2005

Thanks to both of you that replied you guys were really helpful! :) LOL I'm sure it's not how it is on E.R! I'm guessing no George Clooney look-a-likes?!?lol But seriously, how is the real E.R different to how it's depicted on tv? A lot less dramatic I'm guessing!?! Also, what is it like for an ED Paramedic, because I think they have quite different roles compared to the Paramedics here in the u.k.

Thankyou!!! xxx :)

ERNURSE4MS · Apr 17, 2005

Thanks to both of you that replied you guys were really helpful! :) LOL I'm sure it's not how it is on E.R! I'm guessing no George Clooney look-a-likes?!?lol But seriously, how is the real E.R different to how it's depicted on tv? A lot less dramatic I'm guessing!?! Also, what is it like for an ED Paramedic, because I think they have quite different roles compared to the Paramedics here in the u.k.
Thankyou!!! xxx :)

I work in a level 4 (lowest level of acuity :rotfl: ), most of the time it is not like the TV show. We stay BUSY, but with common things like sore throat, cough, congestion in the winter, and sports related injuries- sprained ankle, Colles fractures, dislocated joints. But frequently enough we have our traumas-mvc, boat wreck, gsw, stabbings. The main thing I see different is the lack of inter-personal drama. We tend to stick together more like a family. hope this help.

TeriLuvsER · Apr 17, 2005

Thanks to both of you that replied you guys were really helpful! :) LOL I'm sure it's not how it is on E.R! I'm guessing no George Clooney look-a-likes?!?lol But seriously, how is the real E.R different to how it's depicted on tv? A lot less dramatic I'm guessing!?! Also, what is it like for an ED Paramedic, because I think they have quite different roles compared to the Paramedics here in the u.k.
Thankyou!!! xxx :)

Hey There,

ER nursing can be a little different depending on the type of system you have at your hospital...one thing (at least at the level one trauma center I worked at) is that those patients who come into your trauma bay typically aren't there for a prolonged amount of time. You have your team and they all have specific duties...one person is getting the person on a monitor, one person is getting iv access, etc....if it's a teaching hospital you have to fight your way to get to the patient because of the students who flock in to get their "learning" experience. Once the person is deemed stable the patient is usually sent for their CT, etc and then taken to a floor for care. This is a pretty quick process time-wise. You also tend to get the patients who have serious illnesses (aid's dementia, transplants, cardiac, etc.). You don't really see the less acute patients there because they are sent to the fast track which is the hopped up version of a medical clinic. Now away from a level one trauma center you tend to notice that you have different patients...while you do get your "sick" patients you will find that (this is my opinion, of course) that probably 75% of the patients who go to the ER really don't need to be there. These are the people who don't know enough about self care to realize that they don't need to come to the hospital for a temp of 100...that they can try resting and taking some tylenol or motrin. Or, they can't get into their PCP's quick enough so they have learned to go to ER's. The unfortunate thing is that it seems as though the people who tend to complain the most about wait times are those who could go to their docs. Despite having to deal with these things ER nursing is great. You get to see a wide variety of things and learn something new everyday. The thing that's appealing to me is the "move em' in, move em' out" aspect...I don't have to do bed baths, etc. AND, I do get lots of thank you's from patients. I really do enjoy the work...

britishwannabenurse · Apr 17, 2005

Thankyou to everyone that replied!!! :) Its really helped me get a more realistic picture of the ER! ERNurse4MS mentioned that her team tend to stick together more like a family, and I was wondering if that was true for any other ER Nurses - do you become quite close to your collegues? Also, if you work full-time in the ER, what is your rota-system like and do situations arise often in the ER with patients, that could be dangerous to you?

Many thanks again you guys are SO helpful! :) xxx

Rena RN 2003, RN · Apr 18, 2005

i've worked a couple of ERs and yes, you do become close to your peers. i know their kids and birthdays and anniversaries and favorite foods. you don't have to know these things to work well with people. it's all about personal comfort level. share what you want and keep the rest to yourself.

our rotations vary throughout the day, 7 to 7 being the main shifts. there are other staggered 12 and 8 hour shifts throughout the day to cover "busy" times.

ER has many dangers, some hidden, some in plain view. there are the obvious Hep, HIV, MRSA, TB, etc. a person can protect him/herself from those with PPE. then you have the druggie looking for his/her next fix and pissed off because it's not coming from that ER doc on that specific night. so the druggie threatens to come back and slit your throat. then you have the friday night drunk that was given the option of going to jail or the ER because of ETOH. (i've never understood this) so he/she comes in with arms a swinging. then you have your basic unmedicated bipolar and/or paranoid schizophrenic that winds up in restraints because he/she tried to throw a chair through you. then you have the family of great-great-great-great-great grandmother and they are pissed for any number of reasons. either you didn't allow all 105 extended family members in the patient room or you gave too much morphine and she can't talk to visitors or you didn't give enough. then you have the boyfriend of the hangnail patient that is pissed off because it's been 3 hours and she hasn't been seen and "she's in pain dammit and i want to see a doctor in here NOW!!! even though you are working up an MI, GSW, CVA, __________ (fill in the blank with your chosen life threatening disease process).

Amber_student_nurse · Apr 23, 2005

then you have the family of great-great-great-great-great grandmother and they are pissed for any number of reasons. either you didn't allow all 105 extended family members in the patient room or you gave too much morphine and she can't talk to visitors or you didn't give enough.

I was in the ER the other night as my grandfather had a high temp (Dx chronic renal failure being treated). I found the nurses to be a little rude but i just put it down to them being busy. Your post upset me a little as my grandfather passed away the other day and the last time i saw him was in the ER. So i think it is important to allow family members (appropriatness) to see their respective reletive. Im actually really disheartned with the profession at the moment because no body could tell us what was wrong, what happned and what was being done. Now hes gone and i still dont know why.

TeriLuvsER · Apr 23, 2005

then you have the family of great-great-great-great-great grandmother and they are pissed for any number of reasons. either you didn't allow all 105 extended family members in the patient room or you gave too much morphine and she can't talk to visitors or you didn't give enough.
I was in the ER the other night as my grandfather had a high temp (Dx chronic renal failure being treated). I found the nurses to be a little rude but i just put it down to them being busy. Your post upset me a little as my grandfather passed away the other day and the last time i saw him was in the ER. So i think it is important to allow family members (appropriatness) to see their respective reletive. Im actually really disheartned with the profession at the moment because no body could tell us what was wrong, what happned and what was being done. Now hes gone and i still dont know why.

Hey Amber,

I just wanted to tell you not to be disheartened w/ the profession...what I recommend is you take the things that you don't like about nursing and decide to do better.....we ALL have our moments where we vent about things that we have to deal with...sometimes it's a coping mechanism....sometimes there are people who just like to complain a lot. It's what you decide to do for yourself. I love the profession but I do have my moments of thing "geesh already"...you will be the same way too...it's only human. I'm sorry about your grandfather...just jumping to conclusions based on what you told us maybe he had a UTI and became septic? I see that a lot w/ elderly people, in particular ones who come from nursing homes.

Teri

Amber_student_nurse · Apr 25, 2005

Thanks Terri

I think I was just venting my anger and sadness when i replied to that post. It is hard not to be disheartened when there is nothing that can be done. When I do become a nurse I think I will be able to deal with those situations better. I know a little more about what happned and the family was told it was golden staph. Thanks for listning to my rambles...

Amber