ER - How to stay calm

[Lev]

I'm a relatively new ER nurse and I'm approaching the 1 year mark. I previously worked for 2 years on the floor. I went from a high intensity med-surg floor to the ER. I still work at my PRN job on a less busy med-surg floor. Either way, the ER I work at is huge and very very busy with over 100k visits every year. Fortunately, we don't get a lot of trauma. When I left med-surg I had just reached the point where I was no longer overwhelmed. I just stopped trying to make the impossible happen and just went with the flow and it worked. In the ER, there is not much downtime. I also work swing shift 230-3 and it is the busiest shift. The issue is in the ER, once you finish with one patient, you get another one or you get two patients at once. I also hate having to ignore my other patients when I get a critical patient. I have started trying to cut back on my notes to move things along faster. For example, I will write please see Emar for med details instead of writing down med interventions. I will sometimes skip out on a note altogether depending on the patient. I used to write them on everyone but found that they were repetitive. Any tips for maintaining your calm when tasks keep piling up especially when your tech just doesn't have the same urgency for tasks that you do or there is no tech altogether?

[MassED, BSN, RN]

In the same grain, if you have residents, don't be in a hurry to run to a room as soon as they put an order in. Especially lower level residents, because you will likely have another order or two in within the next few minutes. It seems that without fail I'll go to a room and then they'll add two more orders & then the attending will see the patient and add another one.

that is always so frustrating for me. I will ask a resident to gather all of the orders and place them at the same time. They don't know any better, but it doesn't help me to NOT be frustrated. I know they are learning, but 95% of the time if they just listened to the nurse, they could learn and consolidate their damn orders. Grrrr!!! Teaching hospitals!

[Lev, MSN, RN, NP]

Things are way better. Been an ER nurse for almost a year and a half. I finally have a semblance of a groove. One of my coworkers actually said that I always seem relaxed. LOL I probably don't work with her much. Things are way better. Few things are true emergencies.

[Roy Fokker, BSN, RN]

"When in trouble or in doubt,

run in circles, scream and shout." :-)

Glad you're doing better!

- Roy

[Lunah, MSN, RN]

Things are way better. Been an ER nurse for almost a year and a half. I finally have a semblance of a groove. One of my coworkers actually said that I always seem relaxed. LOL I probably don't work with her much. Things are way better. Few things are true emergencies.

Yay!! That is great. :)

[Scrubs_n_sirens, MSN, RN]

Learning order sets can really be a blessing! I know what to expect so I get as much of it done as I can before the doc rolls in. I alway draw super rainbows (extra green extra purple) so if the doc adds stuff, I just make a phone call to lab. I make my patients at least try to pee as well-- unless they're renal compromised, they will make three times the amount of urine required for a UA every hour. I encourage them to try before they get hooked to monitor or get iv lines and unless they are in a lot of discomfort or actively vomiting or need cardiac meds STAT, they give me pee before I give them meds. (Tough love usually works and then I make it up to them for their efforts (-: )