ER Nurses. Read This!

After circling the drain with compassion fatigue, I stumbled upon this article that was published in the ACEP: read it and tell me you don't feel proud!

Guest Editorial
ACEP News
September 2006
By David F. Baehren, M.D.

For a generation or two, we have lamented the loss of role models in society.

As parents and individuals, we naturally seek out others we would like to emulate. Sadly, a serious search through the popular culture leaves us empty-handed and empty-hearted. Thanks to a long list of legal and moral shenanigans, many entertainers, politicians, and athletes long since abdicated this momentous position of responsibility.

We usually look afar for heroes and role models, and in doing so overlook a group of professionals who live and work in our midst: nurses.

And not just any kind of nurse: the emergency nurse. There are plenty of people involved in emergency care, and no emergency department could function without all of these people working as a team. But it is the emergency nurse who shoulders the weight of patient care. Without these modern-day heroes, individually and collectively we would be in quite a pinch.

This unique breed of men and women are the lock stitch in the fabric of our health care safety net. Their job is a physical, emotional, and intellectual challenge.

Who helped the paramedics lift the last 300-pound patient who came in?

Who took the verbal lashing from the curmudgeon giving admitting orders over the phone?

Who came to tell you that the guy you ordered the nitro drip for is taking Viagra?

The emergency nurse has the thankless job of sitting in triage while both the long and the short buses unload at once. With limited information, they usually send the patient in the right direction while having to fend off some narcissistic clown with a zit on his butt. They absorb the penetrating stares from weary lobby dwellers and channel all that negative energy to some secret place they only tell you about when you go to triage school.

Other kinds of nurses serve key roles in health care and attend to their patients admirably. However, few function under the gun like emergency nurses do.

It is the emergency nurse who cares for the critical heart failure patient until the intensive care unit is "ready" to accept the patient. The productivity of the emergency nurse expands gracefully to accommodate the endless flow of patients while the rest of the hospital "can't take report." Many of our patients arrive "unwashed." It is the emergency nurse who delivers them "washed and folded." To prepare for admission a patient with a hip fracture who lay in stool for a day requires an immense amount of care--and caring.

Few nurses outside of the emergency department deal with patients who are as cantankerous, uncooperative, and violent. These nurses must deal with patients who are in their worst physical and emotional state. We all know it is a stressful time for patients and family, and we all know who the wheelbarrow is that the shovel dumps into.

For the most part, the nurses expect some of this and carry on in good humor. There are times, however, when the patience of a saint is required.

In fact, I believe that when emergency nurses go to heaven, they get in the fast lane, flash their hospital ID, and get the thumbs-up at the gate. They earn this privilege after being sworn at, demeaned, spit on, threatened, and sometimes kicked, choked, grabbed, or slugged. After this, they go on to the next patient as if they had just stopped to smell a gardenia for a moment.

Great strength of character is required for sustained work in our field. The emergency department is a loud, chaotic, and stressful environment. To hold up under these conditions is no small feat. To care for the deathly ill, comfort suffering children, and give solace to those who grieve their dead takes discipline, stamina, and tenderness. To sit with and console the family of a teenager who just died in an accident takes the strength of 10 men.

Every day emergency nurses do what we are all called to do but find so arduous in practice. That is: to love our neighbors as ourselves.

They care for those whom society renders invisible. Emergency nurses do what the man who changed the world 2,000 years ago did. They look squarely in the eye and hold the hand of those most couldn't bear to touch. They wash stinky feet, clean excrement, and smell breath that would give most people nightmares.

And they do it with grace.

So, here's to the emergency nurse. Shake the hand of a hero before your next shift.

Dr. BAEHREN lives in Ottawa Hills, Ohio, and practices emergency medicine.

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