Interested in ER nursing but have a concern...

Blee O'Myacin, BSN, RN · Mar 26, 2009

It's always amusing when you bring a patient to a unit and the team meets you there in goggles, plastic gowns and gloves. Just this month I've been exposed to MRSA, Klebsiella, and bacterial meningitis. Universal precautions and always wearing a face shield when doing anything that might cause a splash, and we've been fine. Our staff usually gets sick when someone brings in a cold that their preschooler brought home!

I worry about bioterrorism about as much as I worry about a meteor hitting the planet. If it happens, I'll deal with it. Right now, I'm more concerned about rumored TJC inspections within this week and we are SO not ready.

hellerd2003, RN · Mar 26, 2009

Ever since I floated to the ER as a nurse extern I've wanted to work there. But here is my concern...ER is the first line of defense for everyone coming into the hospital. You are exposed to everyone and everything before they are admitted to the floors. Do you ever worry about what infectious diseases you are coming in contact with before you even know what they have and what you might be taking home to your family? Do you ever think about bioterrorism? I can think of any of these things to worry about and it's keeping me from following my nursing passion. Is this realistic?

You'll still get exposed to any and everything once they're on the floors . . . And you may not know what they have even when they come from the ED. Cultures take a while to come back, and you could be working with someone who has MRSA or acinitobacter (sp?) long before you hear from the lab that they're infected. It's really all about using universal precautions. My family always jokes about THEIR risk of what I could bring home to them, but to be honest, I've gotten more colds/ flu from THEM than I've ever given back. And if people are getting sick at work, like the previous poster wrote, it's usually from another employee, who got it from THEIR family and brought it in.

As for bioterrorism-- no worries there. If a bioterrorism event takes place in my city, I could just as likely be a victim as an employee at a hospital. Life is too short to worry about things like this. Honestly, I'm more likely to slip and fall in the bathroom and die than I am to be a victim of bioterrorism, and I use the bathroom every day. :-)

emtb2rn, BSN, RN, EMT-B · Mar 26, 2009

I find the ER to actually be less "germy" than say, a respiratory floor....

Larry77, RN · Mar 26, 2009

You guys ever notice though that when you start in the ED you are sick with every cold that is around but after a few years seems like you don't catch the colds that even your family has?

I laugh about the freakish isolation on the floors, so these patients were in the grocery store the day before but now that they are in the hospital they are nuclear and if you even stand next to them without a suit you will turn into DUST!!!

While I don't worry about bioterrorism, it is something you have to have a plan for...we have a system where the fire dept sets up a tent off site with a decon, plus we have a decon shower in our dept that has a separate entrance, we have suits we have to wear etc. Along with the plan you have to have drills otherwise nobody knows where to find the equipment when you need it.

hellerd2003, RN · Mar 26, 2009

You guys ever notice though that when you start in the ED you are sick with every cold that is around but after a few years seems like you don't catch the colds that even your family has?
I laugh about the freakish isolation on the floors, so these patients were in the grocery store the day before but now that they are in the hospital they are nuclear and if you even stand next to them without a suit you will turn into DUST!!!

So true re. the ED and illness. When I worked in an ED, the first 6 months I was sick all the time. After that, I was invincible. LOL.

Also true re. the isolation. Someone is colonized with MRSA in the nares, and we freak out. While, to be honest, 2/3 or more of healthcare professionals should probably be in isolation, because we're also most likely colonized.

Editorial Team / Moderator · Mar 26, 2009

The first week I worked in the ED, I had terrible congestion and no voice by the third shift. LOL. That was when all the HOH patients rolled in, and couldn't hear me at all! Heh. But now? I'm bulletproof. (Although I did end up as a pt. in my own ED on Monday, but that was because of a weird and sudden bout of vertigo while I was at work! Ugh, not fun. I have all new empathy for people who come in with vertigo!)

Medic09, BSN, RN, EMT-P · Mar 27, 2009

Let me give you an analogy.

When I was a young man, I was part of a reconnaisance team for a time. We'd go out ahead of our main force, and search for the enemy. A very small, vulnerable group of guys. Conversation: "Well, what happens if they find us first?" "Then we're dead." "What good will that do?" "The main formation will know where the enemy now is!"

That's what EMS is for. Anything you're afraid of, the medics will have already gotten exposed to on the way in. When they come in wearing masks, with the patient masked, looking worried and asking to see a doc, you'll know to be careful! :rolleyes:

Spoken as a medic, btw.

Seriously, all the stuff you mentioned as worries in your original post can just as easily happen on the street on your day off. Don't worry about it. You see that most of us flit happily along in our ER jobs without much scary stuff happening. And it IS the most interesting place in the hospital.

Delirious · Mar 27, 2009

Thanks to all of you for your input. The universal precautions comment makes perfect sense. But when I floated to ER I didn't see anyone wearing anything more than gloves. We had a young man who was blowing, not spitting, but blowing hard (thought for sure he would hyperventilate) while he was lying on the bed in one of the rooms. I think he tested + for alcohol and marijuana. Anyway, one of the nurses put her hand above his mouth so that he didn't spit on her and the rest of us and her glove turned bright yellow. I guess that's what started me thinking about all of this. Right now, I'm putting my time in in Med-Surg because that's where everyone told me to start out. I've learned soooo much in the last 5 months. But I really can't think of anywhere in the hospital I'd rather be than ER.

Treat et Street · Mar 27, 2009

I am O-neg and donate blood. I would really like to see what, if anything, happens after someone gets 350cc of T + S after all my years of exposure and the resulting antibodies...

ERRN92 · Mar 27, 2009

They should do studies on Er nurses and the rate of illness over time. I have had pts practically cough in my face and they'd later test positive for TB. Its not realistic that you're going to mask up everytime someone comes in with cold symptoms (except maybe Florence Nightengale who could do no wrong). Ive never gotten TB. When we do get exposed to something like Meningitis for example, we all get a Cipro freebie on the house. Its not that much worse than the exposure you get in the general public. Think of the air you're sharing with those around you and the things you touch that have been handled by who knows what...

Blee O'Myacin, BSN, RN · Mar 27, 2009

I am O-neg and donate blood. I would really like to see what, if anything, happens after someone gets 350cc of T + S after all my years of exposure and the resulting antibodies...

OT, but thank goodness for leukocyte reduction on blood products, considering that we healthcare workers are usually the first in line at the blood drive. Although I doubt that even leuk. reduction could filter out all the ER germs.