New Grad in the ER

LlanaG · Jul 25, 2016

Hello!

Welcome to the world Emergency nursing/medicine! I have been an ER nurse for 8 years now and before that I spent about 9 months working on a med surg floor that I found was definitely NOT for me! I transitioned to the emergency department and I learned more there in the first week then I think I did the entire time on the floor! I have ADD like crazy and the ER was able to keep my attention unlike other specialties.

Anyway, my advice to you on dealing with irate patients or drug seekers or really anyone who is less than pleasant to you is to learn to let it go. This is easier said then done I realize but you have to learn to not take it personally.

Sure, some people may say they are scared because they are having an "emergency" but a toothache, while painful, will probably not kill them in the next few minutes. They are in pain and are frustrated. Maybe they are going through withdrawal and they feel like garbage and in their eyes you are the one preventing them from getting their fix.

In reality, it is there issue and while you have to spend a few hours or so around them, they have to spend their entire life like that. Just look at the bright side and remember it reflects on them, not you.

A lot of times I have had not only patients, but family members, treat me terribly and it seemed as though they were out to pick a fight for whatever reason. I used to get annoyed and get angry back at them. It took a little while but I figured out it is not worth it.

Learn to pick and choose your battles. If they are there to get pain medicine why waste your energy trying to prevent this? Sure, we all know it is ridiculous and frustrating not to mention completely selfish. After all, they are taking up a bed that someone who really needed could have. I am sure a lot of people would disagree with me and I can understand that but to me it is simply not worth wasting my energy and getting frustrated with something like that. We are not going to cure their addiction, they WILL come back and try again to get the drug even if it was withheld in prior visits and honestly it they are truly addicted it is unlikely they are going to even get the high they are yearning for. Ever heard the term "Chasing the Dragon?" Trust me, it is simply not worth the time or energy to fight this battle.

If someone is rude to you, instead of getting rude back, which would actually be a reward for them in some ways, kill them with kindness. Trust me this works and it leaves them feeling stupid a lot of the time. Plus, how their complaint have any merit if you simply smiled at their frustration and offered them a refreshing cup of ice water?

It is really sad but people tend to treat the ones who are trying to help them the worst. I am not sure why this is the case but I find this to be true. It is really sad. They may call you names or nit pick and even try to pin staff against each other. The best thing you can do to protect yourself is document, document and document some more.

I have learned, and from speaking to other nurses with years of experience, that the more experience you get, the more confident you appear to people and this also detours irate people some of time from choosing you unleash on. It is kind of animalistic in the sense that the weakest one will be the easiest prey for the predator. They can spot it a mile away and they pounce. While this is completely disheartening, just remember that we all went through this phase. I know I did and I learned from it. I learned a lot about human nature and it really has helped me in all aspects of life. Also, I learned that the more I dealt with it the less I let it get to me. I would be lying if I said I didn't have my moments though!

Now enough for all that negative talk. Sure it happens but most of the time people are not too bad. I have had family members come seek me out to apologize for their behavior if they were rude. I have also had people come back around to thank me for helping them or their loved ones. The authentic appreciation is worth all the bad apples. Just think of all the people you can help. Not only that but you can also meet some pretty amazing co-workers that become very close friends!

Having said that I want to let you in on another tough part of nursing in the ER. You have to have thick skin to make it and the patients are not the only ones who can make you feel like you do not belong. Other nurses and doctors can also be less than supportive. The best thing to do, especially if you are brand new is NOT go in like you know everything. Even when I knew what my preceptor or anyone really, was trying to teach me I did not tell them I already knew it. Instead, I acted appreciate and made some comment that proved I understood really well what they were teaching and in turn it either made them realize that A: I was a really fast learner or B: that I already knew the information but did not feel like I had to show them that I knew it all. Cause in fact, I didn't and I still do not. Every day I learn new things. Remember no one likes a know it all.

However; IF you find that a nurse is disrespecting you, being rude to you or doing anything else out of the way there are effective ways to handle this. Unless it is really malicious and/or dangerous I find that it earns you far more respect to take the person to the side and privately talk about the situation. Ask them if you did anything to offend them and explain (delicately and not in a way to make them defensive) how you feel. A lot of times people do not realize how they can come across at times.

While going to management or whomever is an option and a lot of people say to do this first, I find in the real world it is not always the best choice. It makes the person in question defensive and often times they will not try to reconcile with you willingly. I think most people respect someone who can come to them and calmly explain the situation far more than someone who runs to the boss and tattles.

Having said that, there are times when going to the manager first is the best choice. If you have someone to talk to it about I would discuss it with them before you bring it up to the co-worker or boss. Also, remember, once again you probably did nothing wrong and maybe they feel threatened by you, or they went through hell as a new nurse and they want to "haze" you like they were "hazed" It is well documented that nurses eat their young and places like the ER and other critical care specialties are well known for this. I am not sure why this occurs but it does.

I know I wrote a lot but I remember my early days in the ER and I wish I had asked for advice like you have. I do not know you but I am pretty sure you will be just fine. Hang in there and if you find you really do not like it then guess what? There are tons and tons of others jobs you can take working as a nurse. You are not stuck in any one place! Just make sure you give it a fair chance before you decide it is not for you! The ER really is a great and interesting place to work and there is nothing else like it! Good luck!

Sarama · Sep 17, 2016

Wow, thank you so much for taking the time to write that! I truly appreciate everything you wrote, and it was great advice! I wish there were more nurses like you out there. I just have to take it one day at a time and realize that I'm going to make mistakes, I will run into rude people, and I will be stressed, but this is all normal and it's okay lol. Thank you again for your words.