Please dont hate me for saying this...

angel337, MSN, RN · Aug 31, 2008

ER may not be the best place to get a real perspective on nursing as a caring and nuturing profession. The nurses in E.R. are on the front lines of some of the most manipulative, abusive, and downright evil people that nurses ever have to deal with. I would become a bit jaded working in that pit of dispair. In addition, at least at my hospital, ER nursing is given very little autonomy. You don't scratch your nose without an order from an attending ER doc. When nurses are made powerless by the phylosophy of the unit it always drags down the drive to provide optimal care. See if you can shadow in L&D or even a good med surg floor. They would be happy for the help and you mignt get a better impression of nursing.

actually my experience is the oposite. every ER i have worked has been a very autonomous environment for nurses. before the doc gets in the room, the labs are drawn and sent, ekg, asa given. i don't think a busy ER would work well at all if the nurses had to wait for orders. maybe this is a small rural ER you are referring to, but here in the big city the nurses run it. i know the floor nurses where i work can't give a tylenol without an order, if i had to work like that i wouldn't last very long. one of the things that attracted me to the ER is the autonomy.

Altra, BSN, RN · Aug 31, 2008

ER may not be the best place to get a real perspective on nursing as a caring and nuturing profession. The nurses in E.R. are on the front lines of some of the most manipulative, abusive, and downright evil people that nurses ever have to deal with. I would become a bit jaded working in that pit of dispair. In addition, at least at my hospital, ER nursing is given very little autonomy. You don't scratch your nose without an order from an attending ER doc. When nurses are made powerless by the phylosophy of the unit it always drags down the drive to provide optimal care. See if you can shadow in L&D or even a good med surg floor. They would be happy for the help and you mignt get a better impression of nursing.

I respectfully disagree. And I would also add, that is the first time I've ever seen comments like that from an ICU nurse. Our cohorts in the units tend to be the first to point out, "Where do you think all the manipulative, aggressive, etc. patients go after they leave the ER?? To the unit of course ... "

ER nursing has a great deal of autonomy, in my experience, and I have never heard an ER nurse express concern over a lack of autonomy, except in stories regarding a specific physician ... and the story tends to climax with the tale of how the physician came to *see the light*.

To the OP, I would echo what some others have said. Right now you are taking a layperson's view of what you're seeing, i.e. "caring" for patients only occurs when a nurse is physically at the bedside interacting with the patient. This is not the case. I can be and frequently am sitting at the nurses' station chatting with coworkers while checking the patients' lab results on the computer, getting that *very special form* to document a patient's particular situation, and keeping an eye on the bathroom door that my one patient just went into, all without being at the bedside of one particular patient.

One other word of advice: you've set out to provide your particular vision of excellent patient care and that's admirable ... just be aware that not all patients will need, or even want that. Otherwise it will feel like a kick in the teeth the first time a patient says to you, "thanks, but no thanks" either in an indirect way or something along the lines of "get the **** out of my room."

pagandeva2000, LPN · Aug 31, 2008

Lurksalot- I think that was worthy of our essay contest- you should post it there. Or submit it to the ENA. That's exactly how I feel but haven't been able to put in words that fit.

I am in total agreement here. Very well put, worthy of money and recognition. Way to go Lurksalot! :yeah: :bow:

VICTO3841 · Aug 31, 2008

Hi.......I understand how you fell. I'll graduate from NS next semester, and i had to take my mother in law to the ER last month. While we were waiting, a very nice very old lady was sitting next to us, her face looked pale and she was grabibng her abdomen. She approached this RN and told him that she was really in pain and to please help her. The RN responded to her in front of everybody: "Ms. this is a hospital, a place where everybody is in pain, so sit down and wait". I grabbed this lady's hand and help her to her sit.

I have the ability to see both sides of the story. This was the 20th time this nurse was approched by different people wanting to be help first, and plain and simple he exploded and couldnt take it anymore,and this poor lady was the one to pay the price for all his frustrations.

Just wait, and when we become RNs we will decide for which team we want to play......

Good luck

Victoria. :nurse:

Lurksalot, BSN, RN · Sep 1, 2008

Lurksalot- I think that was worthy of our essay contest- you should post it there. Or submit it to the ENA. That's exactly how I feel but haven't been able to put in words that fit.

Thank you, I am so glad to be able to communicate this. I hope the OP can see how we can change emotionally, and how we may need to keep changing inside to do what we do every day.

And now I go back to Lurking....and I must admit, a glass of my favorite wine. :wink2:

Selke · Sep 1, 2008

The way the OP phrases things, her speech patterns, strike me as a bit odd. I can't put my finger on it. Maybe English isn't her primary language?

I suspect the OP has some codependency issues based on her perception of nursing, or a belief system that she needs to be devoted to selfless serving of others ... something just strikes me as a little weird in all this.

These are just observations, they may be groundless ... nothing personal.

RN2BENAUSTIN · Sep 1, 2008

Selke...I think that was uncalled for...even if English was not my primary language (which it is) was your comment necessary? Did you really even read any of my follow up posts on this thread? I would love for you to highlight my faulty writings, admittedly its been a while, but I have a bachelors in Journalism and a minor in English. But, obviously not good enough to post on this forum or at least to your standards.

"I suspect the OP has some codependency issues based on her perception of nursing, or a belief system that she needs to be devoted to selfless serving of others ... something just strikes me as a little weird in all this."

I cannot imagine having you as a nurse, exactly what were the reasons you became a nurse to begin with? Wanting to hold a persons hand while they are in pain or a pat on the back is my idea of showing care to patient. I have three kids and and a husband, so if I did have some strange desire to serve others, I would just stay home. I am a non paid volunteer, I'm sure you will have some comment on that as well, I'm sure that knocks me down that totem pole of yours even further. I do whatever is needed, and dont complain, I enjoy any and every opportunity I have to learn and grow in this profession. If that makes me co dependent or somehow dysfunctionally selfless, oh well. At least I can go to bed at night, knowing I am a hard worker and that I dont get my kicks out of belittling others.

I honestly have a different perspective towards the down time that is necessary, I just got home from the ER (Labor Day) and it was truly amazing to watch how organized and efficient the whole team was in some very chaotic moments. I stayed an hour longer than my normal measly 4 hours, and my legs were sore from not having a minute to sit, and I was a bit emotionally spent, I can only imagine how all the nurses and support staff must feel after a 12 hour shift on a day like today. I say, if there is a minute to sit and talk with a fellow nurse, take it while you can, you never know whats coming in that door!

Unfortunately I realize I will not be welcome on this board,the majority of you have been kind and helpful. But a few of you really do give nursing a bad name, its not about being a caring nurse or not, how about just being a decent person?

I would like to say thank you to those that actually offered some advice and could see beyond their own insecurities to actually discuss issues and not just jump into rudimentary psychological evaluations.

bagladyrn, RN · Sep 1, 2008

Selke...I think that was uncalled for...even if English was not my primary language (which it is) was your comment necessary? Did you really even read any of my follow up posts on this thread? I would love for you to highlight my faulty writings, admittedly its been a while, but I have a bachelors in Journalism and a minor in English. But, obviously not good enough to post on this forum or at least to your standards.
"I suspect the OP has some codependency issues based on her perception of nursing, or a belief system that she needs to be devoted to selfless serving of others ... something just strikes me as a little weird in all this."
I cannot imagine having you as a nurse, exactly what were the reasons you became a nurse to begin with? Wanting to hold a persons hand while they are in pain or a pat on the back is my idea of showing care to patient. I have three kids and and a husband, so if I did have some strange desire to serve others, I would just stay home. I am a non paid volunteer, I'm sure you will have some comment on that as well, I'm sure that knocks me down that totem pole of yours even further. I do whatever is needed, and dont complain, I enjoy any and every opportunity I have to learn and grow in this profession. If that makes me co dependent or somehow dysfunctionally selfless, oh well. At least I can go to bed at night, knowing I am a hard worker and that I dont get my kicks out of belittling others.
I honestly have a different perspective towards the down time that is necessary, I just got home from the ER (Labor Day) and it was truly amazing to watch how organized and efficient the whole team was in some very chaotic moments. I stayed an hour longer than my normal measly 4 hours, and my legs were sore from not having a minute to sit, and I was a bit emotionally spent, I can only imagine how all the nurses and support staff must feel after a 12 hour shift on a day like today. I say, if there is a minute to sit and talk with a fellow nurse, take it while you can, you never know whats coming in that door!
Unfortunately I realize I will not be welcome on this board,the majority of you have been kind and helpful. But a few of you really do give nursing a bad name, its not about being a caring nurse or not, how about just being a decent person?
I would like to say thank you to those that actually offered some advice and could see beyond their own insecurities to actually discuss issues and not just jump into rudimentary psychological evaluations.

Whoa - deep breath RN2B!

I think if you reread your last post you may find yourself to be behaving in a manner just as judgemental as you accuse others of being. When you post for comment on a board like this you need to accept that some are going to be critical of you as well as those in agreement. We ARE an opinionated bunch and some are more "forceful" than others in expressing it. I do remember that the first time I got "bitten" on this board I stayed away and sulked for all of about 3 days:imbar.

As an aside, your background in journalism/English may account for the "different" tone some perceived in your post as most tend to post in a "conversational" voice rather than a literary one. (Not a criticism, just an irrelevant opservation)

RN2BENAUSTIN · Sep 1, 2008

Whoa - deep breath RN2B!
I think if you reread your last post you may find yourself to be behaving in a manner just as judgemental as you accuse others of being. When you post for comment on a board like this you need to accept that some are going to be critical of you as well as those in agreement. We ARE an opinionated bunch and some are more "forceful" than others in expressing it. I do remember that the first time I got "bitten" on this board I stayed away and sulked for all of about 3 days:imbar.
As an aside, your background in journalism/English may account for the "different" tone some perceived in your post as most tend to post in a "conversational" voice rather than a literary one. (Not a criticism, just an irrelevant opservation)

I hear ya...and realize reacting out of anger is never helpful.

I think I can take alot, I have been repeatedly told I was being judgmental for asking questions. But, I do think Selke's comments were uncalled for. In fact, what if English was not my first language, does that make me less qualified to post? Selke's comments had no value other than to degrade a complete stranger.

Maybe I misread Selkes post the same way my original posting has been misread. I thought I was clear in stating this is something I have wanted to do for many years, so now I am learning that the reality is far different than what I imagined. (My only patient experience in a hospital has been L&D and pedi ICU) I also have stated that I respect the nurses I work with, I get the "dark humor" as a coping mechanism and I think being able to emotionally detach is important. And I never said these nurses are lazy or bad at their jobs, I was asking specifics about protocol, and yes, the fact that family members were coming out to ask for water or a blanket for patient was surprising, but I get it - - I have not been in their shoes, and dont realize what all have been dealing with for the other 8 hours of their shift.

I have realized that when the ED is busy, there is not a minute to rest, when its not busy, eveyone needs the down time to unwind and prepare. I know a few of you feel I am not cut out for ED, but I love it, and I hope someday I will be good enough to be an ED nurse.

Nursing is unlike any other job, and therefore, when newbies come to this board asking about the protocol on discussing patients or how much time at bedside in the ED is the "norm", try to realize it maybe because they didnt know who else to ask.

No wonder there is such a high burn out, there is no way to truly prepare our future nurses for what they will experience. And I intend on going into this with my eyes wide open, I will probably continue to ask questions on this board. Although, it may be a while after this whole ordeal.

MAISY, RN-ER, BSN, RN · Sep 1, 2008

As I head to work this morning, I dread my day. I am assigned to our acute area today....God only knows what is waiting for me....and I am just not up to it today.

Like the OP, before you are a nurse you see "inappropriate" things occur, you hear "inappropriate comments" and you "just know what you would do if it werre you". Then you graduate and work....it's a totally different ballgame!

While I applaud your want to be a nurse, working as a volunteer doesn't give you an idea AT ALL of what lies ahead. Volunteers help, pat backs, and give the "good customer service" that hospitals are espousing. You have no responsibility to a patient and can move on at any time to another area.

Nursing is hard work, mentally and emotionally draining, and keeps you on your toes. In my ER, we hit the ground running! Limits must be set for families, and patients alike. If time is available, extras occur....if not, they don't.

In the past, I spent every minute doing STUFF, I now take advantage of lulls and rest up for the next onslaught.

On my way, just my :twocents: ,

Maisy

CritterLover, BSN, RN · Sep 1, 2008

hmm...

there isn't any denying that there are lazy nurses out there, and i don't want to make any excuses for them.

i like to think though, that part of learning to prioritize is learning to ration your energy (mental and physical), in addition to learning to ration your time.

i think this is really true in the er, when some patients really need your energy; yet others shouldn't even be there.

when i read your comment about checking a patient's vitals and not going back into the room, i laughed to myself. i consider myself to be a pretty hard-working, kind, compassionate, skilled nurse (most days :) ). but i have to admit that i've been guilty of this.

when i worked in the er, i was usually in triage. but on the days when i was in the back and took patients, it wasn't all that unusual that i would go in, check vs, do a quick assessment, and never see the patient again until i went in with discharge instructions.

for a long time, this really bothered me. i went to the er from icu, and the thought of not at least eyeballing my patient every hour or so was disturbing.

one day, it dawned on me: most patients that come to the er don't need more than a quick assessment, a set of vs, and their discharge paperwork. actually, many don't even need that much. the set of vs they get in triage, plus the set i got when i roomed them, plus the set i got when i discharged them, was pretty much overkill. most don't need to be in the er at all, let alone have their bp and hr checked three times.

i can honestly say that i'm much better at spending some time with what i consider to be the "real" er patients -- you know, pts who are experiencing an actual emergency. obviously, if the patient needs meds or treatments, the nurse will be in the room more often. beyond that, they tend to be scared, and need to be reassured and updated.

(and the patient doesn't have to be a major trauma or an ami to be a "real" er patient. just something that warrants an er visit).

on the other hand, the patients that come in for their repeat utis, yeast infections, mosquito bites ... not only do they usually not really need reassurance, they don't want it, either. they are talking on the phone, or watching tv, or napping, and they want/expect to be left alone until it is time to be discharged.

don't let your reaction deter you from trying er nursing. there really is a place in the er for nurses that want to spend a little time with their patients. you just have to accept that you won't be doing that with all -- or even most -- of your patients.

angel337, MSN, RN · Sep 1, 2008

I hear ya...and realize reacting out of anger is never helpful.
I think I can take alot, I have been repeatedly told I was being judgmental for asking questions. But, I do think Selke's comments were uncalled for. In fact, what if English was not my first language, does that make me less qualified to post? Selke's comments had no value other than to degrade a complete stranger.
Maybe I misread Selkes post the same way my original posting has been misread. I thought I was clear in stating this is something I have wanted to do for many years, so now I am learning that the reality is far different than what I imagined. (My only patient experience in a hospital has been L&D and pedi ICU) I also have stated that I respect the nurses I work with, I get the "dark humor" as a coping mechanism and I think being able to emotionally detach is important. And I never said these nurses are lazy or bad at their jobs, I was asking specifics about protocol, and yes, the fact that family members were coming out to ask for water or a blanket for patient was surprising, but I get it - - I have not been in their shoes, and dont realize what all have been dealing with for the other 8 hours of their shift.
I have realized that when the ED is busy, there is not a minute to rest, when its not busy, eveyone needs the down time to unwind and prepare. I know a few of you feel I am not cut out for ED, but I love it, and I hope someday I will be good enough to be an ED nurse.
Nursing is unlike any other job, and therefore, when newbies come to this board asking about the protocol on discussing patients or how much time at bedside in the ED is the "norm", try to realize it maybe because they didnt know who else to ask.
No wonder there is such a high burn out, there is no way to truly prepare our future nurses for what they will experience. And I intend on going into this with my eyes wide open, I will probably continue to ask questions on this board. Although, it may be a while after this whole ordeal.

i commend you for trying to gather as much information as possible about being a nurse before you actually become one, but unfortunately no matter what you do....you truly won't "get it" until you actually become a nurse. i was alot like you before i became a nurse. i was shocked at some nurses attitudes and i wondered why nurses behaved in certain ways. i was a ER tech for years and thought i knew the job of a nurse. boy was i wrong. it was a culture shock for me. when you are a nurse you are not just the nurse you are social worker, counselor, lab tech, secretary, tech, housekeeper....and many times the doctor. the sucky part of it is that you get no credit for being so versatile in your role. and this is why nurses are burned out. if nurses could work as a nurse and just a nurse only, there would not be such a high turn over. i have a good ER job now with great staffing and adequate ancillary help. its hard to find bedside nursing jobs that have this so i consider myself lucky. good luck in your endeavors, you sound like you will be a great nurse.