I know these answers are too late for your paper, but i still want to answer them.
I work in a three bed ER in a small rural facility. I work nights. Most of the time I am alone. Keep this in mind when you read my answers.
The most exciting aspect of being an ER nurse is fixing people. People who come in scared to death that they are going to die, and I can fix their pain. Or, how about that one question that I ask of the patient that nails the definative diagnosis of appendicitis? Or the time I predicted Atelectasis before the patient went into the Radiology and had the chart ready to go and the team ready to be called?
The Provider is the one deciding when a pt is treated and streeted, or admitted to the floor. I can just about predict those admissions based on my knowlege of the disease process, of my working diagnosis, of my providers. Usually, if they cannot be "fixed" in the ER they are admitted, or they become a "drip and ship"
I have frequently been in situations where I wasn't sure what to do. That is the "Oh SH**" moment. So, I say Oh Sh** and then find something to keep moving. Airway. Breathing. Circulation. Vital Signs. By the time I get to that point, I have decided whether it is a crisis or not, and who to call. I pull nurses and aides off the floor to assist me until the code team arrives. The nice thing about ACLS protocol, is it is designed for the single person resuscitator -- for me. It gives me the "recipe" to take me through the blankness of the Oh Sh... moment by concentrating on the ABCs
ER nursing is a focused assessment. A patient comes in with difficulty breathing, I will ask questions primarily of the respiratory function. I will later touch on the other systems, but will focus on the problem area. Sometimes, someone will come in with general complaints, say of my belly hurting. I will ask them to point with one finger where it hurts.
I went to college to become a nurse. I didn't know what I wanted to be when I grew up until I was 40 years old. My husband chose it for me, and I found out that I REALLY love it.
Why emergency room nursing? I have to say it chose me, I didn't choose it. Again, I work a very small facility, and I have had to learn every aspect of this place, including OB, OR (for crash C-Sections), ER. I love being jack of all trades, master of most.
Other fields of nursing I've though about were as follows: 1. Operating Room -- but the culture is not one I can live with. 2. Long Term Care -- I've done that and I'm just not suited to that, although I am very good at it. 3. Large Facility -- I would have to specialize in one area, and I just don't want to be that limited! My specialty is Rural Nursing, and Night Shift.
The kind of person to be a nurse has to be a self motivator, especially in the ER. Intelligent, but not too smart for her own good; Has to be teachable at all times. Has to be able to assist the provider in making the "correct" orders for the patient (this is part of the assessment as well, you know)
The most rewarding part of being a nurse is when I am able to save someone's life. When I predict a lung collapse and have the people ready to rock and roll when the doctor makes that diagnosis. When I call Respiratory Therapist in to help with a distressed newborn, and the infant is all better by the time the RT gets there, because I did my job, and did it well and quick. When the blue baby is shipped out in time for a good outcome. Also, when I can help family cope with the impending death of their father, or make sure the wife is treated humanely until the time of her death.
The most difficult part of being an ER nurse is never knowing what will come through that door. Or when the parents of the croupy child who is not in distress complain about the poor care they rec'd as they were asked to sit in the lobby because all of the ER beds are full with bloody mess, with cardiacs, with dying infant I'm trying to save, and they can see all this going on and left AMA.
My least favourite part of nursing is dying. Whether the death of an older end-stage COPD, or the stillbirth of an infant, it is never easy.
My first witnessed death was while I was a CNA years before I became a nurse, so I had had experience with death and with providing the patient dignity during the dying phase. I have nightmares. But I still work in the ER, and I will continue to do so. I am a Registered Nurse.
