Request from Experienced Nurses

OK, here goes ... my day yesterday 7a-3p. I work in the ER, so my routine (do I have a routine???) is very different from a nurse on a hospital inpatient unit. Which is very different from a nurse in an office/clinic setting ... and very different from a public health nurse or a home health nurse ... and so on.

7a: Started to get report from the nurse I'm relieving. Report for us is very brief - each pt.'s chief complaint, significant/unusual physical findings, and where they are in the ER process - still waiting for x-rays, waiting to be admitted, will finish IV antibiotics & be discharged home, etc.

7:04 Asked by charge nurse to quickly discharge pt. in Room 4 & get them moving so we can bring back 70-year old male in Triage who is having chest pain. Discharge pt. (was a "breakfast clubber" - intoxicated, brought in by police, stays with us until coherent enough to be discharged which is usually miraculously after sleeping a few hours, getting O2, a liter of fluid and a breakfast tray from dietary).

7:08 Pt. brought back from Triage by wheelchair, pale, doesn't look good. With help from triage nurse & ER tech, within about 10 minutes we have the pt. on the cardiac monitor, O2 applied, EKG done, IV started & blood drawn for lab work. EKG shows he is mostly likely having an MI (heart attack). The ER doc & I assess the pt. together. Cath lab team is notified, pt. is given meds for pain, anti-coagulation & to control heart rate & BP. Cath lab calls back - they're ready - hurry up & finish my charting (on the computer), print it out, tear apart the chart & the ER tech & I take pt. up to cath lab. I give report to cath lab nurse & cardiologist, get pt.'s wife settled in waiting room, and head back down to the ER. It's now a little after 8am.

Right now I have 2 other patients - one waiting for the doc to finish writing admission orders & one awaiting lab test results. Both are stable. I continue to monitor them. Every time I get a new patient the routine starts again - pt. either comes from triage with some basic assessment info from the triage nurse, or comes in by ambulance in which case I get report from the medics. Assess pt. before/with/or after doc does, depending on situation. I start IVs, do EKGs, apply O2, administer some breathing treatments & call the respiratory therapist for others, give meds, call x-ray/CT/ultrasound/Doppler lab when pt. is ordered those tests, apply wound dressings, splints & slings, instruct pts. on how to walk with a cane or crutches, call report to nursing homes & other extended care facilities on their residents - whether they'll be admitted to the hospital or discharged back to the facility, work with the social worker when a situation requires his/her intervention, occasionally call security for back-up when a patient/family situation is threatening to spin out of control, explain planned course of treatment to patient & family, call family/next of kin when appropriate, chart both on the computer and on those pesky paper forms, and keep in constant communication with docs & charge nurse. I ask for help from ER techs and other nurses when I need it, and help them get a patient started when my patients are caught up. When a patient is admitted I either fax report to the floor, call to make sure the bed is ready & send them up with a tech, or if it's an ICU patient, I call report to the ICU nurse & transport the patient myself. On transports of very sick patients I'll be accompanied by a tech & respiratory therapist & sometimes the trauma team docs. Patients can and sometimes do code in elevators.

Around 1pm the flex nurse relieves me for a break - I take about 20 min. to use the bathroom, check my cell phone for messages and eat a piece of the pizza that we ordered.

Unless I'm assigned to triage, I typically spend no more than 30 total minutes a day sitting - and that's when I'm on the phone coordinating care for the patient.

In my department we generally leave pretty much on time, unless a patient is crashing at shift change.

This only scratches the surface, but I hope it helps.. This is a job where I use my brain, my heart, my instincts, my humor and my physical presence constantly. For 8 or 12 or however many hours, I'm just about constantly "on."

Every single day I learn something new - a new condition, a new presentation of an "old" condition, a new medication, a new procedure or test ... or just a tip from another nurse, physician or medic about how they handled a situation.

Best of luck to you! :)

WOW, thanks so much for that info. There are some things none of us can even imagine in a nurse's job. Thanks for taking the time to share this!!

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There is no forum about going to Medical School from nursing. Please does anybody know if its easier for nurses to go though the medical school than for the other graduates?

Will I be able to work as a nurse and study in Medical School?

Please help.

Thank you UTALIZ. I admire the work you nurses do. It is amazing the responsibilities one has as nurse.

Thank you to all the nurses who have responded to this thread! I am starting my pre-reqs for nursing school in August. I am going into nursing as a second career and hearing about "a day in the life of" makes me excited.