Top Skills for the ER Nurse

Christina Whalen

Today's nursing professionals must have an increasingly complex set of skills and abilities to thrive in their health care careers. That is even more important in the ER setting, where decisions must be made quickly and decisively. Being an ER nurse is not an easy job, but it is one of the most rewarding. People become nurses because they want to take care of people and give back, but they need the training to support them.

Of course, an essential component is a professional skillset to administer emergent care. Now more than ever, nurses must be equipped with hospitality, organization and adaptability. These are a few necessities among a list of skills that can help nurses deliver quality care.

Adapting to a fast-paced environment isn't for everyone, but for those who enjoy the rapid, last-minute changes and the prospect of seeing many patients with various conditions, it can be a rewarding experience. However, it can also be exhausting, mainly because there is no other industry like the emergency department.

Therefore, it's integral to develop skills to adapt to these demanding environments to better serve those needing care. Additionally, they can prove helpful personally just as much as professionally. Keeping a level head, focusing on goals, and being prepared for any and every situation a nurse might encounter are the foundations for being a great individual and an incredible registered nurse.

1. Organization

Understandably, organization might be one of the most overused listicle items, but it's there for a reason. Organization is one of the most important features of being a registered nurse, if not for the supplies, then certainly to keep track of patients. With as much paperwork and data confidentially shared between patients and their medical team, that information must be secured and stored.

Then, there's keeping track of supplies, ensuring enough utensils and hospital materials are available for staff, such as medicines, masks, scrubs and gloves. Most patients may not realize this, but nurses have other duties beyond caring for individuals in rooms; they range depending on job position and requirements, but the sentiment is the same. It can also be essential to organize the brain and grasp multitasking. There are a million and one things going on within health care systems, and attention needs to be spread evenly.

Most people think they're organized, and they're not. Nurses must be organized mentally and physically, and they've got to be able to multitask. That doesn't mean they should give 110% focus on one thing and 5% focus on another, but they need to know what's going on with the whole floor. The room assignment is not the only job. So, nurses must be organized and learn to handle multiple tasks.

2. The Ability to Quickly Assess Situations

Quick judgment calls are a practiced skill, especially for new nurses who haven't been in the field for very long. School can only teach professionals so much, but being knee-deep in the trenches of the medical field will render experience that can be utilized in any nursing position, especially in an ER environment. Paying attention to professionals and mentors is a great way to pick up on action cues, as is being an eye and an ear during those timely moments. Soaking up as much knowledge to determine a patient's wellbeing is especially useful for emergent situations.

New nurses who would like to provide emergency room care should start at larger hospital systems to build experience and time management skills. Essentially, stack the resume to get the education needed to adapt quickly and efficiently. Then, it becomes smoother to make split-second decisions during emergency medical administrations.

ER nurses must make decisions quickly because it can be a life-or-death decision. Everyone on the team must be able to look at each other from across the room without asking a question and decide: sick or not sick. Many nurses right out of nursing school do not understand that yet. They teach many things in nursing school but knowing sick versus not sick is not one of them.

3. Patient Prioritization

A critical component of administering medical care is knowing a patient's level of sickness. Every patient deserves quality care, but those at risk of complications or life-threatening conditions should come first in an emergency. Monitoring the ER is an essential task because while a patient waiting might be okay, their health can decline within a matter of minutes.

Just like the ability to quickly assess a situation and make a quick decision in the ER, the same can be said about understanding the difference when a patient is worryingly sick. It takes experience to recognize the signs that something is not right.

Sick versus not sick: that is a huge thing. Once nurses have assessed the situation, they must be able to prioritize care. It doesn't matter if one's been waiting two hours. Another one's got to come in first because they don't look good. No one knows what their deal is. No one knows what the patient's story is or their history, but it's obvious something is not right because that is not the right color, and they shouldn't be slumped over in a chair like that.

4. Focus, Forgive and Forget

The emergency room is a challenging environment because of the level of care it's administering. Patients who come in for emergent needs are there to be taken care of quickly because their condition is detrimental or life-threatening to their health. There is no time for hurt feelings when tension is high, and a patient's health could rapidly decline in those moments.

Demands made by nurses and doctors, for example, might sound rude in the moment, but they're not to be taken to heart. It's about the patient more than it is about purposefully being disrespectful. ER nurses are a special breed. They've got to forgive and forget the things that happen in an ER quickly. Things are said in an ER when the team is coding a patient. When a patient is sick, manners may go out the window.

For myself and in my position, I'm not saying please and thank you. I'm saying, 'I need this. Get it to me.' Because when we're in that room and that patient is coding, everybody's focused: ER nurse, ER tech, ER doctor. Everybody's focus must be on that patient. It must be on saving that patient. So, nurses must be blunt and a little bit demanding.

Only after a patient is stabilized can the reconciliation begin. Apologies are needed afterward. Everyone needs to be able to step back after that happens and say, "I'm sorry." Then, we should move on and forgive and forget that.

I've been lucky enough to land a career with a company that genuinely believes in servant leadership. From our emergency room physicians to our ER nurses and techs to the front desk receptionist, the overarching mindset at Intuitive Health is that of servant leadership. Our team is devoted to building community trust and satisfaction. This begins by simply doing more than what is expected. When we serve others, we know that we put their needs before our own. Having the heart of a servant means you leave everything and everyone better than the way you found them.

We know patients are not seeing us on their best day. Their expectations may be low, but we intend to go above and beyond. Intuitive Health empowers employees to make decisions with a patient that improves their experience or WOWs them. Empowered employees have the opportunity to change frustrations and provide a moment that surprises the patient. Sometimes it is as simple as a joke or offering a blanket. It may be running next door to grab a patient's favorite flavor of drink. We hear hundreds of these stories every month in feedback from the customers we serve!

At Intuitive Health, the facilities management team is actively involved in the company's day-to-day operations. In our servant-leadership-focused matrix, the customer is at the top. The employees who serve them are the most important and highest priority within the provider system, not the C-suite. Leaders are continuously engaged, providing encouragement, direction and support to all employees so the facility can maintain the highest level of service.

This constant positive presence of ownership and servant leadership has allowed for continued improvement in a thriving culture, which is reflected in patient care. We hire the best health care employees who work in an Intuitive Health facility where they're exposed to more opportunities to grow than anywhere else in this industry.

Ultimately, it's essential to find a health system where they care deeply for their employees and the patients they serve and uplift the experience of all parties. This, in turn, restores confidence in the health care system for health care consumers.

Summary:

Working in an emergency room takes dedication, skill and passion. While sometimes hectic and full of surprises, it can be a rewarding experience. For those interested in becoming a nurse in the ER, there are a few essential requirements that can improve and hone the necessary skills to make it in a tough environment.

Top Skills for the ER Nurse

1. Organization

2. The Ability to Quickly Assess Situations

3. Patient Prioritization

4. Focus, Forgive and Forget

Summary:

About Christina Whalen

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