I am a nursing student and will soon be starting my last year before graduating. I am interested in the ER, but it is really hard to pin down exactly what the job consists of.
I have looked at a lot of old posts that talk about how a lot of the work is determining priority. But it is hard to understand what is usually seen or done in the ER because "no day in the ER is the same".
So, in order to get a better understanding of the variety of situations an ER nurse encounters, I was hoping you guys could answer my question:
Took care of an admitted patient who refused a bed the bed we assigned him so he was stuck with us the whole shift. Quite annoying patient I may add. He was in for infection around a fixator on his leg.
Took care of a stroke patient 1:1 monitoring vitals and doing neuro assessment q15 minutes for 2 hours. Started seizing during an X-ray and we gave her ativan and keppra.
Took care of a post septic patient who got an infection from an abscess.
Got one stick out of like 5 tries but I'm gonna keep working on it!
I really have enjoyed reading this thread! I start in the ER as an ASN New Grad in September and simply can not wait!
Just a bit of advice... dump the "ASN" from your statement... it's irrelevant.
Congrats, though. I've had the opportunity to see inside a bunch of different units and departments and, bar none, the ED is still the best from what I've observed... though also incredibly vexing for a variety of reasons... kind of a love-hate thing with me... I am hooked on it, though.
I had a patient who fell from a horse whose brain seemed to "reset" every 2 to 3 minutes. I finally just wrote her a note about what happened, put it on a clipboard, and put the clipboard in her hands. When I saw the "where am I?" panic set in, I would direct her to the clipboard. It was a challenge getting her to complete her CT scan, she would reset just as we were getting ready to scan her and we would have to explain over and over why she needed a CT! Lol
I did that once with a dementia patient who kept asking where she was and what was going on.
I think you should have a good idea about the ER from the posts here. you also get lots of stubbed toes, colds, tummy aches, rashes, need a note for work etc. I was having a discussion with some of my cohort students and the big difference in ER I think, has to do with an individuals personality and nursing style. In the ER, you have a short period to interact with the patient and they are then gone from your care. On the floor, esp in oncology, rehab, LTC, etc, you may have a patient over multiple shifts for days, weeks, months or longer. I would think LD would be similar in having a different type of relationship with the patient. You follow the patients progress and have a longer nurse/patient relationship etc. I much prefer the shorter ER type interactions, but some of my cohorts really like the long term relationships and being an active participant and seeing the patient recovery and be discharged.
-completed several full sepsis work-ups (IV insertion x2, blood cultures, lactic acid and other lab work, CXR, IVF and IV abx )
-assisted in a stroke code
-Was told by a patient and her family members that I needed to "be nicer". And advised that said family member "worked in customer service" therefore "I know that you could improve your customer service" .
-took care of a cancer patient with ascites requiring bedside paracentesis of 4L fluid, admitted her to the floor but had her as a patient of mine for >9hrs.
- helped tell a 43 year old who thought he had a DVT/blood clot in his leg going up to his scrotum that he has a 12x7mm mass in his pelvis that is likely a malignant tumor
-got threatened by a dementia/alzheimers patient and had my arm death gripped until a bruise formed. Said patient also threatened to "send my cats to attack you and f*** you up"
- assisted in conscious sedation of a gentleman who had pork stuck in his esophagus requiring GI endoscopy procedure to advance the food bolus/fix his distress.
-helped triage a young girl who overdosed on 50+ tablets of benadryl PO when her boyfriend broke up with her. She started off AOX3 but quickly started having anticholinergic symptoms
- brought a patient to the Medical ICU on Bipap who will need to have either a thoracentesis or pigtail catheter to drain fluid from his lung . He hugged me, thanked me and had tears in his eyes when he said goodbye to me. I only was his nurse for 3 hours.
It's not always pretty, it's not always a good shift. Today I almost wanted to cry a million times because I had tough, needy patients that did NOT have realistic expectations of what it is like to be in the emergency department on a busy afternoon. They were not susceptible to being updated by me, only wanted to be seen as soon as possible so mostly just got angry with me /yelled at me until they either got a doctor's attention or decided to leave. Some days really test your patience, and patients always test your patience. But at the end of the day, I love what I do. Every day is a new day and is different. Good luck with your nursing endeavors
CX_EDRN
62 Posts
Fun thread!
Primary in a L1 ejected at highway speeds. C2/3 fxs.
Secondary in two L2s, neither of which sustained significant injuries.
Primary in a stroke alert, which should never have been called in the first place.
Irrigated a huge forehead laceration.
Helped prep a patient for emergent cath lab.
Lots of IVs and EKGs.
Lots of run of the mill belly pains/migraines.
Got rid of a drunk frequent flyer who likes to abuse staff.
I think that's about it.