What is it like to work as an RN in the ER

Probably would get answers if you post this in the ER nurse forum :)

Depending on the community surrounding the hospital, there will be various types of patients. In my experience in working in community hospitals, in the past 5 years I have seen one stabbing, one shooting, a few drownings, many minor MVCs, and the rest being a mix of genuine "sick" people and then a lot of things that could have been handled by a PCP. I have also had a lot of drunks and a lot of psych patients. Major traumas and very involved ICU patients went to larger nearby facilities. You basically get a little bit of everything, but it is not always as exciting as what is portrayed on tv and in movies. I love the randomness and never knowing what to expect. Plus, as you stated in your post, there is a lot of autonomy for nurses in the ED.

Drama... lots of drama.

It depends on where you work. Obviously, a level 1 trauma center will see a lot more than a level 3 or level 4. The ER isn't all blood, guts and gore but you do see everything. The nurses do have a lot more autonomy in the ER than they do on the floor. There are protocols in the ER which include sets of orders based on the patient's current complaint. For example, if a patient comes in with chest pain and you look at the chest pain protocol set, it will include IV insertion, cardiac monitor, oxygen therapy per protocol, CBC, CMP, troponin, urinalysis (urine is like gold in the ER...99% of patients coming in will need a urine sample, whether it's a UA, pregnancy test urine and/or urine drug screen). You can then anticipate other orders based on the patient's presentation. For example, if the patient is diabetic, you can anticipate the provider ordering their blood sugar to be checked, so I will go ahead and do it. If that chest pain patient makes me even a little suspicious of a possible pulmonary embolus, I will anticipate a D dimer to be checked (so I will go ahead and draw one) and make sure they have the appropriate-sized IV in case the provider orders a chest CT with contrast. And it goes on and on.