Why I'm sick of the ED

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Specializes in CVICU, ER.

1. When I try to delegate things to an ED tech because I'm busy medicating, assessing, triaging, or discharging patients, I get attitude, or "I'll get to it" while they're chatting someone up. That's if I can find the tech.

2. I have to fight to use my nursing knowledge and skills, my "job" consists of nursing "tasks", aka "tasks" that a tech "can't do": medicating, triaging, discharging, etc. My triage of the patient also doesn't seem to matter, the docs often interrupt me to ask the same questions I'm asking. Nurses don't seem to have a place in the ER, I feel like a medication monkey who starts IVs and reads preprinted discharge instructions to people, because there's not really time for anything else. The only time I feel like Im worth my pay is when I catch mistakes: wrong dose or wrong route for a med order, etc, or actually teach someone something: keep a list of the medication you're taking in your wallet. There seems to be very little time actually assessing patients, there's not enough time, more focus on CT scans, lab work and Xrays.

3. When I triage and prioritize patients according to urgency, I get flack about some non-urgent task that needs to be "done" so the patient can get discharged, aka tylenol for a "fever" of 99.4, etc...

4. I'm becoming sloppy, because "there's no time", some days I'll say "***" it and take my time to do what I consider a good job, these are the days I get yelled at the most.

5. I get no to very little report on patients that I'm responsible for, if I ask questions, I get an attitude like I'm being difficult. If I act "nice" and joke around like everyone else, I get treated well. This furthers the feeling that we're all just med and task monkeys.

The last couple of months have been rough, to say the least :)

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Specializes in Medical Surgical.

I was pulled down into the ED once and hopefully never again. (I'm on the Med/Surg floor) It takes a different type of a nurse to like ED nursing. I prefer to not being rushed and being in a more controlled environment.

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Specializes in ER.

sounds like you're in a slump. Hang in there, it's not always like this, though I certainly understand how you're feeling. Sometimes it seems to hang on for a while, but eventually your days/nights will get better. Sometimes it depends on the crew you are working with. Try to be positive. We're not just med/task puppets, though it may feel that way. Don't be discouraged! All it takes is one "thank you so much" from an appreciative patient that touches your soul and you're filled up for a bit to take the beating once again. :hug:

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Specializes in Emergency, Telemetry, Transplant.

First, it sounds like there is a 'culture' issue at your ED. I'm not trying to pretend to know how things are at your ED, but, to me, it is not appropriate if you are "yelled at" when you don't move at their optimal speed.

My second comment is about the techs...again, I don't know your ED, your techs, etc. I have to say, however, I have worked in LTC (as a CNA) and then on a step down floor and a telemetry floor as an RN before I came to the ED last September. For the most part, the ED techs are (way) better and much harder working than any of the techs/aides I worked with in other places (of course there are some outliers in both groups).

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Specializes in CEN, CPEN, RN-BC.

ED Nurse = Work Horse

It's true.

Sometimes I feel as though our value isn't measured by our critical thinking skills, but by our ability to come in early, stay late, get called in, and basically man a demanding department with a door that never stops revolving.

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The nurses in the ED I worked at the last year (I'm a NP) were the best trained nurses I have ever worked with so far. I hope I let them know how much I appreciated their assessments/judgements enough. They worked hard and had fantastic perspective. Being prn I learned quickly that they were the best resource I had on any shift!!! I'm sorry you don't have support in your department...

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Specializes in Trauma, Teaching.

"The only time I feel like Im worth my pay is when I catch mistakes: wrong dose or wrong route for a med order, etc, or actually teach someone something: keep a list of the medication you're taking in your wallet."

Don't discount just how important those times are. The mistakes are (hopefully) few and far between, but you were there at the right time! Be more worried if it was frequent!

My docs are usually far enough behind that they don't get in the way of my history and assessments; but I can usually tell the docs history the patient left out while talking to the MD.

Take your time to do your assessments anyway; here the docs mostly look up all their own results no matter what I tell them they are.

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Sounds like some department/staff issues... I feel for you

Every nursing job is different, ED may not be your niche but don't forget that you play a very important role when you are there!

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Specializes in Emergency Medicine.

Techs are the same everywhere. Get use to doing it yourself.

I find it in departments with no accountability.

Sounds like ER burnout to me. Try traveling...

At least they pay you more for your efforts.

You can also rid yourself of all the political stuff as well...

Welcome to the burnout club. :D

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Specializes in Emergency.
Techs are the same everywhere. Get use to doing it yourself.

I find it in departments with no accountability.

Sounds like ER burnout to me. Try traveling...

At least they pay you more for your efforts.

You can also rid yourself of all the political stuff as well...

Welcome to the burnout club. :D

Techs are not the same everywhere. There are a few bad techs everywhere maybe but there are certainly some great and outstanding techs. Most of the techs in the ER where I work do more than the nurses. Desk tech, clean rooms, stock rooms, do IV's, EKGS, Hook them up to the monitors when coming from triage or EMS, CPR in a code, transporting patients to X-ray, CT, MRI, to the floor, etc. While the lazy nurses (some not all) boss the techs around and tell them to do this that and the other while they play words with friends on their phone. Seems to me that the nurses are thinking all they have to do is chart and pass meds. The techs keep our ER flowing. Again, this is some not all. Nurses and Techs both need to remember we are working as a team. I'm starting to see a division.

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Specializes in ER, telemetry.

I have a love/hate relationship with the ER.

I have learned to do things as fast and safely as I can, whether that means the discharge or calling report waits, so be it. If the charge nurse, or whoever needs the bed that bad, they can get off their tush and do it. A little teamwork never hurt anyone.

As for ER techs. There are good ones and bad ones, just like ER nurses.

I have learned that if you treat the techs with respect and don't overuse them or abuse them they will bend over backwards for you.

I have also been burned with a crappy report. I always get report while reading over the other nurses charting, making sure things are charted accurately, making sure assessments are in, tasks are done, med list put in, etc....

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Specializes in ER.

Burn out!

We all have those same complaints.... How much they are affecting our work can be fixed!

What about going pool or PRN and trying out some other dept? Challenge your brain and your skills by shaking it up? That is what I did (go Pool) and now I get to go to different locations and work with different people. Makes that "same-old" a little different!

That is the beauty of nursing, you can change your "job" but not have to change you "career."

Think out-side the box! Good luck!

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