National Emergency Nurses Day – Typical Days in ER

National Emergency Nurses Day – Typical Days in ER

“Room 1 is here with chest pain and a significant cardiac history. His initial ECG showed a long QTc and he has had 5 runs of V-tach with the longest run being 2 minutes. He received a bolus of 300mg Amiodarone and is now on an Amio drip. He also received 2 grams of mag and has been normal sinus rhythm with a normal QTc. We are waiting on Cardiology to come see the patient.

Room 2 is here with a small bowel obstruction. She has an NG tube already placed and is on low intermittent suction. She is admitted and waiting for a ready bed upstairs. She has been hypertensive that has been controlled with pain meds. Last BP was 130/85.

Room 3 just got here, they are complaining of right flank pain, I haven’t gotten blood work yet, they are in the bathroom getting you a urine sample, and a doctor still needs to see the patient.

Room 4 is here with nausea and vomiting. They have received 2 litres of normal saline, 8 mg of Zofran and need a PO challenge in an hour. They will be discharged if they can tolerate the PO challenge.”

If you’re not an emergency room nurse, this handover is probably enough to give YOU chest pain. I am an ICU nurse but have been pooled to emergency many times throughout my nursing career.  All areas of nursing have their little idiosyncrasies and culture that we might make light of, all in good fun but I really do admire what emergency nurses do.  On any given shift, they are running around managing multiple patients with a sharp eye on picking out life-threatening conditions.  Many nurses say that they don’t like the ER; it’s too hectic, very fast paced and nerve-racking …. but it is also exciting, more autonomous, and builds confidence. Not every day will be excitement. Not every day will be heroics, but it is putting out a lot of spot fires.

When you clock in, you will huddle for a handover, receive your assigned beds and cover the current state of the department. This typically includes how many patients are suicidal, critically ill, and what is happening in the resuscitation bays.

Resus bays are specialised rooms in the emergency department for the sickest patients and most time-sensitive interventions.  From trauma to medical mysteries, any type of patient can be cared for in the resus bay.  It’s important to listen to this information because you may potentially be taking care of one of these patients, but also because those patients require extra hands so be prepared to help out a lot.

Patient-nurse ratio is usually 4-6 patients to one nurse, however, this is not the rule, rather the hope. In the Australian public health network, you cannot, by law, turn away a patient who comes in the doors. On the floor, you can refuse to take any more patients. If emergency can’t move patients upstairs, the waiting room fills up. When patients are waiting in the waiting room, the nurse/s that are in triage are responsible for these patients. Depending on how many nurses are assigned to the triage area, will determine the ratio. If you have 2 triage nurses and 20 patients, your ratio will be 1:10, if your waiting room fills up with 50 patients, the nurse to patient ratio becomes 1:25. That can be scary, but the scariest part is that they are solely relying on your ability to assess them correctly because in most emergency departments, a doctor doesn’t see patients in the waiting room.

This is why, when a patient has a ready bed upstairs on the floor, emergency staff make haste getting that patient to the floor so they can pull one of those 50 people in the waiting room into a room to be seen by a doctor.

As an ER nurse, you will be trained to recognise life-threatening situations, stabilise them, then get that patient to the proper place where they will be cared for long-term. Everything in the ER is short-term and fast moving. No matter what, every patient you see will need to have an assessment done on them. However, the most important part of emergency nursing is which patient you’ll see first. This is a skill that takes time to learn and is carried out with a lot of teamwork.

We use National Emergency Nurse's to say “thank you” to these nurses for their hard work, dedication, service, and commitment. They provide unwavering care to their patients and families. Their loyalty to the emergency nursing profession does not go unnoticed. Emergency room nurses are the first people we see when we have an accident or a medical emergency. They work hard to put us at ease and eliminate pain and discomfort. This is a day to let them know just how important they are in keeping hospitals running smoothly.

National Emergency NurseÕs Day on the second Wednesday in October recognises the dedication of Emergency nurses across the nation. Promoted and sponsored by the Emergency Nurses Association and having originated in Australia back in 1989.