A Day in the Life of an ER Nurse

By Jordie Papa

Image courtesy Public Domain Files

As stressful as being a nurse can be, if you really want to get your Adrenalin pumping in the healthcare field, nothing compares to working in an emergency room.  To begin with, there’s no telling what’s going to walk in the ER door.  ER nurses have to be ready to handle anything from gunshot wounds and traumatic amputations, to head injuries and drug overdoses on a moment’s notice without losing their cool.  Not only do they have to deal with daily doses of trauma that would make most people swoon, they sometimes need to defend themselves from patients who can be verbally abusive or physically combative.    That’s why it takes a very special kind of nurse that can report for a stressful 10 to 12-hour shift day in and day out with a smile on his or her face.

If it bleeds, it leads.

While all nurses have to deal with blood from time to time, when it comes to working in the ER blood is the norm.  Depending on the type of accident or even the time of day, emergency room nurses not only have to deal with open wounds and worse, they have to be able to determine who needs to be treated first. While ER nurses don’t have ice water in their veins, they do have triage in their genes, since they have to be ready to deal with mass casualties at the drop of a hat.  What’s even worse is that they’re forced to perform triage in the midst of sheer chaos that comes with life in a busy emergency room. 

If you aren’t prepared to multitask, don’t work in an ER.  Not only are nurses there required to juggle everything from triage and first aid, to caring for patients while dealing with concerned family members, they also have to find the time to grab a bite to eat whenever and wherever an opportunity presents itself.  Even before they begin their shift they are required to prepare mentally for whatever calamity the day throws at them.  They also have to take into consideration the emergencies that occurred on the shift that preceded theirs, since some of these patients still need to be evaluated and treated before they are either released or admitted.

Being cool under pressure.

Image courtesy Max Pixel

ER nurses are called on to do everything from drawing blood and inserting IVs, to stitching wounds while comforting patients and loved ones.  No sooner do they finish with one patient, when they will be required to give their attention to the next one in line. This means that long shifts and non-stop stress can take their toll on ER workers. 85% of ER nurses report that they typically experience at least one instance of “compassion fatigue” on a weekly basis.

During a shift, ER nurses also need to be prepared to treat people of all ages, since everyone from newborns to grandparents can walk or be carried in the door at any time.    While everyone who enters the emergency room clamors to see a doctor, nine times out of ten, it is an ER nurse who will initially be assigned to care for them.    It is then up to the same nurse to decide where to send the patient.  Typical emergency rooms are divided into 6 areas:

      1.      Triage – The air traffic control of an ER

      2.      META (Minor emergency Trauma Area) – where non-life-threatening injuries are handled

      3.      Trauma Unit – Deals with the immediate needs of patients who have severe injuries

      4.      Rapid Assessment Team (RAT) – These units typically focus on patients brought in via ambulance

      5.      Surge – An area used when the ER exceeds its capacity

      6.      Main ER – contains all of the above, plus consultation and observation rooms, store rooms and ambulance bays

Who keeps changing the channel?

Image courtesy Health.mil

While ER nurses are typically assigned to a unit, depending on the nature of the traffic coming through the doors, a nurse may be asked to float from unit to unit as the need arises. Whether they are fixed or float, ER nurses have to be able to handle not only non-stop trauma care, but they have to be able to shrug off whatever condition the traumatized patient is in. When dealing with inebriated or drug addled patients, it can take an extra helping of intestinal fortitude to both treat and communicate with them.  It is also sometimes necessary to defend themselves when an intoxicated patient gets too pushy.

Bear in mind that unlike ward nurses, those that work in the emergency room are expected to move from patient to patient rapidly.  There’s sometimes no time in a busy ER to chitchat with patients or family members.  No sooner has one victim been treated or stabilized, when the nurse is summoned to another treatment room.  They are also required to work with the other members of the ER team that includes ER doctors and surgeons, other nurses, EMT’s, radiographers, respiratory therapists, pharmacists, hospital administrators and possibly even medical students.

Keeping all this in mind, is it any wonder than less than 30% of all nurses choose to work in the ER?  For those who do, they have to be prepared for hours of boredom interspersed with moments of sheer panic day in and day out.  While some nurses would cringe at the roller-coaster ride that emergency room nurses routinely deal with, others who have worked in the ER for years find that it’s just the thing to get their blood pumping as they pull into the parking lot to start their next shift.

Jordie Papa is owner of Uniform Destination with four locations in North Florida offers scrubs and medical accessories, including stethoscopes.