by Sarah Jividen | Dec 20, 2017 | ER Nurse, Nurse Career, Nurse Life
Have I mentioned how much more I love my job now since I started working as an emergency room nurse?
A year ago, I was a per diem resource nurse who worked on multiple different med/surg and telemetry floors all over our hospital. Being a resource nurse works well for me due to the flexibility it gives me as a working Mom.
But unfortunately, I was becoming incredibly burnt out. Bitter even. I was losing my passion, and I started to wonder if I was due for a career change-up.
I even went so far as to interview for a few medical device companies as a Clinical Nurse Specialist (I was a medical device salesperson before my career change into nursing). I am so glad I decided not to accept any of those positions!
Instead, I adopted a new specialty as an RN in the emergency room and reignited my passion for nursing and healthcare. When the opportunity came up for me to interview for cross-training into my own hospital’s level 1 trauma center, I jumped on it. I started my ER journey on Easter Sunday, 2017.
I have always thought of the ER as a scary portal into the hospital. We are often overbooked with patients, and the load can be relentless. There are sometimes grim patient situations, and sometimes patients die, despite every life-saving effort.
You will be hard-pressed to find medical professionals who deal with more stress and pressure then emergency room nurses. But I am grateful to expand on my med/surg and telemetry knowledge base and learn a new specialty.
Here are my top 6 reasons that I love being an emergency room nurse:
My IV start skills are so much better.
Since becoming a nurse in the emergency room, my IV start skills have gotten so much better.
In an emergency, we need to be able to start IV’s fast for testing, various medications, pain and nausea relief, IV hydration, and antibiotic therapy, among other things.
Fortunately, in the ER, I get the opportunity to start anywhere from 5 or more IVs in a single shift. So I have the chance to perfect my skills frequently on many patients who are difficult IV sticks.
Many of the nurses I work with have been in the ER for a decade, or longer and their IV skills are unbelievable. Several nurses are even trained to do ultrasound-guided IV starts on patients with hard-to-stick veins.
There is an enormous variety in our patient population.
Every day is an adventure. Sometimes it can be overwhelming, but never boring. I have had patients ranging in age from 2 days to 108 years. Patients have arrived with complaints from hiccups, to every type of accident you can imagine and everything in between.
As one would expect, many of our patients are really sick or critically injured. Our patient loads include various types of trauma patients, septic patients, elderly patients, organ transplanted patients, patients with cancer or autoimmune diseases, psych patients, and small children and babies, and so much more. There is rarely a dull moment and always something new to learn.
The teamwork in the emergency room is impressive.
The coordination when a trauma patient arrives is impressive. Patients come into the ER in urgent situations where the cause of injury or disease isn’t yet known. Doctors, nurses, techs, pharmacists, and other medical professionals cohesively work together to give fast life-saving medical treatment.
Also, emergency room nurses often have their own sections, but there are also many “resource” nurses on the floor to assist with additional patient care. When a patient arrives with a more serious condition, there are always nurses who come in to help.
For example, we call a “code” for septic, stroke, and head trauma patients. It is an overhead call to other nurses in the ER that a particular room needs additional help. Within seconds there are a handful or more nurses in the room helping with triage, initial assessments, IV sticks, blood draws, and many other nurse protocols and procedures.
The emergency room moves fast.
Many call it “organized chaos.” The emergency room is a fine-tuned machine with each nurse component working semi-gracefully around one another. From the outside, it might look like craziness, but the madness always has a method.
I am constantly learning.
I am a closet science geek. And I love the cerebral stimulation that I get as an emergency room nurse. I have had the opportunity to see more disease states, complex injuries, and unusual diagnoses then I ever could have imagined even existed.
It would not be an exaggeration to say I learn ten new things every day at work. To top it off, I am surrounded by some of the most intelligent people I have ever met. Many of my co-workers have the same drive for helping people I do. They motivate me to keep learning.
I just have to laugh at some of the stuff I see.
Nursing is a work of heart.
Please forgive me for saying this. This may seem inappropriate, but it is how I maintain my resiliency.
The emergency room is a very emotional place. Patients never want to be there and usually don’t understand, for example, why they have to wait in the hallway an hour or even much longer until their test results are completed, or the medical team decides on a plan for them. They get upset and tired of waiting.
Sadly, sometimes they take out there frustrations on the people working the hardest to get them the medical treatment they need: the nurses.
Sometimes things just get so odd that I can’t help but laugh. There are days when I see people come into the ER saying that they feel like dying, but end up having a diagnosis of constipation. Once I had a college student come in for a temperature of 99 degrees. I’m like, seriously? How do you even get through the day?
I have had so many “I couldn’t make this stuff up if I tried” experiences in the emergency room to last me a long time. But that’s one of the reasons I like being in the ER versus other parts of the hospital. It can get weird, but I’m always learning. And I’m so grateful for the opportunity to keep learning.
Additional recommended reading: 5 Best Trauma Shears For Nurses
by Sarah Jividen | Dec 18, 2017 | ER Nurse, Nurse Life
While most people were with their families this Easter Sunday, I was working day one of Emergency Room RN training.
In light this, my family had our Easter celebration and egg hunt with our daughter the day prior. Celebrating holidays the day before or the day after has been one thing I have had to get accustomed to as an RN.
It was surprisingly not as busy as most days in the emergency room, or so I’m told. My preceptor, who has 10 years working in the ER, mentioned that fewer ER admissions occur on holidays then on other days of the year. Apparently, many people like to wait until the day after a major holiday to have a medical emergency and show up in the ER.
There are a wide variety of patients in the emergency room.
The day started off with a bang. I had my very first trauma patient. The unfortunate victim of a car crash that occurred somewhere along the 405. I was hoping the ER would get me out of my comfort zone, and my first experience absolutely did not disappoint.
I also got my first pediatric patient: a baby who luckily didn’t have anything seriously wrong. Having my own 20 month old daughter, I seriously don’t know how well I’m going to handle pediatric patients that are not so lucky.
My patients ranged in age from 8 weeks to 96 years old. Talk about a diverse patient population!
My IV start skills are constantly being challenged.
I started 3 IV’s during the shift, including a few elderly patients, which I often have a difficult time with. Not too shabby, if I don’t say so myself. I have always been pretty good at IV starts, but I hope to really fine tune my skills within the next few months.
One thing I was super impressed with was that my preceptor does ultra sound guided IV’s on a daily basis. So cool. I didn’t even know that nurses were allowed to do that. There are apparently several nurses who do it in our emergency room and it requires additional classes and a special certification. I don’t know of any other floors in the hospital where that happens.
HIPPA and patient privacy
I have been having an issue with how much I ethically can and should disclose on this blog. As much as I want to break down every little detail of what I see, we have this super important legal policy called the Healthcare Insurance Portability and Accountability Act. Otherwise known as HIPAA, it is basically a fancy way of saying that any healthcare professional will get fired if they disclose anything about a patient’s identity or medical information. Essentially it legally protects patient confidentially, which is a good thing.
On the off chance that anyone actually does read what I am writing I want to be very careful of this. Therefore, I am going to focus my writing on the skills and tasks that I perform and not on any patient information. It seriously limits what I can talk about, so I am mentioning that upfront.
Also, my husband is also a legal investigator at the hospital and he frequently reminds me about HIPAA. He even teaches courses about it to staff. It is a complete coincidence that we happen to both work for the same medical center (for the record though, I was there first).
Tomorrow I will get up at 5:15am and head out for day 2 of ER training and a whole new round of learning experiences. At some point I need to get a start on the 50 hours on online ER training courses I need to complete. My brain is tired just thinking about it.
Sarah, Mother Nurse Love
by Sarah Jividen | Dec 18, 2017 | ER Nurse, Nurse Career, Nurse Life
Two weeks ago I was writing about how I wanted focus on trying to relax a little more and work a little less.
But life is so unpredictable. Just when you think things are going to be a certain way, a new opportunity spontaneously presents itself.
For the past year my RN title has been Resource Nurse, Float Pool. Essentially this means that I am a resource nurse for short-staffed units and I can float to any Med/Surg or Telemetry unit in the hospital. Soon my skill set is going to get an upgrade.
Soon I will be training to be an Emergency Room Nurse.
Emergency Room nursing is a whole new challenge for me.
I was recently selected to be in a new cross training program in our Emergency Department. Apparently they have some staffing issues and want to make sure they have trained Resource Nurses to help fill in the gaps.
In a few months I will be an Emergency Room Nurse at a Level 1 Trauma Hospital! Yay! Wait, wasn’t I just talking about not working so hard? Yup. Isn’t this program going to be stressful, exhausting and require a lot more work? Yeah, pretty much.
But opportunity is knocking and I’m going to go ahead and open the door. This is the first time this kind of cross training opportunity has ever been available at my hospital and I would be remiss to pass it up. In return, I get to expand my nursing prowess and make myself more marketable in my field.
I’m a nerd. I admit it.
If I’m not constantly learning or doing something new I get board pretty easily.
That partially explains why I left a lucrative career to go back to college for a second bachelors degree in nursing at the age of 32. I talk a little more about that here.
Back in my nursing school days I wanted to go directly to working in the ER or ICU after graduation. I had the desire to challenge myself right off the bat by caring for the most critical and vulnerable patient populations. But first I needed a job.
Nurse Residency programs are the place to be for a new grad.
As graduation approached I was frequently reminded that most new grad RN’s had a slim chance of getting excepted into a nurse graduate residency program. In fact, I knew of many RN grads who had been out of school for over a year and were still waiting to get their first job. This was due to the fact that there was a large surplus of graduate BSN’s coupled with a very limited number of nurse graduate residency programs available. From what I hear from new grads today, the problem still exists.
Patients never forget how their nurses made them feel.
To not have employment after 3 years in nursing school was definitely not OK for a gal graduating with 35k in student loan debt!
Since there are more Telemetry and Med/Surg Floors in most hospitals I thought I would have a better chance of just getting my foot in the door if I started there. So to maximize my chances for employment I asked to interview for ANY Telemetry unit position that was available in the entire hospital.
Fortunately my gamble paid off. Shortly after I applied to the nurse residency program at UCLA I started my nursing career on a Neuroscience and Stroke Telemetry Unit. I stayed on this unit for about 4 years and became certified in the specialty.
I still love Neuroscience and I’m so glad I started my nursing career there. Even though I have moved on to other things, I still feel like it is my home.
I’m back in school again. Sort of.
I’m back in student mode. I’m quickly finding out that becoming an Emergency Room Nurse requires an extraordinary amount of study and training. Just this week I completed Pediatric Advanced Life Support Certification (PALS) and Adult Certified Life Support Certification (ACLS).
Last week I shadowed two RN’s in the Liver Transplant ICU and Pediatric Unit to briefly introduce me to the specialties. This is because in the ER I will be working with Pediatrics as well as doing Trauma and Critical Care. Both are new specialties for me.
Next week I start orientation and will meet the preceptors who will help train me for the next 3 months. Then I start the 50+ hours of additional classroom training. I guess I will be doing a lot of studying after I put my daughter down to bed in the evenings.
Training to be an Emergency Room Nurse in a Level 1 Trauma Center will be very challenging to say the least. But I’m ready for it. It is amazing what opportunities arrive when you are least expecting them.
I’m sure I will have many tales to tell about the madness as an Emergency Room Nurse. Stay tuned!
Sarah, Mother Nurse Love
