Something I wrote that I thought I would share here.
I've been thinking a lot lately about what it is to be an ER nurse.
Some days it is the most rewarding job a person could have. You get to do amazing things, meet some amazing people, and learn something new every day. Last week I learned how easy it is for someone with the knowledge and experience to drive to a hospital in the middle of the night and place a drain into someone's brain. No yelling for this or that, just calm professionalism at its best. Pretty amazing.
Some days its the least rewarding job a person could have. People are rude, expect their medical problems to be treated in 30 minutes (a downfall from television shows about emergency rooms I expect), and act like the minute they walked into the door they lost all ability to do things for themselves and their ability to say "thank you".
You take people food and beverages when they're allowed, explain to them why you can't when the doctor wants to keep them from eating or drinking, and hope that you can find something more than graham crackers and juice for the people who "haven't eaten anything in three days" because they've had a stomach bug with lots of nausea and vomiting. (Then you hope like hell they don't throw it all back up... because you're the one who's going to have to clean it up.)
Some physicians treat you like they need to hold your hand and explain things you understand and others who expect you to understand things you've never seen before. Some who yell, some who are meticulous to the point of ridiculous and some who actually treat you like a professional and trust your instincts when you say 'you need to come into this room right now'.
Compassion is best met in elderly and pediatric patients because they know the value in holding someone's hand or putting your hand on their arm while you simply pay attention. It's lost the most on those who are chronically ill, expect things to be done the way they order them instead of the physician's best judgement, and those who have lost, sold, or otherwise used their prescriptions in ways not prescribed by a physician; but expect to be treated like their illness is an emergency when, in fact, they have had the same complaint for sometimes years with no change.
It's trying to remember to document real-time, even when you feel like you can't take the time to sit down and get it done. You play catch-up from the moment your feet hit the floor to the time when you've at least set eyes on the last patient of your shift.
It's cringing every time the rescue phone rings or they call for a 'resusc room', knowing you have to be ready when they get there regardless of how badly you really would like to use a bathroom or grab a bite of the food that you've already reheated twice and is cold again.
It is also being excited every time the rescue phone rings... not knowing for sure the status of a patient before they come in the doors. Knowing that things you initiate, changes you notice, or questions you pose may save someone's life... literally.
It is teamwork at its best, and worst. You have to rely on others and yourself to do the things that need to get done. Surviving personalities of not only the patients, the doctors, but also the other nurses and techs who can make or break your shift. Having someone who will take your patient to the bathroom or help you calculate a medication dose can make a huge difference. Having someone there to answer the phone that seems to never stop ringing or call for another set of scrubs because you've again made a huge mess on yours and cannot walk into another patient's room until you've changed.
Teamwork at its worst when you don't have the support you need, taking care of others work so the doctor will stop interrupting you asking who has what patient and why a test hasn't been done... when you have no idea, but since you've been interrupted for the second time, you find out or get it done. Cleaning up someone's mess because they're too lazy to find a garbage can, or discharging their patients and cleaning rooms because they don't want another patient regardless of how many are waiting to see a physician.
It is taking responsibility for the life and well-being of a complete stranger and putting their needs ahead of your own. Holding a spouse while they perform CPR on her husband or crying with a family who is saying goodbye to their child. It is heart-wrenching, raw emotion expressed at the worst time of some people's lives and you are the person they have to share their grief.
It is watching a mother blush in embarrassment as you flush the air freshener bead out of her daughter's ear, or the happy delivery of healthy baby who's parents waited just a little bit too long to head to the hospital. It is the embarrassment of listening to someone explain how objects got to places they should have never been introduced and the laughter at the descriptions that radiology can provide for strange objects on xray.
It is sharing stories with coworkers and seeing that although people respond to things in completely different ways, sharing that experience with others forms a bond that you can't get at a desk or in a cubicle.
It is doing things you cannot describe over the dinner table or at any social occasion, smells that stay with you for an entire twelve hour shift, and stains that you'd rather not remember on your uniforms.
It is taking it all and coming back for more, the good with the bad, the happy, the sad...
Saying hello to a face you recognize on the rescue stretcher, knowing that you really don't want to take care of that person again, but smiling as you walk into the room and discover today's complaint.
Saying hello to a face you've never seen before, smoothing their hair, holding their hand as you know they are dying and their family won't make it. Listening to the surgeon who's graphic description of what they found in the operating room stays with you for the rest of your life when all you really wanted to remember of a patient was his bright blue eyes and grip on your hand as you ran up to the operating room with the stretcher.
Above all, I believe its a true 'calling' and something not everyone can do and continue to do as a lifetime profession. It takes a special person, a particular personality and a great team to be successful. I am thankful every day that I work with such wonderful people, that I can continue to sometimes hate the job I love, and still be ready for the next shift when truly anything can happen.
Well said Jayne. . . You hit the nail on the head in all of it ; ) Jumped into the ER "feet first" for the first time 29 years ago. . . as a nurse extern, my last year in Nursing School. Didn't know much back then, was green as a new blade of grass; now, some might say, somewhat jaded. . . All those skills since learned from those who first had held my hand and guided me. . . I was hooked from day one, then in the many years since; have always gravitated back to the ER. I tried working the ICU, POH/PACU, and Step-Downs; in all those experiences; the ER had always called me back. . . Have always felt most at home/comfortable in that setting. . . I totally relate and could share many stories of my own. You stated things beautifully. . .