I just celebrated my 2 year RN anniversary! I still feel so little and young in the world of nursing, especially in the realm of emergency nursing. There’s so much to learn, and so much more to know. Every day I walk into the hospital with my Starbuck’s coffee in hand, I put on a mask of confidence, and somedays this mask reflects how I truly feel inside. However, there are many times in which this “confidence mask” is simply that; a mask.
Besides all that I must know in the emergency department, there is continuous hospital wide education, continuous changes in policy, and continuous new nursing guidelines. I feel as though I’d just love to master the basics first. Sometimes I arrive home after a shift, to read and study certain material that has vacated my brain after nursing school was complete. There’s nothing worse, and also more motivating then not knowing what to do in a certain situation. Thank goodness I have loads of help, and senior nurses that guide me through those tough cases. Thanks KQ, Gail, Dawn, Mo, Andrea and Jen!
I LOVE working in the ED, because I’m always learning something new. My knowledge base since transitioning from Med Surg to ED has grown tremendously in 6 months. There are two aspects in which my knowledge base has grown: skills and critical thinking. In the realm of skills, I’m becoming an expert in:
- IV and foley catheter insertion
- Wound care
- EKG interpretation
- Vaginal exams
- Charting EVERY last thing I’ve done
- Defense techniques and verbiage (for the out of control psych and alcoholic patients)
- Administration of Haldol (for the out of control psych and alcoholic patients)
- How to quickly restrain a patient (for the out of control psych and alcoholic patients)
- How to scream for security when feeling threatened (for the out of control psych and alcoholic patients)
- How to bribe a screaming 2 year old with ice cream, in exchange for sticking something up his/her nose
- How to appease the drug addicts
- How to grab report from the incoming paramedics
- How to cry with the family
- How to titrate an IV drip
- How to run a code
- How to draw up meds for rapid intubation
- How to assist the ED physician in procedures such as a chest tube insertion or PICC line placement
- How to properly chart and care for a stroke alert patient, including TPA administration
- How to care for, document and transfer the STEMI alert
- How to administer charcoal through a PEG tube
In the realm of critical thinking I’ve learned:
- How to improve prioritization. Think ABC’s. Which patient comes first?
- How to anticipate what the patient will need. Oh… you have chest pain? Let’s rapidly hear your story (I’ll cut you off if it’s more then 1 minute long) and your medical history, perform a STAT EKG, place a nasal cannula in your nose at 2 L, insert an IV, place you on the monitor, obtain labs, and watch your vitals, all prior to the ED doc or PA stepping into the room.
- How to ask for help! When 3 patients have just been assigned to my rooms, there’s no way to do it alone. This is where I’ve learned to call for help from either the charge nurse or the medics. And, there are times in which neither are available. This happened to me the other day. My first room occupied a lady who felt weak and dizzy. My second room was occupied by a patient in DKA who needed an insulin drip. The hall beds carried two suicide attempts who were now Baker Acted. And, an ambulance wheeled a drug overdose into a third room. Meanwhile, at that very moment, a CCU nurse called to question my charting on a stroke patient that had been transferred to the unit hours prior. The charge nurse was unavailable, the medics were unavailable, and the ED physician was wondering why urine hadn’t been collected on my dizzy lady. To say I was overwhelmed is an understatement. It was then that I had to stop and ask myself who needs me the most?? And the winner of my time is: the patient behind door number three… labeled OD patient..who’s respirations were waining and who’s blood pressure was tanking.
- How to stock every pocket on my scrubs with supplies. Do you realize how much time would be wasted if I had to keep running for saline flushes, needles, alcohol swabs, or scissors? I carry with me a stock of supplies which often times weighs me down, but also saves me time.
I’ve only listed some of the top things I’ve learned in the ED, but there is so much more I’ve learned, and so much more to learn. While this makes me feel small and young in the ED, the challenge is also exhilarating. I love it. I love that I’ve been gifted the opportunity to expand and grow everyday. I love that with each shift I grow stronger and more confident. I feel a sense of anxiety being on the bottom sometimes, but I also feel a sense of “bring it bitch” as well. I know I’m going to rock the ED someday, and when that new (frightened) RN comes in to join our team, I’ll be the senior that helps guide him or her.
Most of all, I’m so very proud to work with a group of people who serves the community and also helps save lives everyday. I’m so proud of my title as R.N. I’m so proud of where I’m going, and what I’ve accomplished in my two years as a nurse.
Happy belated Nurses Week to all the amazing men and women who give of themselves everyday! You are amazing!