Wednesday, June 25, 2008

Choosing the ER: Surviving and Thriving

Braden at 20 out of 10 asked me to write a bit on why I chose ER nursing out of all the kinds of nursing that exist. Actually, it was one of many I tried out, but I have done it the longest. I thought back over 30 years to my exposure to various specialties, and it was like Goldilocks' take on the 3 bears house:

Critical Care? Too long in one room with one patient!

OR? Too cold, and too long in one room with one patient!

Pedi? Did that. School nursing, too. Loved the kids, parents were all nuts!


Med surg? Did that, but not enough action! Gave me good assessment skills though.
OB? Um, not my cup of tea.

I fell in love with the ER the first day. It was different. It was fast. The nurses were assertive, smart, confident. They were taking care of babies, kids, teens, adults and grannies all at the same time. The nurses in the ER seemed to magically juggle 3 bowling balls and a chain saw while starting IV's, giving meds, giving instructions, and actually making people better so they could go home. The docs not only worked with the nurses, they were depending on them; clearly they couldn't do their jobs without them, and there was none of that "handmaiden" crap that was beginning to go out of style in the 70's. Finally I had found a home where collaborative practice existed. Wow

If you asked 20 ER nurses why they do what they do, you would probably get 20 different answers. Variety. Adrenaline. Challenge. The need to know about a lot of different kinds of nursing, and nursing care across the life span. Some would tell you blood and guts, and it may be partially true; the real answer is probably closer to really helping people when their lives are hanging in the balance, to REALLY make a difference.

ER nursing is physical, demanding, often overwhelming, frequently frustrating, sometimes heartbreaking; the patients flow in endlessly, and the floors often can't/won't take the admissions which creates a bottleneck. What keeps an ER nurse going back day after day, year after year? Well, for me the answer is being part of team; knowing that I can always do better; making a point of learning something new everyday; and choosing to make CARE the most important part of Emergency Nursing Care. That's what makes me an ER survivor.