Reply With QuoteGlad to have you Jaunita. 30,000 patients is indeed a busy ED. I'm not sure I could handle that!
Hi! I work in a somewhat busy ED that had 30,000 patients last year. I must say this is the greatest place to work! We have great teamwork and a lot of fun. I am also an instructor for the ED Nurse Residency Program for newbies and a S.A.N.E. But my greatest love is being a mother to my 6 yr old son! This is a great website, keep up the good work, we need a place to vent!
Juanita
Glad to have you Jaunita. 30,000 patients is indeed a busy ED. I'm not sure I could handle that!
I have been an ER nurse for 17 years. I recently left the ER because of on-going problems with the general mood and atmosphere in the ER where I have worked the last 15 years. I now work as a clinical resource nurse. It is a small hospital with a 34 med-surg unit, 6 bed ICU. We don't do trauma..as least not the come in an ambulance type. Losts walks in the door. We don't admit peds either. We stabilize and transfer..same with people who need interventional cardiac treatment. We give clot-busters and ship. In an 8 hour shift I go where I am needed. Give breaks, help out in a code or a crisis, do conscious sedation etc. I spent 5 years in Icu before moving to the ER. I am a ER nurse at heart and will always be. Does anybody else have problems with the whole department being just a real downer?? Granted the ER can be stressful.. We don't see the most intelligent or better sides of our patients.. Most of what comes in is not really an emergency. But if they didn't come see us we wouldn't have a job. And no one else is going to take care of them. So suck it up, deal with it and try and have a good time while doing it. Some of our docs are so burned out...the nurses aren't much better. It's hard to go into a patient room and hear them say "you're the first person whose been nice to me". How do you deal with it?? I finally had to quit the dept before I became conpletely burned out.
Laura
Laura, I understand what you are saying about burn out in the ER. I have been an ER nurse for two years now. It is true the ER see's the worst of the worse for abuses of the system. Lack of insurance, poorly educated, and lack of other resources creates a growing problem for ER's. In our facility we do not have a fast track area. So we can get a large number of clinic cases, drug seekers, and true emergencies. It is frustrating when you are in the midst of trying to keep someone alive and clinic pts are standing in the hall frowning and complaining. Our facility has no control mechanism's (ie key locks)for limiting who walks back into the ER including into other pt rooms. This is very frustrating to managing pt care and privacy.
AS a result of these problmes I think ER nurses do face burnouts at a higher rate than other fields. I often tell myself check your attitude when a clinic pt is reporting in as if they have an emergency. It is difficult to drum up compassion sometimes for the cold sores, flu, ear aches, pimples, back pain X 2 years, I missed work last week I need a work excuse pts. I have no problem producing compassion for the truly sick who belong in the ER. I have to constantly go home and check myself and my attitude so it does not continue spiraling down. I love nursing. I love ER nursing. I just get frustrated with the abuse that is throwing our system into further debt. My fear is that it will lead to crack downs to the ones who need it most.
Sherry
Sherry,
It is difficult. I pride myself on not showing my attitude to the patients. When I started..I knew it was time to move on. The sad thing is that the patients who come in with the little things sometimes have no choice. No office will see them without money or insurance. So they are forced to come to us...the most expensive place to go. It is such a cycle...The ones who manipulate the system are something else. Keep your attitude up and enjoy your job. ER nursing is very special...I think we end up with the broadest base of knowledge...I feel I really got to use my clinical judgement in problem solving, triaging, prioritizing. Cute story...I now work as a resource nurse.. I float the entire hospital in an 8 hour shift. I was doing an admit for the med-surg unit. She was a 94 yr old Nun..came from the office..being admitted for weakness. While undressing her..she had on five layers of garters, slips, dress, mylons etc...I caught just a whiff of that gi bleed smell..Her clothes were clean..her skin and undergarments impeccable...I walked out and asked the MD if she could be a GI bleed. He kind of looked at me and I explained what I smelled. He just shook his head. My shift was over so I left. The next day I found out that he was goodnauturedly making fun of me...made a comment like "hmmm..must have missed that class in med school, gee, smells like a....MI!!! Well, about 20 minutes later her admit blood work came up. Her labs showed an H&H of 6 and 18. They shipped her to the unit and transfused her.. Ha!! Last laugh was on him...Moral is...always trust your instincts and you will never go wrong.
I hope you enjoy your time as an ER nurse...I did
Laura
I'm a 29 year "vet" of the ER.
Traveling and working per diem at my home has kept me from burning out. I was close to total burn out before I decided to travel.
The trend towards putting new Grads in the ER without further education/training is growing. What thoughts does anyone else have?
Traditionally I have been against this concept for ER and CC...however, they are so desparate for help, I guess if the new grad gets enough internship and orientation, it's working....I know 3 new grads who have done this....but after less than 2 years they are all 3 burned out as they work in a trauma unit
I think it depends on the nurse. I have seen some nurses dive right into the ER as a new grad and do great. Most have had hospital experience or field experience either as an EMT or an ER tech. I have seen some just shrivel up and die too..The worst part about being a new grad in the ER is dealing with the ER nurses. Depending on the department and how big or small it is, if the newest nurse isn't keeping up the pace or carrying her load the other nurses will just chew her up and spit her out. You have to have a strong enough personality and enough confidence in your ability to know when to ask for help and be able to handle criticism and direction not handed out in the kindest manner. If you can do that, then you'll make it. I usually encourage most nurses who want to do ER to get a couple of years of ICU under their belt. That way when they do move to the ER they already have the critical thinking skills they need...they just need to learn the things specific to the ER like lacerations and pelvics and other fun stuff. I'm not burned out on the ER, I'm just burned out on the specific nurses at the ER that I used to work in. I still pick up shifts, and I float down there as resource...I will always be an ER nurse at heart..I do hate to see people burn out though...
Laura
Hi Sherry & Jill..
Jill, we all need a change of scenery every now & then. Who knows... perhaps you'll decide to return to the ER someday after you've had enougb time away. If not, then it means you're happier with what you're doing now & that's a good thing too.
I've been an ER nurse since 1988- with breaks to teach, be a DON, and run Medi-Smart.com.. I started out in NICU first, then moved to adult SICU, then to ER.. and I'll always be an ER nurse at heart too.
I've never understood the attitude some ER docs & nurses have towards the patient that presents with minor problems. Some of the folks I've worked with were just plain ugly to those type of patients- or their parents in the case of the 3 a.m kid with the week old earache... Why??
I guess I just think differently. I've worked in some pretty intense situations-- level one trauma center, trauma team leader.. on active duty in Desert Storm- I've worked horrendous cases, ungodly hours, in unbelievable circumstances... and had a wonderful time every second of it. Every now and then a simple earache is a relief! Isn't it sweet to get to see & treat something so easily taken care of once in a while? I looked at it like this as well- that mother didn't really want to be out at 3 am with her kid at the ER.. the fact that they were there told me the kid was so miserably nobody was getting any sleep. If we can fix that isn't that a good thing?
As for frequent flyers.... well.. try not to become so jaded that you believe every person coming in with low back pain wanting something for the pain is a drug seeker. Sometimes they really are in that much pain.
For example: I had a next door neighbor who had broken her back in an on the job injury years ago and had had a fusion. The fusion has snapped and her spine is unalligned and shifts causing her excrutiating pain sometimes. Her orthopedist is 60 miles away and sure isn't around on weekends or late at night so on occassion I've had to take her to the local ER when her spine would shift and she'd be on the floor crying. I've had to convince her to go because she had had such horrible experiences with ER docs and nurses thinking she was just after pain meds in the past.
She has osteoporosis as well and is on Fosomax. Has to have that for a full year to build up bone density before they can try another spinal fusion.
When I got her to the ER the young ER doc on duty started right out with that "attitude" -- the smart ass started treating her as if she was a crock and roughly started doing SLR testing etc.. she was in too much pain to explain her medical history but at least I was there and stopped him & had him get the other hosiptal to fax her records & films.
So.. what good is that attitude towards "pain seekers" -- or towards the simple cases? In my way of thinking- we're there anyway... whether we see multiple trauma patients or we see simple ear aches... why not enjoy the simple when it comes?
Hi! I've been following this forum for some time before deciding to sign up. I work in a fairly busy ED (40,000+ pts per year); I've been there about 8 months, first job as a new RN. (I'm what you'd call a non-traditional student, or maybe it was just mid-life crisis!) I have found that the moral level in my dept. changes depending on who's working that night. Moral is low to begin with, but some staff just seem to bring it down further. Pity.
Murph
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