Receiving Patients In The Er
When I receive a patient in the ER, assuming the ABCs are intact, I gather their story and discern a chief complaint. After reviewing their history, meds and getting vital signs, I assign the patient a level of urgency. Each ER has a different triage process but generally speaking patients are assigned a number that rates them on a scale between non-urgent to urgent to emergent.
After rating the patients level of urgency I will start my assessment. I always do a primary assessment and a focused assessment. If I am able or have the time, I put in a secondary assessment.
I then try to anticipate any orders the provider may want. For example, someone with a fever will need a CBC, or someone with abdominal pain will need a urine sample. I start IVs, gather labs, place the patient on the cardiac monitor, order some basic medications if indicated among other things. Once the provider has seen the patient, I carry out any further orders.
Once all tests have resulted, the provider will decide to either admit, monitor, or discharge.
What Does An Emergency Nurse Do
ER nurses treat patients who require immediate medical attention, such as those with severe injury, trauma, or acute-onset symptoms. As most patients in the emergency room are experiencing life-threatening situations, an ER nurse must be able to think and act quickly, to identify the patients problem and begin stabilising them.
Emergency Departments Rarely Hire Nurses Straight Out Of School
The reason is that new nurses take six months or more to get oriented and start being productive. Some ED nurses start off in intensive care, telemetry, or mother-baby units to gain experience before applying to work in the emergency department. Another way to get a foot in the door is to start as an ED tech, which offers on-the-job training and can give you the experience you need to help you transition to an ED nurse after graduating. Some nursing students can get their senior practicum in the ED and can train with an ED nurse for a few months before finishing school. Weve taken students for their senior practicum and several of them have been hired in the end, so its a good way to make connections and prove you can do the job.
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Er Charge Nurse Requirments
Charge nurses must be registered nurses as opposed to licensed practical nurses, and need either an associate or bachelor’s degree in nursing. Most hospitals require previous nursing experience and proven leadership ability prior to serving as a charge nurse. Sierra View Medical Center, for example, requires at least one year of acute care experience and RN experience in the ER within the last two years. Emergency department nurses might serve as charge nurses on a rotating basis, or the department might have a permanent charge nurse called a shift supervisor.
Key Responsibilities Of An Er Nurse
ER nurses must be prepared for anything that is thrown their way during a shift. Each shift may go a little differently, but in general, any of the following tasks may be included:
- Triage and stabilize incoming patients
- Perform minor medical procedures, such as setting broken bones
- Clean wounds and apply sutures
- Draw blood, start intravenous lines and administer medications
- Maintain patient records
- Transfer stable patients to hospital beds
Educating patients and family members is another important part of this job. After patients are stabilized, nurses must help them understand their diagnoses and treatments. ER nurses also frequently interact with worried family members. They must display calm and compassion while helping family members understand their loved ones condition and prognosis.
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Nurse Care Coordinator Job Description
A nurse care coordinator is a registered nurse who organizes treatment plans between the patient and medical team. The primary groups of patients they work with have specific diagnoses that require treatment either inside or outside of the hospital. Each department needs a nurse care coordinator as theyre the primary communicator for interdisciplinary teams. Therefore,
Common Employers Of Emergency Room Nurses
While its commonly assumed that emergency room nurses work in the ERs of hospitals, you can often find these professionals in other settings as well. Many work in urgent care clinics, where they treat patients with urgent but not overly serious health issues, such as respiratory infections and sprained ankles. Urgent care nurses tend to have a great deal of autonomy.
Of course, there are differences from one hospital to the next. Common injuries and cases that ER nurses work with vary across regions and urban versus rural locations. Most frequently-seen cases at a hospital are often dependent upon local industries, cultures, landscape, and other factors.
ER nurses also work in schools and universities, on search and rescue crews to stabilize rescued patients, and even as on-site medics on movie sets, in sporting arenas and on cruise ships.
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How Do You Become An Emergency Nurse
The first step is simple: you must become a registered nurse by obtaining either an Associates Degree in Nursing or Bachelor of Science in Nursing . Both roads lead to an RN career, but youll have to decide whether an ADN or a BSN is best for your own career aspirations. Once you have your Nursing degree in hand, youll have to pass the National Council Licensure Examination before working as a registered nurse.
After becoming a fully licensed RN, you can begin working toward a specialty in emergency nursing. Gaining experience in emergency medical situations will be key. Try working as a floating nurse in your hospitals emergency room or assisting teams of paramedics to acquire applicable experience.
After earning a minimum of two years of related emergency experience, you can also apply to earn a certification from the Board of Certification for Emergency Nursing . This credential isnt required to land employment as an emergency nurse, but it could give you an edge on other candidates.
Emergency Room Nurse Job Description
An Emergency Room Nurse is primarily responsible for developing a patient care plan after a quick and thorough evaluation of a patients injuries. Common responsibilities include bone setting, blood transfusions, wound care, medication administration, and much more. Similarly, an Emergency Room Nurse will chart vitals and monitor the patients condition like a typical Registered Nurse .
However, Emergency Room Nurses work in a fast-paced environment that requires quick thinking and decision making. There are no fixed tasks for Emergency Room Nurses since their patients are quickly treated and moved to another ward. Oftentimes, nursing professionals in this field enjoy spontaneity and not having a fixed routine. Though they constantly experience high levels of stress compared to other registered nurse jobs, Emergency Room Nurses receive high satisfaction with their rewarding career.
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Just Being There With A Patient Or Patients Family Can Be Healing
Most people, when they come to the emergency department, are not making a planned visit. Patients and their families are dealing with a lot of anxiety and stress, and we have the opportunity to be there when people are most vulnerable. Just being there, holding their hand, listening that can go a long way.
Most emergency nurses would never want to work in any other specialty once its in their blood. It takes a special person to be an emergency nurse, a person who possesses the ability to rapidly organize thoughts and prioritize tasks, a master multitasker with a bladder of steel, a compassionate person who can hide her emotions well so that patients feel her warmth and empathy no matter what just happened in the other room. If that describes you, youve got what it takes to be an ED nurse!
Workplace Violence In The Ed Is Unfortunately Relatively Common
Theres a lot of what we call violent verbal abuse in the ED. Patients might call you names or take out their frustrations by yelling at you. There is violent physical abuse scratching, spitting, biting, and kicking are unfortunately all too familiar to the ED nurse. A bond is developed with coworkers as it helps to be part of a professional association where you can vent to other nurses at the end of the day, or just talk it out with somebody who understands the environment.
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Er Nurse Salaries By Level Of Experience
Discharging Patients From The Er
Most patients will be discharged after they have been evaluated and all life-threatening causes are either eliminated or taken care of. Stable patients that dont need hospitalization will be discharged with instructions to follow up with either their PCP or a specialist. Patients need to have their vital signs taken within one hour of them leaving the ER and their discharge instructions need to be reviewed.
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Emergency Nurse Skills Knowledge And Qualities
Emergency nurses must be able to sit, stand, walk, reach, squat and lift throughout their eight- or twelve-hour shift. They must have good manual dexterity, hearing and vision. They must understand principles of human development, anatomy, physiology, pharmacology, They must also have a working knowledge of the many legal issues impacting health care such as consent, handling of evidence, mandatory reporting of child and elder abuse, and involuntary psychiatric holds. They must be adept and comfortable working with patients of many different backgrounds, cultures, religions, ages and types of disabilities. They must be calm and professional at all times, especially when dealing with situations which are difficult, emotional or disgusting. Emergency nurses must also know how to care for themselves physically and emotionally.
Required Emergency Nurse Practitioner Certifications/credentials
There are a few ways individuals can become certified as emergency nurse practitioners:
- Nurses who are enrolled in graduate degree programs who have chosen the emergency nurse practitioner specialty track can gain certification through their academic institutions once they successfully graduate.
- The American Nurses Credentialing Center offers an Emergency Nurse Practitioner – Board Certification credential . It is currently available for renewal only.
Other certifications that could prove to be useful for emergency nurse practitioners include:
- Certified Emergency Nurse
- Advanced Cardiac Life Support
- Neonatal Advanced Life Support
- Pediatric Advanced Life Support
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The Ed Nurse Needs To Know How To Treat People Of All Ages And Needs
Emergency nursing is considered a nursing specialty, but were also pediatric nurses, orthopedic nurses, neuroscience nurses, labor and delivery nurses, psychiatric nurses you name it, we do it. Its essential to regularly brush up on medical information and keep current in your continuing education, because you have to be prepared for any kind of patient to walk through the door.
What Is An Emergency Nurse Practitioner
Emergency nurse practitioners are advanced practice nurses who work in emergency medicine. These nurses are trained to treat common urgent medical conditions in patients of all ages in collaboration with the attending physicians, nurses, physician assistants, and specialists in the emergency room . ENPs should have strong backgrounds in critical care, acute care, and chronic conditions – and be able to thrive in a fast-paced environment while delivering effective patient-centered interventions. You can often find ENPs working in urgent care facilities, hospital emergency rooms, or freestanding emergency clinics. Depending on the specific state that an ENP is practicing in, they may or may not require physician oversight.
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Whats The Difference Between An Er Icu And Cc Nurse
Emergency room, intensive care unit and critical care nurses care and treat patients in critical conditions. Their roles, however, are different. An ER nurse prioritizes care and stabilizes a patient and then moves on to the next patient. ICU nurses and CCN plan and provide long-term care to help patients recover from critical illness. CCNs may also provide medical care and treatment to surgery patients as they undergo particularly risky operations.
Clocking In And Starting Your Day With Huddle
In the ER, we have new people coming onto shift every 4 hours. You have many different opportunities for which time youd like your shift to be. You can work 3 twelve hour shifts a week, 2 twelves and 2 eights, 5 eights, and you can come in all around the clock.
Once you have clocked in, you will have huddle where the charge nurse and managers hand out assignments and cover the current state of the department. This typically includes how many patients are suicidal, restrained, critically ill, and what is happening in the resuscitation bays.
Resus Bay: A resuscitation bay, or resus bay, is a special room in the emergency department for the sickest patients and the most time-sensitive interventions. From traumas to medical mysteries, any type of patient can be cared for in the resus bay.
It is important to listen to this information because you may potentially be taking care of one of these patients, but also because those patients require extra hands so be prepared to help out a lot.
This is why, when a patient has a ready bed upstairs on the floor, you need to make haste getting that patient to the floor so we can pull one of those 50 people in the waiting room into a room to be seen by a physician.
You will see anywhere from 10-30 patients in your shift. The ER is fast moving, you will not have a lot of time to get to know your patients well. Movement is vital in the ER, or patients get backed up in the waiting room.
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What Are Some Emergency Nurse Practitioner Duties
Some common duties that emergency nurse practitioners are tasked with are likely to include:
- Observe, assess, diagnose, and reevaluate the medical condition of patients
- Admit patients to the hospital
- Collect comprehensive patient histories
- Family Nurse Practitioner/Emergency Nurse Practitioner
- Acute Care Nurse Practitioner with Emergency Nurse Practitioner subspecialty
- Trauma, Critical Care, and Emergency Nursing: Mixed Clinical Nurse Specialist and Acute Care Nurse Practitioner Program
- Acute Care Nurse Practitioner with Emergency Nurse Practitioner subspecialty
Overseeing Other Er Nurses
An ER charge nurse supervises the rest of the department’s nurses, monitoring them closely to ensure they provide sufficient care to patients. If another ER nurse behaves inappropriately, doesn’t fulfill her duties or provides substandard care, the charge nurse is responsible for reprimanding her and giving her instructions for improvement.
The charge nurse also acts as a teacher to nurses with less experience, giving them advice and acknowledging when they provide superior care. The charge nurse also makes assignments for the ER department’s nursing staff, based on the skills of individual nurses, the number of patients needing treatment and the types of emergencies facing ER staff.
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You Will Become Fanatical About Your Loved Ones’ Safety
Weve seen a lot of things come through the ED doors, and a lot of injuries could have been prevented. For instance, we treat people who were in car crashes but didnt have their seatbelts on, or children who were not in their car seats, or bicyclists and motorcyclists with head trauma who werent wearing helmets. All of those injuries can be prevented. If your mother is a nurse, youve heard her say, This car isnt moving until youre buckled in!
Excitement Stress And Enormous Reward Is A Career As An Er Nurse For You
Are you an aspiring nurse, student nurse, or registered nurse, considering a career in emergency room nursing?
Demand is high for ER nurses, with the Bureau of Labor Statistics projecting a higher-than-average job growth rate of 7% . But is it a good career choice for you?
Heres all you need to know.
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What Do Er Nurses Do
Along with other first responders and emergency medical professionals, ER nurses work quickly to provide the best possible care for patients who might be suffering from life-threatening injuries or illness.
ER nurses work in a variety of settings, from Level 1 trauma centers to rural hospitals or clinics. We treat a variety of injuries, illnesses and complications and work with patients of all ages and backgrounds.
Due to rapid patient turnover, ER nurses also work across several medical disciplines. Throughout my nursing career, I have gained valuable professional experience and knowledge in several different areas of the nursing field, from trauma to pediatrics.
What Are Emergency Room Nurse Salaries
According Payscale.com, an ER Trauma nurse can expect to earn between $20.40-$38.65 per hour, this is an average wage of about $60,000. Salary.com states as of July 2018 the average wage of an Emergency Room nurse is $72,832. Salary range is contingent on education, certification, skills and experience.
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Ed Nurses Remain Calm In Chaos
A recent visitor to our ED shared her experience with me. She was amazed at the composure of the ED nurses and the way they handled the chaos around them. It was a busy time, and she said one patient was constantly complaining about how long the wait was. Every nurse was kind to him anyway. She saw that every nurse was professional and focused. Emergency rooms couldnt exist without the expertise, professionalism, attention to detail, and compassion of the nurses. What the upset patient doesnt know is that its actually better to have a longer wait: that meant he was stable. If were rushing you back, it means youre having a medical crisis!