October 6th to 12th, 2013 is Emergency Nurses’ Week (also known as ER Nurse week)! During the last five months, I have had many unfortunate introductions to a couple of my local emergency rooms. Emergency nurses? They’re the backbone, and they keep the most chaotic part of the hospital moving, while dealing with an incredibly diverse population of patients and medical conditions within a very high stress environment.
From minor injuries to life-threatening medical crises, emergency nurses are there at the frontlines of the ER [the triage desk], determine how quickly a patient must be seen based on interpretations of his or her heart rate, blood pressure and body temperature, as well as what their presenting concern is. Once a patient crosses into the back of an emergency room, nurses will once again check their vital signs and determine what treatment first-steps might be, and brief the doctor in the ER. The doctor will then provide detailed instructions for patient care—ER nurses may draw blood for diagnostic testing, set up cardiac and respiratory monitors, provide ordered medications that the doctor has charted for that patient, and listen to patients’ subjective experiences of their symptoms and determine what needs intervention, and how quickly. Emergency nurses also will prepare patients for emergency medical procedures and tests—for instance, placement of IV access lines, injections of contrast dyes for diagnostic imaging tests, insertion of urinary catheters prior to surgery, for patients who must remain immobilized or patients with altered consciousness.
Emergency nurses also must be able to act quickly in the event a patient’s condition changes for the worse rapidly—they must possess critical decision making skills and be able to make quick decisions regarding a patient’s care, physical strength to lift or move patients, recall or rapidly determine necessary patient medical information that is pertinent to a potential medical crisis, and be able to administer basic life-saving care practices in an extremely stressful environment.

Like most ER nurses, emergency nurses go into work uncertain of what will be ahead of them that day—but, unlike nurses who work with a standard population set each day [i.e. pre- or post-surgical patients, critical care patients in an intensive care unit, people with cancer], an emergency nurse may provide care to any or all patient subgroups in a single shift!
As a patient with a string of emergency room visits in my recent past, of all the nursing specialties, I think emergency nursing would be among the most interesting and diverse (and of course, if they have the pleasure of treating ME… I must make their shift awesome ;)). If you’ve never been to an emergency room, and I do not by any means provide a “standard” example, you can check out my personal blog for my latest string of ER visits—I mention a handful of experiences with emergency nurses, specifically on Tuesday, that can probably give a decent glimpse of all of the crazy things emergency nurses can do!
So what can you do to help your emergency nurses out in case you are the one to end up in the emergency room?

• Wear a medical identification bracelet or necklace at all times if you have specific medical needs: medical conditions; allergies to foods, medications or latex; or other requests you need known [i.e. do not resuscitate orders, no blood product transfusions, organ donation desires]
• Keep a list of your medications on hand—(free medical ID card download) this can provide vital information in case medications need to be administered in an emergency situation to ensure there are no adverse interactions.
• Provide an “introduction note”. This is a trick I learned from the amazing Breathin’ Stephen that made my life a LOT easier in the past week [see his post here]. The intro note may contain specific guidelines for your care written by your personal doctor, or—as I opted to do—be self-created detailing medications, doses, potentially pertinent medical information and emergency contact information. While I answered a few questions at triage, this note was more coherently able to explain my medical history and expedite my care. I had many ER nurses and a couple doctors comment on how helpful the intro note was.
• Let your caregivers work. If you’re in an emergency room and are waiting… that’s a good thing: it means you aren’t going to die any time soon. Speak up if your condition changes, but otherwise, wait it out. As I read in an article last week “the person you have to worry about is the one who goes straight to the back”. If they’re making you wait—it’s because you CAN wait. Don’t pester them with 800 questions of when you’ll be cared for unless you think something is wrong.
• Use the emergency room for emergencies. In the post from my blog I linked to above, I give the example of when my ER nurses were triaging the triage line—the girl beside me had a “bad cold” as did her mom—I was experiencing severe bleeding and tachycardia [high heart rate]. She, with a shocked look on her face, remained seated—I got pointed immediately to the triage nurse and then rapidly moved into a treatment room. Save yourself some time: use another option if at all possible unless you are experiencing a true medical emergency. If it’s not possible to seek care elsewhere, be prepared to wait (especially here in Canada).
• SAY THANK YOU! I try my best to never let a person taking care of me leave my line of sight without saying “thank you”. Medical professionals do the most important work of anybody—keeping you and those you love alive and healthy—and are often treated extremely poorly and rarely receive thanks. Whether they are offering you a warm blanket (hospital perk!), poking you with a needle repeatedly, giving you medicine or checking your vitals for the 400th time, those two words are important because they are helping YOU. I have honestly said thank you to the ER nurses around after I was pulled off the floor and guided onto a stretcher and taken to resuscitation—if you’re conscious and coherent, please say thank you to your emergency nurse!

WRITTEN BY:  Kerri MacKay  for My Identity Doctor