Things I’ve Learned as an ER Nurse That You Should Know

• A career as an ER nurse is not for the faint of heart. 
  
• Coming into my fifth year as an ER nurse, I have learned many things about myself, my patients, my community, and my coworkers; some good, and some bad. 
• But within those learning moments, I have narrowed down a few that stick with me daily. 

Coming into my fifth year as an ER nurse, I have learned many things about myself, my patients, my community, and my coworkers.  

I have had the opportunity to grow into my profession with an amazing team to cultivate me in a variety of ways: some good, some bad.  

But within those learning moments, I have narrowed down a few that stick with me daily. 

Whether you are looking to begin a career in this field, or are simply showing interest, these are a few of the things I have learned as an ER nurse that I believe you should know!

Never the Same Day Twice. You Will Always Be Learning 

Working in the ER you never encounter the same scenarios twice, at least in the same day. ER nurse, Laura Kinsella, highlights this in her blog with The Daily Nurse, too!  

I recall days where all the abdominal pain patients I took care of had different diagnoses. I can also recall having two very different patients suffering from diabetic complications.  

The Emergency Medical Treatment and Labor Act (EMTALA) requires all patients to be treated and stabilized upon presenting to the ER. In short, we could see anything, at any time.  

Because of this, we have an ever-growing knowledge base that expands each time we encounter the same condition, even if it’s a year later.  

I’ve had my fair share of interesting cases and have even had the chance of taking care of the same patients on very rare occasions.

It Can Be 0 to 100  

Emergencies don’t have a set schedule, and they can occur at any moment.  

The patient who had a simple asthma exacerbation can suddenly develop severe respiratory distress and need intubation. 

The chest pain patient who had a stable EKG an hour ago now reports worsening pain with a change in cardiac rhythm.  

As an ER nurse, the ability to drop everything and pivot is very important, even if it is not your patient.  

Emergencies require multiple sets of hands, eyes, and skill sets to accurately address and treat, so being available, when possible, is a good practice to have; that goes for any specialty!

Preparing for the Worst 

Adding to emergencies, I have found the phrase “expect the worse and hope for the best,” to be something I still use and share with students. 

The reasoning behind this is every patient is assumed to have an emergency until proven otherwise.  

A patient with chest pain is assumed to have a heart attack until an EKG is done. A patient with right sided abdominal pain is assumed to have a ruptured appendix until a CT is done.  

Anticipating the worst is what the ER does.  

Unfortunately, expecting the worst in people is something that can occur too.  

People don’t come to the ER because they are in a good mood. They are often hurting, thinking something is seriously wrong.  

They may have been going about their day and one of their physicians called to tell them they needed to report to the ER for one reason or another. 

People are not happy to be in the ER, so anticipating and understanding their frustration can help ER nurses be ready to put on a smile and do what they can to ease the underlying fear or frustration.

Your Team Will Be Your Ride or Die 

From aggressively manic to severely unstable, there has been no shortage of critical situations in the ER. 

In those situations, I come to rely on several things: my skills, knowledge, and coworkers.  

Since the start of my career, I have observed the way the ER team comes together in high-stress, critical moments to make an impact on the life of an individual they may never have met. We may have less than ideal situations, but I have phenomenal coworkers.  

They have been my support, resource, and extra set of eyes many times.  

The physicians who trust and know you are more likely to call when you say you need them. Ancillary support can make or break a shift—I have had a sitter recognize a patient was deteriorating and spoke up to ask for help while I was with another critical patient.  

Camaraderie is essential in the ER, and I am fortunate to work with amazing people who would drop what they were doing to help. 

The Bottom Line

Overall, it is safe to say that the ER is not for the faint of heart.  

As an ER nurse, we have a unique set of skills and knowledge that continues to grow with an aging population and ever-changing infectious diseases. We stand at the front doors of our hospitals with the ability and willingness to care for those who may have nowhere else to go. 

While every day is something new, we are always ready to face it.

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