The Joys of ER Nursing


The Joys of ER Nursing

I’ve been a nurse for 10 years now.  Really hard to believe.  In that time I’ve had the opportunity to work on a cardiac and medical surgical floor, home health, ICU, PACU (post anesthesia care unit), surgical recovery, and ER.  The most experience I have is in the ER.  I was able to travel full-time as an ER nurse for several years and visit parts of the country I never would have otherwise.  It has really been good for Dawna and I.

When I started in the ER, the guy that was assigned to teach me how to be an ER nurse sat me down and told me, “If you wanna be a good ER nurse and not lose your sanity, there are 3 things you gotta learn.”

Here they are:

1:  There is NEVER any such thing as a paperwork emergency.  The patient ALWAYS comes first, no matter how far behind you get with the charting, you can always stay after your shift ends and chart if you need to.

2:  You can’t control the chaos.  No matter how hard you may try to control things, we are an EMERGENCY room.  Crazy stuff happens, ALL THE TIME.  The only thing you can do as the nurse is try to direct the flow, and hang on for dear life.  Enjoy the ride!

3:  If you forget everything I EVER teach you, don’t forget this, the most important thing you will ever need to know as an ER nurse………in NO CIRCUMSTANCE, EVER, EVER,EVER…….never.  You CANNOT fix stupid.

These 3 rules have kept me from becoming one of my psychotic patients.

It has been quite the journey becoming proficient in the ER.  I have had the awesome opportunity to really be able to bless and help people begin their healing process after tragedy has occurred.  I have also seen many people that force me to enforce rule #3.

For instance:

While working late one Friday night, I had the patient that comes in and tells me she has a toothache.  I asked her to show me which tooth, so she opens her mouth and shows me her tooth, the only tooth in her mouth.  Yellow, crooked, right in the top front of her mouth.

Just can’t make that up.

While working in Colorado, I asked the standard question to the patient if they smoke marijuana, since it’s legal here.  She says to me, “Well, I’m here visiting from Kansas, and since marijuana is legal here, I did smoke some this morning.”  My response, “well, whiskey is legal everywhere, that doesn’t mean I drink the stuff.”  She laughed her silly head off.

Really?  I don’t think she understood what I was saying.

Had a 20 something-year-old that comes in telling me he can’t breath and he’s going to die.  I asked him to tell me why he is feeling this way.  He says “I don’t know, I just don’t feel like I can’t breath.” He then goes on to tell me he felt like he was starting to choke after eating a sandwich, so he asked his dad to do the Heimlich on him, twice.  For those of you who aren’t medically trained, if someone asks verbally for you to do the Heimlich, DON’T, they aren’t choking.  His dad corroborated the story.  Both father and son could not complete a sentence without the f-word being used in some descriptive way.

Don’t worry, the kid was fine, he didn’t die.  I do suspect he is still using the f-word often though.

Then I’ve had the people who have come in that are just looking for their next high.

They are the ones that come in, while sitting in bed eating a sandwich, tell you they have level 20 pain when you ask what their pain is, from a level 1 to 10.  These are the ones that have allergies to everything but…….”What’s that one med that starts with a D?”  Ummmmm…….Dilaudid?  “YES!!!  That’s the only thing that fixes my scoliosis pain, but my pain management doctor won’t give it to me anymore.”


Then there are the folks that come into the ER, EVERY day, our frequent fliers.  They make up ailments on a daily basis and come in, “Just to get checked out.”  Every time they walk in the door, they say all the right things like, “I have chest pain”, or “I’m vomiting blood.”  All to get a full medical workup just in case they might have something wrong with them, this time.

I asked one of the frequent fliers I knew in California, “You know, you’re a heck of a nice guy, and I really enjoy visiting with you.  Just wondering, why do you come into the ER every day?”  His answer: “You guys are the only people in my world that are nice to me.”

Wow, how deeply sad.

In my job, it is really easy to get burned out.  I give, give, give, all day long to people that seem like they would absolutely suck the life out of me.  MORE MORE MORE!  “Why won’t you FIX me?”

On top of that, the braniacs at Medicare have determined it’s a good idea to have a sliding-scale reimbursement rate to ERs and hospitals based on patient satisfaction scores from a survey they send to the patient after their visit.

Guess what?  People AREN’T happy when they don’t get the narcotics they want.  They aren’t happy when ERs don’t prescribe unnecessary antibiotics, or perform an unnecessary test just because they happened to look up their symptoms on Google.

The reality is this:  In the ER, I’m NOT here to make my patient happy.  I am here to help determine if they are going to die in the next hour.  If they are, I save them (or try to).  If they aren’t, I send them to see what is called a PRIMARY CARE DOCTOR.  He is the doctor they should see if they wake up with a runny nose, not an ER doc.

Don’t take me wrong, I love what I do, I love my patients, and I LOVE being a part of heroically saving lives.  I think it’s the coolest thing ever.

The reality is that ERs are taken advantage of, doctors, nurses, radiology techs, ER techs, respiratory therapists, all come to work day in and day out, only to get dumped on, puked on, spit on, pooped on, and any other kind of “on” imaginable.

But I remain faithful to the call, in spite of all the negatives, not because of the glory, but because I LOVE.  It’s really cool to have someone come in sick and miserable, get treatment and relief, and leave happy with how much better the feel.

I may be the only person that has ever shown my patient kindness and love.  Although it is hard, I do my best to remember that every person that walks into my ER, whether they are having a true emergency or not, has a need, a need for Jesus and the life He freely offers them.

SELF TALK:  “I may be the only Jesus my patient ever sees.”


Earnestly contending for the faith,


ABOUT THE PICTURE:  This is Julie, one of the Radiology Techs I work with, she is awesome.  The big ugly dude on the left is me.  😉