Monday, October 10, 2011

How I Do It

ER nursing is so, so much bullshit. Really. I mean, it's obvious from this blog, but I'd say about the vast majority of the people we see don't need to be there, for various reasons- either they're here for a problem that could be handled by a clinic, or they're looking for drugs, or they have a problem that could have been prevented if they bothered to fill their prescriptions and actually freaking take some responsibility for themselves or their health, or they're just overall not bright and/or educated enough to know that the problem they feel is an emergency is not an emergency at all. I go whole shifts sometimes without seeing anyone in need of help that I can actually provide. A lot of the times I'll go a whole day where everyone I see treats me like total shit.
I have no regrets about my career path, but it's certainly not what I envisioned when I became an ER nurse. I was not prepared for the kind of douchebaggery people dish out in this place. I know I probably sound jaded and hateful sometimes. People ask me pretty regularly why and how I do what I do.
This is how. Night before last, I can truly say I had a role in saving a man's life. A man who wasn't ready to die, who actually had a chance, but who was very much on his way when he came to us. My teammates and I busted our asses for about two hours to save him. I left work an hour late with blood and vomit residue on my scrubs. Exciting, exhausting, stuff, a nice change of pace from the CYA chest pain admissions and nursing home dumps.
Tonight I was back in the midst of my regular routine, when I noticed a familiar face coming around the nurses' station- the wife of my patient from the night before. She walked up and gave me a big hug, and with tears in her eyes, and thanked me and my charge nurse and our doctor for saving her husband's life. She told us he was up in the ICU, doing much better, and that he would probably be released in the next few days. She had so many kind things to say about the care he had received, even in just the short couple of hours he had been with us. She told me she could tell how much I cared, and that she would always remember my face- I couldn't possibly hold back the tears. Even our cocky cowboy doctor was clearly touched.
It's hard to describe the feelings surrounding this, the exhilaration, how important it is. It's not an issue of hearing someone praise you and say nice things about you. It's knowing that you actually changed someone's life, that you were able to help them for the better, and be there for someone who needed for you. It's really not something we get to do a lot here. But when it happens. Wow. It's like being on top of the world. It's something I'll remember forever. Something so wonderful that one million abusive drug seeking trolls can diminish it's joy. It's why I became an ER nurse, and it's how I do what I do.


  1. Nice, I guess it is the moments like this one that can keep you sane during the endless grind of drug seekers with a sense of entitlement.

  2. Those are the greatest moments of ER nursing...when you actually have a real emergency. An even bigger bonus when the family/friend thank you and mean it.

  3. Just curious, what is YOUR definition of an emergency?

  4. I understand that many people come to the ER with bullshit complains.But there are certain situations when serious conditions are not even taken into consideration. My boyfriend went to the ER complaining of back pain and numbness in his thighs. He also complained that his walking was a bit "funny" and that he fell a couple of times, at least that's how he described everything. He was seen by a PA and a resident ( I am not sure about this) and diagnosed with a pinched nerve. Luckily, 2 days after that he had another appointment with his regular doctors. To make things short: that was no pinched nerve but a tumor wrapped around his spinal chord and he had surgery asap. Now how can I make him trust ER people again?

  5. I found your blog while researching ER stuff after my own visit a few months ago. Had a bleeding ulcer and was in shock and passed out while being wheeled in - a nice man saw me struggling to walk in from the parking lot and offered the wheelchair. My husband says that when we got to the check in desk and the guy pushing the wheelchair looked down and saw me unconscious and convulsing, he said some sort of code and a group of people came, quietly and extremely quickly, and took care of me.

    I woke up in a bed in the ER, with eight or ten people around taking my blood, getting the IV started, putting things on my chest, taking my clothes off, etc. And I am so very grateful for them. My mother says that she's going to take me back to the hospital and show me all the stuff I didn't see, and I hope to have the opportunity to thank everyone who took care of me.

    Thank you for everything that you do, and for this blog. I've read it all the way back to the beginning, and now I check in for new posts all the time.

    And, as a sort of opposite story from the above comment - the primary care providers I went to for the pain from the ulcer misdiagnosed it as costochondritis, and prescribed a strong NSAID for the pain. That didn't help, really. ;)

    But everyone in the ER, and in the hospital after I was admitted, was competent and skilled and caring.

    You're awesome, and I'm sorry that you have to deal with sucky people. I'm glad that someone like you was there when I needed it, though.


  6. anon- I'd define an emergency as something acute and life or limb threatening- not that there isn't a lot of legit stuff in between that and the b.s. that I enjoy taking care of, it's just not the super exciting stuff I dreamed about when I was a baby nursing student.
    anon 2-I'm sorry to hear about that- it's a situation that sounds CT worthy but without being there, I can't really say. I can't defend something someone else did- all I can say is that some staff are better than others, but ER staff generally want to help, but we're not perfect. This is a classic example of the importance of follow up, I'm glad they caught it.
    @medleymisty- So glad to hear you're doing better, and thanks for your kind words. I encourage you to go back or write a letter- I can guarantee you it will probably make the staff's year. This brought me more joy than I can express.

  7. Or how about being dx in 2011 with 2 murmers (at 22yrs) and sinus tachycardia 115 at rest but in 2007 got yelled at for questioning the er docs dx of "anxiety". I'm still fighting to get doctors (specialists) to stop down playing it because of my age. Sure it's not emergent but when I'm laying down, at 19 and feel my heart falter after hours. What should I have done? Btw, I have familial history of heart problems and was born 2 months to the day premature.

    I now avoid that ER as much as possible.

  8. You rock. Thanks so much for sharing this, and brightening my evening. I really needed a happy story today, even if it wasn't mine!

  9. Great job.
    Moments like these are why most of us went into medicine.

  10. Dude, I don't know how a post about the rare event of being able to help save someone turned into me having to explain the diagnostic choices of ER doctors from before I even became a nurse.

  11. hoodnurse, it's like you said - different providers work differently. As far as diagnosis, the fundamental problem is that physicians (and NPs and PAs) are imperfect on account of being human; diagnoses won't always be perfect, either. *shrug* Some people cruise medical blogs looking for an outlet to complain about past medical care they've received.

    As far as being jaded, I think it's all of nursing. Humanity be crazy, yo! Someday I'll start a blog about life in the NICU; you will not believe some of the stories about our families.

  12. It's just the icing on the cake, isn't it?

    A month or so ago I had a squad run of a 50ish guy having a heart attack. First MI, no previous history besides watching for HTN due to family history. Time from squad paged until he was out of cath lab was under 3 hours. (That includes a helicopter ride from itty-bitty hospital to bigger hospital!)

    One and a half weeks later him and his wife went to each squad member's house with a dozen roses and a box of chocolates to thank us for what we did that night!

  13. Savor that moment, it occurs so rarely. People routinely tell me "thanks" or "can we keep you, you're funny" or similar, but I can't think of a time where someone came back to specifically find me.

    I love the random "my heart is at 115 BPM and I have 'murmers'" sidenote.

    My favorite food is lasagna, but it makes my stomach feel kind of full sometimes...what should I do? Should I eat lasagna? Do I have a digestive disease? Oh, and sometimes my fingers feel tingly, should I go to the ER? Just asking, Hood Nurse.

  14. Well, with thanks to EMTALA, Nurse K, all I can tell you that if you feel that your fullness due to eating lasagna is a medical emergency and it is distressing to you, we would be very happy to see you at Hood Hospital regardless of your ability to pay. Take an ambulance if you don't have a ride! Hoooraaay!!

  15. Love this post!! In my recent ER rotation in grad school I couldn't believe the ridiculous things people bring their kids into the ER for!! And yet, it only takes one patient to wipe that away and change your (or my!) whole perspective! A much different world your ER is than my PICU. But I was so glad to have been a part of it for 6 short weeks! keep up the great stories!