Working in the emergency room can be one of the most challenging, most fast-paced, and most rewarding environments in which a nurse can work. And just because right now you may not actually work in the ER, it's a HIGH possibility that you will be floated to there in the very near future. It's because of this reason I've chosen to list my top 5 tips to conquer the ER.
After putting in some serious time in the emergency room over the past 10 years, in some of the busiest emergency rooms and trauma centers in the U.S., I feel like I've picked up a few tips and tricks which have given me a slight edge over newer, less experienced nurses. Because working as an ER nurse is a team sport, it's important that you be able to pull your own weight. As the old saying goes, "Teamwork makes the dream work!"
Although there are quite a number of things you can and should do that can lessen the stress and workload during your time in the ER, there are exactly 5 things I would encourage you to begin doing ASAP. Let's begin.
1. Get the urine FIRST
First things first, friends. 90% of the patients you will care for in the ER will need to submit a urine specimen. It seems like an insignificant piece of the puzzle, but it's really not. The urinalysis can quickly rule out a variety of illnesses while conclusively diagnosing others.
Many nurses I've worked with over the years have chosen not to prioritize this simple task, resulting in many delayed diagnoses and needless time waiting in the ER. Lastly, if YOU make it a priority, you'll stand out among the rest, making a solid impression with the MDs, NPs, PAs and ER ChargeRNs with whom you work. Trust me, they'll notice...and you'll hear about it.
2. Pre-Made IV Starter Kits
This little gem has saved me from a lot of stress over the years. Do you know how long it takes to get all the supplies necessary to place an IV and draw blood? I'll tell you. It can take up to 15 minutes. I've timed it! Here's what happens. The patient comes in. You triage them. Once you've established that they most likely will need an IV, you'll make your way to the supply room and then inevitably get stopped by someone (most likely not your patient) needing you for something. You'll need to take care of that situation or find someone else that can. You'll eventually get to the supply room, get the supplies, go back to the patient's room, open them, connect them, and THEN start the IV.
Alternatively, you can have about 5-10 pre-made IV start kits (with tubes) already bagged and placed in an easily accessible location within your pod. As soon as you determine the patient needs the IV and get confirmation (after working in the ER for awhile, you'll know) you can quickly place the IV. BOOM! 2 minutes. Believe it or not, a 10-12 minute segment of time saved here and there can prevent a lot of stress in the ER. If you work in the ER, you know this to be true.
3. Keep an IV flush or 5 AT ALL TIMES
For those of you who don't know, flushes are extremely important in the ER. I can't tell you how many times I or someone near me, ER Practitioners included, needed a flush and needed it STAT. So what happens? You or someone else has to step away and go find one, right? Well, this could take some time and even raise your stress level just a bit.
Conversely, what if you kept 3-5 flushes on you at all times? I'll tell you. First, and most importantly, you'll be much more prepared throughout your shift. Second, you'll shave a lot of time off your work. You may not think that just carrying a few extra flushes will help with time management, but it does...BIG TIME. Lastly, you'll be a tremendous help to all those others who don't have one in a time one might be needed most.
4. Stock your rooms during down time
Most often, especially if you work nights, you'll come on shift and the room won't be stocked. This happens mostly because, in the ER, things GET REAL from 1pm to 1am. Thus, it's tough to get those rooms stocked before shift change. The very best thing you can do is stock your rooms once things start to slow a bit.
I worked in an extremely busy level II trauma center just a few blocks from the Las Vegas strip for nearly 4 years. Even in that ER things started to die down around the same time each night. While others were sitting down chatting, I was stocking my unoccupied rooms.
This will benefit you in three ways. If and when things start to pick back up, as they usually do before 7am, you won't have to hunt down supplies. Second, when shift change comes up, your rooms are all stocked for the oncoming nurse and you won't have to stay late stocking. Third, your relief will be extremely thankful.
5. Be a team player
I'm going to spend a little time here. Your ER crew is your team. It's been said that a chain is only as strong as it's weakest link. You do NOT want to be that weak link. Your attitude and willingness to help your team can make you or break you. Have I made my point?
I have made some amazing friends just by jumping in and getting my hands dirty right along side my ER co-workers when I noticed they needed it. Not only will this go a long way with your team, but when you need help (and you will) you'll find that you, more often than not, will have willing co-workers along side you ready to lend a helping hand.
This being said, if you have a few spare minutes, ask your co-worker if they need anything. If you see they're tied up with other tasks, get their new patient on the monitor, grab some vitals, or throw an IV in them. It will go a long way.
As I've said, working in the ER can be challenging. Learning how to work more efficiently and effectively will lessen the stress that often accompanies ER work. I promise that if you take my advice and implement these tips, you will find yourself more productive, less stressed out, and might even decide you actually enjoy the working in the ER than you previously thought.
If you're an experienced ER nurse and you're reading this, I bet you have some great strategies you could share as well. I'd love to hear about them! Let me hear from you so I can add you AND them to the list in a follow up blog. By the way, thanks for reading! Please share it with someone that may benefit from reading it.