The Role of an Emergency Room Nurse
The role of an emergency room nurse can be demanding and may require a nurse to use many different nursing skills at certain times to take care of a variety of patients. The main role is the nurse must be skilled in client assessment, priority setting, critical thinking, multitasking, and communication. The nurse must be knowledgeable and able to make some decisions independently. The nurse also needs to be able to prioritize so the pts who are at highest risk of major injury or complications are treated first. In a busy ER, time management is important too because there may be a lot of pts waiting for care. The nurse must be mentally prepared for rapid change and be able to keep calm in hectic situations. The ER nurse must be able work well in a team and be able to interact with all levels of ER professionals in order to give the pt the best possible care. ER nurses also need to be flexible and adapt quickly to rapidly changing situations. Nurses usually choose to work in the emergency area because they dislike routines and thrive in challenging, stimulating work environments. In one situation I observed, a male came in with chest pain. The nurse went to get him from the waiting area right away and hooked him up with the heart monitor and got him ready for an EKG. The nurse stayed calm, and gathered the information from the pt next. She had her own system for what she normally does depending on the level of the pt’s injury. Another key role is teaching. The ER nurse needs to make sure the pt knows what to do after discharge and/or when they may need to return to the ER for further testing or treatment. There are some similarities and differences in the roles and responsibilities between emergency care nurses and other general staff nurses. The scope of practice for ER nurses includes managing pts across the lifespan; from birth to death. Other general nurses usually pick their area of work, so they mainly work with pts who have certain conditions, mostly all adults, or mostly children. Usually prior to employment in the ER most nurses are required by employers to have 6 months to one year in an acute care medical surgical or critical care unit before working in the ED. This is so they have developed some of the skills and competencies in basic nursing care and organizational skills before entering the ED, while the general nurse can start out on a medical surgical floor with no previous experience (other than school and their license to practice). The ER nurse is also required to have two general types of certification: the Health Care Provider Basic Cardiac Life Support and Advanced Cardiac Life Support. Some facilities even require Pediatric Advanced Life Support and the Certified Emergency Nurse certification. The general nurse does not need to have any special certifications. The ER nurse also has a higher risk for errors and adverse events because of the chaotic nature of emergency management and key health risks are not as evident. For example if a pt comes in unconscious, and the pt’s name, health history, and allergies aren’t known there is a higher potential for error. The general nurse usually has an updated H & P with allergies sent to the floor right along with the pt who is wearing a name band already. Similarly, the ER nurse and the general nurse all need to have competence in basic nursing skills, time management, prioritization, knowledge, and critical thinking. They must both have knowledge to be able to work independently. Depending on the place of employment most facilities require all medical personnel to have an updated CPR card, so ER and general nurses have this in common also. Another similarity is communication. Both nurses still need to be able to communicate well with other medical personnel and pt’s families. In the emergency care area the nursing process is a little different, but parts are still used, although with the...
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