Dear America,
I have gratefully and proudly been an Emergency Department and Trauma Travel Nurse for the past 4 years. I have held your love one’s hands as they have passed. I have laughed with you when you came in for the boo-boos and the “hold my beer and watch this” mess-ups. I have put my blood, sweat, and tears into working as efficiently and effectively as I can to make sure your wait out in the triage room is not as long as it already is. Someone dies, and I do my 30 seconds of silence next to them. Within minutes I am in another patient’s room smiling and holding my composure as if the last few minutes haven’t been difficult.
People don’t come into the ER because they feel great and sunshine is coming out their butts. If you come into the ER, it’s because you ARE in pain and think you are in distress. But emergent distress to us, is a lack of oxygen, lack of circulation, organs injured, or potential loss of life and limb. Doesn’t mean we don’t believe your pain, but pain doesn’t kill you. We know in the ER that your emergency feels more important than the person’s emergency next to you. But what you need to know America, is that in the ER you don’t ever want to be first. First means you have a chance of not walking out of those double doors. First means that your family may not see you again.
I look around and I can see my co-workers running just as fast as I am. All of them with the same intention; continuously asking who needs help or another thing they can do, in order to help see you, America, faster. But I am struggling, America. I am struggling with the pace that I run at, and the difficulty of coming to work and continuing to smile when I walk into your room and you are already mad at me. Your wait was an hour before you got to your room? So you take this aggression out on me as I am diligently collecting your blood and determined to find out why you came in as you expect top-rate smiling customer service. You are hungry. You are thirsty. You now have a CAT scan ordered and are additionally mad at me for telling you not to eat or drink. I continue running room to room, with you still frustrated with me, America. Frustrated that you had to wait on your blood work. Frustrated you had to wait on the CAT scan report. Frustrated you are still hungry. Frustrated the doctor hasn’t been back in. Frustrated you didn’t get a warm blanket immediately after asking the first time. And frustrated that your trip to the Emergency Department hasn’t ran as quickly as a McDonald’s drive-thru.
What you didn’t see during your wait is the ambulances coming in back-to-back. The lady next to your room in respiratory distress requiring a team to stabilize her. The radiologist having 27 reports ahead of yours with a delay if another trauma patient comes in. Even the patients not breathing or heart’s not beating still do not receive full-report scans or blood work faster than yours. They get stabilized and their tests get bumped up the line before everyone. But the results take just as long as your tests.
But our chaos doesn’t stop. Not in the full five hours that you’ve been visiting. Not because it’s 0300, and you thought this would be the best time to get in-and-out. Our staffing is cut in half at night and sometimes to a third. Not because it’s the hospital’s problem of inadequate staffing, but because it shouldn’t be staffing at 100% capacity through the night, health-care workers need rest too.Grandma needs help to the restroom. Little Johnny just had a seizure. Uncle Tom has kidney, liver, and heart failure in addition to his diabetes, COPD, and 10 other diagnosis’. Pregnant Sarah continues to vaginally bleed. And the nurse taking care of all of these people is getting heat from the doctor about the laboratory not running a blood specimen yet. As the nurse sits down to chart Little Johnny’s seizure while calling the lab, a pass-by family member starkly comments, “look, they are just sitting there”. Our jobs dilemmas are not like a computer malfunctioning. In fact, we can still operate really well if our charting systems go down. We train for it. But YOU AS PATIENTS are not computers. You’re humans, and our every quick critically-thinking decision can mean life or death to a person. It’s a heavy weight to carry at times. And sometimes we don’t make a lightning speed plans of care when you don’t present so black-and-white. We don’t give you a medication ‘just because’ or withhold ‘just because’. And for the love of God, I do not know if you will be admitted without your tests back.
We don’t do this job for the praise because we don’t get it. We don’t do this for the insane vacation or money benefits because it’s not insane. If we weren’t passionate about our specific positions then trust me, we would have never made it through school. When you come into our establishment with a lot of non-emergencies while treating us impolitely or ignorantly, it is wearing down our passion to want to help you. It is just as frustrating as your really, really, really, bad days at work. Just because you are in lack of control in the Emergency Department does not mean you can take it out on us that are here trying to HELP YOU. And so I ask you America, if you’re going to visit me and don’t have the best story or YouTube video to back up the cuss words coming out of your mouth from the pain, then you need to be nice.
And so I leave you,
The exhausted Emergency Nurse
Jennifer Grooms, BSN-RN
Emergency Dept / Trauma Adult & Pediatric Travel Nurse
Supplemental Healthcare
This article was republished with permission from SCRUBS Magazine.
“our every quick critically-thinking decision can mean life or death to a person. It’s a heavy weight to carry at times. And sometimes we don’t make a lightning speed plans of care”
…or *maybe* these things do not apply to you since you are a RN, not a physician; it’s difficult to be empathetic right after such obvious hyperbole. While a nurse having to do these things is not unheard of, to say that “decision-making” or “creating plans of care” are a nurse’s job is plainly untrue. You are absolutely invaluable to the structure of American healthcare because you implement plans of care. Please do not detract from powerful accounts of ER nursing like this one in the future with exaggeration.
I retired after 48 years of nursing in critical care, OR, PACU, ambulatory pre op and secondary recovery, cath lab, stroke and cancer research, clinical trials, teaching RN and LPN students, etc. I am just saying, I know ER is demanding. I observe the nurses when I have to come in with a loved one. But if you are burned out, you just need to choose another area of nursing. There are so many places to work as a nurse.
I also believe the pressure is overwhelming on nurses now because, not only do we have to do our jobs well, put up with all the frustrations of labs not coming back in timely fashion, doctors who are demanding, working with too few staff,etc. we also have to worry about patient satisfaction and other surveys. Since they started surveys, we find that the patients that usually send back a survey are unhappy about some aspect of their care. It is very rare for a patient to send in a survey to say that the care was excellent. It is human nature to complain and not compliment.
So, America, please look for the good in the nurses who are trying so hard to take care of you. Find something to compliment them for, instead of complaining. They are doing the best they can.
Should be a handout at the door! Loved it.
I don’t mean to sound heartless , I’ve been a nurse for over 20 years , in various specialties including the ED. The environment of the ED is well known.. patients at their worst and patients that aren’t emergent. Or nice. And not nice is not exclusive to ED. But as crappy as it can be it’s part of the deal. Trying to educate patients about appropriate ED use incl promoting Urgent care clinics has been going on for years. Hospitals have been trying to develop new ways to deal with issues. One of the most innovative I’ve seen though initially it seems counter intuitive, is making an appt, or “signing” in remotely and waiting at home . Which helps annoyance and increased drama, plus brings awareness that maybe it’s not that emergent.
Any nurse has to take the bad days with the good.. and when the bad outweighs the good it’s time to re assess what you’re doing. Venting is one thing, but “schooling” America ( vs educating) isn’t the answer, nor will it change anything. ( educate). You knew what you were getting into.
I am not an er nurse but I know what frustration and thankless work nursing can be. The new insurance regulations and all the cost cutting measures add to it I do not understand why all cuts have to come from nursing. More attention must be given to the nurses’ emotional well being or the whole system is going to fall apart. Wake up hospitals!
I am RN but not an ER nurse but I have always admired them after my rotation in the ER in nursing school. I admired the way they keep their cool and composure in the mist of the chaos and sad circumstances. I appreciate and thank God for all your hard work and the care you all provide.
Ok, really? I have been a nurse for 43 years. 50% in the ER and 50% in acute and non-acute behavioral/mental health. I feel that the article was a “pity party”. Buck up little buckaroo’s. This is life in the ER. Maybe I have 43 years of tough skin. Here’s a slap of reality, it’s not gong to change. The ER is in the human business with all the human frailties. One should have self control plan to maintain your emotional baseline or try, “letting go and let God”. Here’s a mantra I use when I feel myself moving away from my baseline. I repeat to myself 3 times, “Mountain Solid, Water Reflection”. This helps be feel both strong and calm. An ER doc shared this with me. Occasionally, before the trauma arrived, the ER staff would hold hands and softly repeat the mantra.
This article was so artfully written, it says just what all nurse ate saying. We are people too,; we feel pain when those harsh words hit us. We feel frustration when we can’t exceed your expectations, we feel compassion when you lose a loved one. We are human beings and we have feelings too.!!!!!
A kind word or a smile is worth gold to a nurse. None of us work for the money, we do it because we are “called” to be caregivers. Let us take care of you, we really want to help!
Vanessa Richmond, MSN, RN, NE-BC
Well said. 10 years later, after being an Emergency Nurse, I have literally been called every single name, been bitten, punched, kicked, and had every bodily fluid thrown at me. I have worked extra only to ensure we could give one patient a little more care, continuity, or one less nurse short. I have cried in the med room, in the car on the way home, in my bed before having nightmares, or in the shower that morning. I have missed so many firsts for my kids, so many holidays and anniversaries, celebrations, fevers, and illnesses at home.
So why keep going? Why chose to do this? Why after 10 years could I and my teammates possibly want to come back to work? Because holding your hand is THAT important. I want to be there to explain a little more so that you understand and aren’t alone ever. I want to maybe be that one person who makes that one difference and helps to save one life or at least make one difference to you today.
So, if you want to yell, cuss, hit, punch, kick just remember we are all mothers, fathers, daughters, sons, sisters, brothers, aunts, uncles and grandparents. Our families live with those marks. They live with those tears we shed. You may not be that patient I can make an impact on today but your actions can profoundly impact. I will be back tomorrow and the next day…don’t kill the passion.
This really should be posted where everyone, not just nurses, will see it. I felt guilty when I went to the ED when I was having difficulty breathing, knowing how much sicker other people would be and how busy the nurses would be. The general public has no idea.