The ED
I haven’t been able to update my little corner on the internet for a bit because of my new clinical rotation in the Emergency Department. But I will have to say, I absolutely love it. The environment is fast paced and can be daunting to some but I love learning and the ED is the perfect place for that. The ED is a revolving door of different conditions which makes the day go by fast and the learning opportunities endless. I get to see a little bit of everything and work with my nurse preceptor to understand how different components of someone’s health relate to their diagnosis in the ED.
My first day in the ED, my preceptor and I started off in the mental health area of the hospital which can take normal medical patients if the emergency department is getting full. This area is separate from the rest of the department because the space offers the ability to have a quite area for those who have come in under mental distress and the atmosphere of the hospital is overwhelming to their senses. A nurse, nursing assistant, and emergency department tech are all stationed in this area. It allows for better monitoring of patients who are in mental distress and the ratio for the nurses is 3:1 which can help deliver more immediate care.
My nurse and I primarily had medical patients for the first 4 hours of our shift before moving to the main room in the ED where we had one medical patient and one trauma room. At the hospital, trauma rooms are similar to normal medical rooms but are equipped with life saving equipment right in the room rather than a crash cart in the hallway. This is because patients coming into the trauma rooms need more specialized care immediately upon entering the ED.
The coolest part of the ED is working with the resident physicians as they try and figure out what is wrong with different patients. I have had my patients be on my unit the whole day and after labs, imaging, and monitoring the patient, their conditions are still head scratchers for the doctors. And this is more common than one would think because humans aren’t a one size fits all. The way one person presents to the ED is not the same way the next person will present so it can take a while to figure out what is wrong. Unfortunately for the patients, it means being in the dark and stuck in the ED for longer than they expected, which can be a harrowing experience.
The hardest part of working in the ED can be the overstimulation with all the noise, bright lights, and constant moving. While I work best under pressure and enjoy staying busy, this clinical rotation is not for everyone. Especially for the first clinical rotation that is one-on-one with a nurse preceptor rather than a group led clinical through the nursing school. The nurse you’re paired with also makes a huge difference. I am lucky that I have been paired with an amazing nurse who loves teaching, pushes me into the action, and is willing to give me all the feedback I want so that I can improve.
The ED has been a huge learning experience and confidence booster for me as I have developed me clinical skills as well as my technical skills. My clinical skills include hanging IV fluids, pushing medications, inserting IV’s and accessing ports (primarily used for patients who require frequent and long term infusions). In terms of my technical skills, I have really focused on being able to write patient notes, perform intake assessments, and both writing and verbalizing end of shift reports to the oncoming nurse. In just 6 shifts in and 3 more to go, I feel my confidence as a baby nurse has really skyrocketed, especially because of the feedback my preceptor gives me. Our hospital has been very full this new year but every day offers something new for me to grow as a nurse.
