ER Nurse

An emergency room is the window and face of the hospital. Most of the patients in particular are admitted on the emergency room. With this demand of efficient nursing care, a registered nurse is warranted to have a good place in the emergency room. The impression of clients in a particular hospital involves the individualized care for patients as well as how they are accommodated in the emergency room.

In order to be assigned in the emergency room, here are the steps of a nurse to take after being licensed to practice:

1. Further education and Training – The registered nurse must be adept in responding to emergency situations. Further education may involve proceeding to master’s degree. This program will prepare nurse to manage and prioritize nursing care in times of crisis. The triage system is always observed when the flock of patients arise. The training that needs to be undergone by a registered nurse will include basic life support and advanced cardiac life support. ECG reading and intubation procedures must be also done.

2. Competency Based Training – A registered nurse must also be responsible in terms of his or her clinical exposure. A thorough clinical exposure may also involve learning to withstand the stressful hours and prioritizing jobs. Managing your time well is very important for emergency room nurses to develop since they are in charge of the events between life and death of patients.

3. Good Communication Skills – This is an indispensable tool for nurses as they are the first people to be encountered by a fatally injured patient as well as its folks. Giving an accommodating attitude will help the people to verbalize the true feelings and complaints of the patients. Trust can be further established if the emergency room nurses show an open mind and attitude to the patients.

Using Hildegard Palau’s Stages of Nurse-Patient Relationship, the emergency room nurse’s activities can be classified as follows:

1. Orientation Phase – This stage the nurse meets the patients on the entrance area. The patient perceives the nurse as a complete stranger. The challenge in this stage is to take the initial data from the patient as well as the vital signs which as initial baseline for the make-up of the patient. Trust must be initially established in this stage.

2. Working Phase – This stage starts when nursing actions as well as dependent roles are done. The physician initially orders first aide measures to which the nurse must be alert to prioritize it during the span of time given. Some of the procedures done can be starting an intravenous line. Nurses in the emergency room are trained to have a license to insert intravenous cannula, administer medications and blood products via the intravenous line. The next procedure can either be working with heart station personnel in acquiring the ECG tracing. Chest x-rays and other diagnostic examinations are also requested. Some of the laboratory samples are also taken in the emergency room as to which the nurse is responsible for its freshness and sterility.

During this stage, the nurse must continue of assessing the patient and document it properly. The conditions of the patients being admitted can be unstable. The challenge is here is to get the cooperation of the patient as well as the folks.

Some of the activities may involve sending the patient for immediate ultrasound imaging or CT scan imaging. The emergency room nurse is responsible in taking an informed consent and placing the patient comfortable in the stretcher in order to prevent falls and other injuries.

Aside from that, an emergency room nurse may also be assigned to carry out orders for an immediate surgery. The consent is still an important part of the activities since it is the ethical part of the surgical procedure. After which, scheduling and preparing the patient for the said procedure can supervised by a registered nurse. The delegation to the LPNs is also needed to be established to come up with the time frame being prescribed by the hospital protocol.

3. Termination Phase – When the patient is stabilized and initial orders are done. This is the time for the emergency room nurse to endorse the patient at the assigned wards. Terminating the nurse-patient relationship in a brief time may also pose a new beginning for a patient to trust another care provider. The emergency room nurse must assure the patient that other nurses can provide the nursing care just like the way he or she was treated in the emergency room.

Recent reports about the potential income of a registered nurse in the emergency room can range between $70,000 to $80,000, in order to gain such pay, emergency room nurses are challenged to have the following skills:

  1. Good time management skills
  2. Critical thinking skills
  3. Resourcefulness
  4. Dedication
  5. Therapeutic communication skills


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Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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