newbie in the ER

[thomygirl]

Today is the end of my second week of orientation. I am a new grad working in the ER and I only just took my NCLEX on July 1st. Still don't know if I passed or not, but it shut off at 75 if that means anything. I love working in the ER but my fourth day on the job, very first thing in the morning, EMS brought in a five week old infant who was in respiratory arrest and asystole. It was sad. It was probably too late when the mom woke and discovered that the baby wasn't breathing, but we did everything we were supposed to do for about twenty minutes. There just wasn't any hope. That will probably end up being the most difficult and heartbreaking memory of my entire nursing career. It wasn't even that the baby was dead at only 5 weeks old, but the mother's grief and anguish that tore my heart out (I am a mother of four also). Anyway, I came back the next day- so I guess that counts for something. Any tips for a new grad working in the ER??
Thanks!

[1mg.epi]

13 years ago I was a new grad in the ER. I did work there for a few years as an aid, never "worked" code. Any ways, my first code was an infant and I had to use a interaosseous to get an IV. When I think about this, I tear up. You know, I never got over this but I have learned to deal with it. The child did die during the code. This was my first, but not my last.
I also came back the next day.

Two pieces of advice. When you start to say, oh no another patient with a head ache or back ache, that is when you become dangerous. That is when you will miss some thing and some one will die.

Never speak your mind to a patient, you may get days off with out pay. (I did not like the little pay check)

I'm glad you had these feelings..Now I know that sounds trite. But if you weren't upset and sad and angry you wouldn't be human .. Nurses first of all have to be human and care for their patients.. Many nurses think we shouldn't get "to" involved with our patients. That we need to keep a distance and protect ourselves.. I believe you only get something by giving it away.. And many days you are gonna need a shoulder to cry on or support..So give those things freely. You'll never regret it.

Many times a nurse is the only person a patient can trust and lean on.. That is an honor for us.. Take that honor and run with it.. Right back to the ER and do what you do best.


WR,,, three commas for Becca

[doubleA]

I have been doing this for a long time, to this day a pedi code will be given its fullest by all staff. you will never get used to it, you will just deal with it better as time goes by.

Hint hint.. I don't work ER,,


WR,,, three commas for Becca

[cassioo]

I don't work ER either but I also don't just "deal with it" in a peds code or a stillbirth (especially the late 3rd trimester ones).

Why would a nurse worry about giving too much of themselves "away".. Isn't that part of our personal job description...I've never had a problem with being a "fall guy" for a patient.. When one is sick they do/say things they don't really mean. And you have to understand that. You have to realize it's not you it's them..

OMG don't let me get on this bandwagon..


WR,,, three commas for Becca

[cassioo]

I get families everyday that say how do you deal with this? I couldn't do this..they are talking about the getting yelled at by women in labor and cussed etc. I get women that say I can't push and I say ok don't but sure enough when that contraction is big enough they do it anyway. Those kinds of yelling at I can ignore.

[nursie911]

Dear Newbie,
Been there...done that...always breaks my heart. Congrats on going back, that was the hardest part. That babe could have been SIDS, could have been "rolled-over" on by the parent in their sleep, could have been a true resp arrest...only autopsy will tell.
ED nurse for 11 years and the kids ALWAYS tear up the staff. Guarenteed. Try and learn from the code...what could have worked better? Did you have a Broslow tape? Did you have a "PEDS" crash cart? Did you have the right supplies? What could YOU have done better.
The only way for me to get thru the tough codes/patients/families is to debrief, review my own work and learn. Hope your career is rewarding and fulfilling...and remember...the best thing about nursing is that you can always do something else. Tired of ED?...learn forensics...tired of floor nursing?...learn cath lab. Always do what your heart tells you!!
Take care!

[1mg.epi]

A few of the nurses that worked in the ER attempted to get a debriefing team together and could not get support from management. We wanted to get a professional debriefer brought in after critical events. Never happened. Been out of that er for 6 years now and they still do not debrief. This would be so important to decrease turnover and improve continuos improvement program in that unit.