Emergency Nursing: Interview with Katie Rose McGauhey, RN, BSN
Where do you work?
I’m employed at the Truxtun Campus of Mercy Hospital in Bakersfield, a 144 acute bed hospital. I work part-time at Mercy because I also teach nursing at the local university. I teach courses in nursing fundamentals and the care of adults, and I really like both jobs.
As a new grad, you worked med-surg then transitioned to the ED. How did that work out?
Ultimately, I’m really glad I worked on the floor first. I’m a little bit meticulous, and being under so much pressure as a new grad the ED would have been too nerve-wracking for me. I honed my assessment skills on the floor where patients are already relatively stable. You actually have time to look up a med before you give it, and that’s very helpful to a new nurse. It depends on the person, but I would generally recommend med-surg first.
What do you love about the ED?
I love the variety and the fast-paced nature of the work because I don’t like to sit still. I worked in restaurants for many years before going to nursing school, and while this may sound strange, the ED has a similar feel to a restaurant. Your patients and their families have different needs just like your different customers in a restaurant have needs, and you learn to triage what’s most important and less important. It’s also about customer service and moving people through quickly and efficiently.
Can you tell us about a challenging situation you have encountered?
The situations that are most stressful are when we don’t have enough staff. You have so many acute patients that prioritization skills become stressed. It’s incredibly busy when many acute patients arrive at the same time.
A patient comes to mind from a time when I had not been in the ED that long. There was a staffing issue that day, so we only had three out of five total nurses for the shift. My patient was going into respiratory distress, her white count was astronomically high, and there was unidentified bleeding and obvious sepsis.
I worked one-on-one with that patient for six hours, administered multiple units of blood and IV antibiotics, and it was one of the first times I had worked with a critically ill patient. The charge nurse supported me in the process, and I’m happy to report that the patient did have a good outcome and was later discharged from the ICU. Even though it was such a challenge, it was very rewarding to see how nursing interventions can profoundly affect a patient’s life.
How is the life and death dynamic of the ED for you?
I’ve had to really shut off being personally invested in outcomes since all you can do is your best and there’s no magic involved. I sometimes have experiences where the patient expires and making the transition from the clinical side to the personal side of speaking with the family can be challenging.
How do you take care of yourself outside of work?
I used to skate in the roller derby, but now I do yoga and meditation. I eat well, garden, and I try to put good whole nutritious foods into my body.
What are your professional goals?
This September, I’m starting a program at Fresno State to get my master’s degree as a nurse educator. I like working at the bedside part-time and teaching part-time. I love the ED and would like to get my trauma nurse certification and stay in the ED for a while. Eventually I also want to do hospice since the opportunity to really provide care for your patients and their families is something that’s missing from the busy ED. I’d also like to teach critical care some day.
What would you recommend to new grads who want to work in the ED?
I recommend time on the floor, and I especially advise finding hospitals that have specialized orientation programs that mentor the new nurse with both didactic and hands-on guidance. At Mercy, I had 18 weeks of new grad orientation, and that was enough to get me started in my new career.
Did You Know? Emergency Nursing
Emergency nursing is a specialty that many nurses find both personally and professionally fulfilling. From urban trauma centers to small rural community hospitals, emergency departments handle a wide range of complaints, injuries and urgent situations, many of which require split-second decision-making by highly-trained personnel.
What Training is Needed?
Many emergency department nurses pursue advanced training and education in order to deliver the most up-to-date evidence-based care. Both seasoned and novice nurses interested in emergency nursing can choose to pursue the certifications that will bring their skills to the next level and demonstrate their keen desire to enter this specialty.
Belonging to the Emergency Nursing Association, seeking certification (see below), reading professional journals, and joining related list-serves can all assist in developing a broad knowledge base particular to emergency nursing.
What Do ED Nurses Do?
Emergency department nurses assess, triage and treat patients who enter the ED by their own volition or through the auspices of emergency medical services. Patients present in varying stages of illness and need, from mundane procedures (such as simple lacerations) to precipitous childbirth and acute trauma. Depending on the level of care provided by a particular emergency department, cases may involve significantly high-level acuity.
Prioritization and keen assessment skills are paramount, as well as the ability to work under pressure and tight time constraints. In many facilities, standing orders allow the ED nurse to initiate basic treatments and interventions independent of a physician. ED nurses collaborate with nursing colleagues and ancillary staff, use critical thinking skills, and assist ED physicians.
Where Do They Practice?
Emergency nurses can practice in many settings, including but not limited to rural, urban and suburban hospital-based emergency departments, educational institutions, urgent care centers, EMS and pre-hospital transport, ambulance services, emergency helicopter services, poison control centers, telephone triage centers, the military, correctional facilities, research institutes, cruise ships, camps, sporting events and community facilities.
Earning Potential and Career Outlook
According to several online resources, the median salary for a registered nurse in an emergency department in the United States is approximately $64,000. There are currently approximately 90,000 emergency department nurses in the U.S.
For nurses already working in emergency medicine, the challenges and rewards of this fast-paced specialty are clear. For nurses or nursing students who are considering emergency nursing, advanced training, additional certifications and skilled mentorship are important in order to gain entry into this exciting area of nursing.
(all available through the ENA)
ACLS: Advanced Cardiac Life Support
TNCC: Trauma Nursing Core Course
ENPC: Emergency Nursing Pediatric Course
CEN: Certified Emergency Nurse
CATN: Course in Advanced Trauma Nursing
PALS: Pediatric Advanced Life Support
The Emergency Nurses Association (www.ena.org)
California Chapter of the Emergency Nurses Association (www.calena.us)
The Society of Trauma Nurses (www.traumanurses.org)
Emergency Nursing World (www.enw.org)
The Journal of Emergency Nursing (www.jenonline.org)
American Academy of Emergency Medicine (www.aaem.org)
This article is from workingnurse.com.