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Emergency nursing.

Article in Imprint · February 2004

Source: PubMed

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Anne P Manton
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EMERGENCY
NURSING
By Anne Manton

Emergency nurses are elegant generalists…they must newborn. Nurses working on a psychiatric unit must
know psychiatric assessment and interventions, includ-
know a great deal about virtually all aspects of nursing… ing appropriate medications. In order to work effec-
tively in the emergency department, the nurse needs to

“I s emergency nursing really like the television pro-

gram ‘ER?’” I am frequently asked. My answer is

know all of the above and much more. In a typical day
(if there is such a thing!) the emergency nurse may well
treat patients with everything from severe respiratory
distress, to chest pain, overdose incidences, seizures,
yes and no. Yes, in that it is unpredictable, dramatic, pulmonary edema, and countless other scenarios. A
similar list could be created for the nurse working in
challenging, and requires a team effort. Emergency
the surgical area
of the Emergency
nursing is not like
Department,
television in that
including: fractures,
the numerous life-
lacerations, trau-
threatening and
matic injuries, or
dramatic events por-
ectopic pregnancies.
trayed do not occur
You never know
in rapid succession
what your patient’s
in a neat, one-hour
situation will be,
time frame. In addi-
yet you need to
tion, the role of the
provide the best
emergency nurse in
possible nursing
providing patient
care no matter what.
care is much more
Emergency
significant than is
nursing is, by
evident in the “made
nature, sporadic
for TV” script.
and unpredictable.
As appealing as
Unplanned situa-
emergency nursing
tions and undiag-
is for some of us,
nosed health
it is clearly not for
problems require
everyone. The advantages are many. As an emergency
prompt and accurate assessment and interventions.
nurse, I face a variety of challenges every day, which
Motor vehicle crashes, heart attacks, strokes, falls, and
makes the work exciting. I feel privileged to help
hundreds of other emergency situations can happen to
others during what is often the most difficult time of
anyone. The sporadic nature of emergency care, how-
their lives. Emergency nurses are “elegant generalists”;
ever, contributes to what I believe is one of its greatest
that is, they must know a great deal about virtually all
disadvantages—there is usually no opportunity to
aspects of nursing. For example, nurses who work in
follow the patient’s progress. As one of my colleagues
a coronary care unit (CCU) must have a good knowl-
described it recently, “it’s like reading half a book or
edge base about cardiac disease. Nurses working in a
seeing half a movie.” Emergency patients range in age
maternal-newborn setting must be proficient in labor
from minutes old to over 100 years
and delivery, pregnancy complications, and care of the (continued on p.25)

NSNA/Imprint 23
(continued from p.23)
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4. Critical There are many opportunities for

thinking and nurses with an interest in emergency
sharp decision- care outside the Emergency
making are essen- Department setting, such as flight
tial in emergency nursing and ground transport or
nursing, as in prehospital care. Nurse educator,
other nursing spe- nurse manager, emergency nurse
cialties. The dif- practitioner, psychiatric-mental
ference in emer- health nurse practitioner, and pre-
gency nursing is hospital care coordinator are other
that the patient’s possible choices within the hospital
illness or injury setting. Some hospitals are develop-
state is frequently ing roles for nurses in disaster plan-
old. Socioeconomic status varies undiagnosed. This presents an ning and management, mass casualty
from the richest to the poorest in additional challenge in the care of planning, and bioterrorism. Forensics
society. While most patients are emergency patients. and sexual assault nurse examiners
cooperative and grateful for their (SANE) are other areas of interest,
5. Good communication skills as are injury prevention education
care, it is not unusual to experience are imperative. Emergency patients
angry and even combative behaviors. and community outreach roles.
and their families are often in a As with most specialty areas of
It is important that the emergency crisis situation, and the emergency
nurse be prepared for this vast nursing, there are numerous positions
nurse must have the ability to com- available in emergency departments
variety of scenarios. fort, educate, and listen to patients across the U.S., and predictions are
and families in a caring, nonjudg- that the need is likely to continue
How does one prepare for a mental manner. Other important
career in emergency care? for years to come. As the health care
attributes for success in the emer- system and technology advance,
Consider the following factors: gency nursing role are compassion, there will always be a need for emer-
1. First, know yourself. Can you humor, good organizational skills, gency care and emergency nurses.
think on your feet and prioritize and being a team player. Emergency nurses are heroes and
quickly? Do you have the flexibility Employers often expect emergency heroines who make a positive differ-
to continually restructure your day, nurses to have completed courses ence in peoples’ lives every day!
sometime by the minute? Then such as Advanced Cardiac Life
emergency nursing might be a good Support (ACLS), Trauma Nursing
career choice for you. On the other Core Course (TNCC), Emergency
hand, if you dislike multitasking, are Nurses’ Pediatric Course (ENPC),
resources
uneasy in a high pressure environ- as well as certification in emergency
ment, or if you prefer to focus on a nursing (CEN). In some cases, www.ENA.org
this education should have been web site of the Emergency Nurses
few patients for the entire shift, then
Association
emergency nursing is probably NOT completed prior to working in the
for you. department, while in other cases the www.elsevier.nl/locate/jen
courses can be completed over time. The Journal of Emergency Nursing
2. An emergency nurse must I am frequently asked whether Official publication of the Emergency
have good assessment skills, both in Nurses Association. Published six
new graduates can and should be
obtaining a health history as well as times per year, it includes clinical
hired to work in the Emergency articles, research articles, government
in physical assessment. In addition
Department. As a general rule, I updates, and more.
to recognizing abnormal findings,
advise new graduates to gain experi-
emergency nurses must be able to
ence in the medical/surgical setting
understand the significance of those
first, to give them some solid experi- Anne Manton,
deviations from the norm in order to
ence. However, this is not necessarily PhD, RN, FAAN,
determine urgency levels.
the case for everyone. If the new is an associate
3. Emergency nurses need a graduate has worked previously in professor at Fairfield
strong knowledge base in every area the emergency setting, as an emer- University, Fairfield,
of nursing, from pathophysiology to gency medical technician (EMT), or CT, and past
psychology, pharmacology, policies as a paramedic, they may be better president of the
and procedures, and everything in prepared to jump into emergency Emergency Nurses
Association (ENA) and the Board of
between. But it is also important to nursing sooner. If the employer
Certification in Emergency Nursing.
know your limitations, and how and offers an extensive preceptor experi- She can be contacted at:
when to use resources appropriately. ence for the new graduate, this can amanton@mail. fairfield.edu.
also prove quite successful.

NSNA/Imprint 25
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