Danielle McMinn

ER experience

Today, I got to experience the ER as an offsite of critical care. The type of patients that I
observed in the ER were an overdose on pills male patient, SOB signs and symptoms of an elder
female, self-harm of a 12-year old female and an active bleeding patient. The first patient and
most interesting patient all morning we saw was the active bleeding patient. He complained of
severe stomach pain and had black loose stools every few minutes. The hgb level was 5.9. At this
point, I got to experience hanging blood for the first time with my nurse- 2 units.
The members of the ER team are about the same as any other floor. There are RNs who
care for patients during an ER visit and who works with the physician to meet the needs of
patients. Also, there are social workers who are available to help patients and their families to
connect one with resources as needed. There are respiratory therapists who work with patients
who have breathing problems to improve breathing. Also, there is a charge nurse who oversees
making the assignment, as well as in charge of every patient that comes into the ER. There is a
case manager who is available to help answer any questions or concerns one may have while in
the ER. There are heart monitor techs who oversee observing all the monitors and heart rhythm
strips. Security guards are there to ensure safety during one’s stay. Being that Mercy is a
teaching hospital, there are also students around who are learning and very helpful with patient
care.
The triage area is very important. Those nurses allow us to indicate the priority of our
patients, which provides a snapshot of the patient's medical condition at the time triage is
performed. An important aspect of the triage is the acuity. This is the classification of the patient
that characterizes the degree to which the patient's condition is life-threatening, and whether
immediate treatment is needed to alleviate symptoms. This goes from 1-5, with 1 being the most
life threatening.
As far as discharging goes in the ER- I personally did not get to experience this. Nurses
are at the frontline of the hospital admission and discharge process. My nurse explained to me
that discharging a patient from ER is the same type of discharge on any other floor. The nurse
needs to do a lot of education to both the patient and the families with them. The same goes for
admission- the triage nurses gather a lot of information generally about why the patient came
into the ER. The RN who does their assessment gathers more information from the patient and
relays this to the doctor.
An ethical concern in emergency care is judging someone. It is very hard to take care of
people who are continually coming into the ER with an overdose, however nurses cannot
develop a bias against that person. The nurse may not do everything she can to save them after a
certain point, and this can be an ethical concern.
My overall experience in the ED was amazing. I loved the fast pace and never sitting
down type of environment. This made the day go by so much faster. The range of patients
arriving for treatment vary widely, from an earache or minor laceration that needs suturing to
cardiac arrest after suffering a heart attack as the result of a car accident. There is no accurate
means to predict the type of case that comes through the doors of the ER at any moment- and this
is what I like most about it.