Welcome to the Wild West: My First Day as an ER Nurse

Can you imagine waking up, slipping on your scrubs, and plunging straight into the heart-pounding world of emergency nursing? Well, that's exactly what my first day in the unit was like, complete with a cardiac arrest code and post-mortem care. It's a challenging world to step into, but oh, the rewards are incredible. This episode takes you along on my journey into this fast-paced specialty, offering a glimpse into the unique experiences and responsibilities that make emergency nursing so fulfilling.

As we wrap up our first season, I'm filled with gratitude for all of you incredible listeners. Your commitment to becoming future nurses is nothing short of inspiring. Let's take a moment to celebrate our journey so far before we plunge back in for season two in January. And trust me when I say, it's going to be packed with even more insights and experiences from the world of nursing. Can't wait to reconnect with you all then!

Episode Transcript

Speaker 1 (00:00):
Nursing school is a wild ride, but that doesn't mean
you have to run and hide whenthe going gets tough.
Don't leave your stressundiagnosed.
You gotta call the nursingstudent coach.
Real-life tips from aregistered nurse In school and

(00:21):
out.
She's seen the worst.
Now, without further ado, yeah,here is your host.
It's the nursing student coach.

Speaker 2 (00:33):
Hello everybody and welcome to Nursing Student Coach
.
This brings us to episode 27,and if you've listened to any of
the shows so far, you may knowthat 27 is a favorite number of
mine.
It's a lucky number of mine,and so I think it is appropriate

(00:54):
to make episode 27 the finalepisode of season 1 of Nursing
Student Coach.
We will be back in January,coming in strong with season 2.
This is the end of our nursingschool semester, so let's take a

(01:14):
few weeks, let's enjoyourselves, take a breather, and
we will be back in mid-JanuaryWith new episodes with season 2.
So for the final episode, whatI wanted to talk about Is
something I haven't reallytalked about yet, and that is my
job.

(01:35):
I am currently doing a nursingresidency program In an
emergency department.
I graduated nursing school inMay, past my NCLEX in June and I
started my emergency departmentresidency in September and I

(01:56):
chose emergency.
I didn't know that that's whatI wanted to do all along.
My problem in nursing schoolwas that I genuinely really
liked everything and I could notmake up my mind.
I love psych.
I have a passion for psych thatkind of caught me by surprise.
I love mother-baby.

(02:17):
I really wanted to get thefoundation of med-surge.
But every time I thought ofleaning in one direction, I just
thought you know what, maybeI'm closing myself off to other
learning opportunities.
And I saw this posting come upFor emergency department

(02:38):
residency for new grads and Isaid that is it, that is my job,
because I will have theopportunity to learn everything.
And, if I'm being honest, itintimidated me a little bit also
.
I mean, emergency room soundsscary, and that's another reason

(02:58):
why I did it, because I wantedto really do something.
That was such a challenge.
I just want to learn and I wantto absorb as much as I possibly
can, and so I just want to talkabout what my experience has
been like, share a few stories,and then I want to just talk
about what season 2 will be allabout.

(03:19):
So, basically, the emergencydepartment you will see every
age and almost every diagnosis.
I mean just the other day andI'm still precepting I am on an
orientation for nine months,which is really, really great.

(03:41):
If you have an opportunity to doa residency program.
You are very supported by thehospital educators.
You split your time betweenworking on your unit and doing
classes.
Learning all about it'sbasically going back to nursing
school again, except everythingis super, super relevant to your

(04:06):
specialty and you're gettingpaid, of course, which is a nice
bonus.
You're getting paid as an RNfrom day one, but a lot of the
time you're in class or you'rein a simulation lab, you're
doing mock codes, you're doing,you know, simulation similar to
what you would do in nursingschool, except it is extremely

(04:28):
specific to your specificspecialty.
So that's one of the thingsthat I really love about
emergency is that I'll have onepatient in one room who's 95
years old and a two month oldbaby in the next room, and so
you really just have to knoweverything.
So that's why I'm onorientation for so long, because

(04:51):
there's a lot to learn.
You know, I have friends thatare working on other units in
different hospitals and theywere off orientation working on
their own with six patients onby themselves in eight weeks.
So I very, very happy that Ifeel so supported that I'm doing
this nice long residencyprogram.

(05:13):
You know, I think there'ssomething to be said about being
thrown right into it and youwill learn that way as well, but
I definitely feel safer in thisenvironment.
I just wanna talk about my firstday on the unit.
So respecting HIPAA privacy, ofcourse when I first stepped on

(05:34):
the unit and I was justshadowing, just observing this
first day, and I literallywalked into cardiac arrest code
and unfortunately this patientdid not survive.
It was a drug overdose anddespite their best efforts this

(05:56):
man did not survive.
So that was literally myintroduction to the emergency
department was literally justwalking into a code where this
patient died and then severalhours later I was part of the
team that did the post-mortemcare.
So that was very humbling aswell.

(06:17):
You know, extubating a patientwho has passed on I had never
experienced that before removingeverything and just seeing
technically all the things thatthey have to do, was extremely
humbling and I considered it aprivilege to be there in those

(06:40):
moments.
And it's the kind of thingwhere it doesn't hit you until
later what you're actually doing.
This man had a family.
He lived a whole life.
We knew really nothing abouthim, but we had the privilege
and the honor to be with him inthose final moments.

(07:01):
So that was one introductionthat I will never forget.
And it kind of hits you on yourway home sometimes the things
that you experience because whenyou're working in the ED you're
just go, go, go, go, go, go go.
You're so busy.
That's one of the things that Ireally love about it.

(07:23):
Another thing that I reallylove about it is that it's so
busy.
It's just it's very, veryfast-paced.
You right now I'm working theday shift as I'm orienting.
I'll eventually go to nights,but you will blink and six hours
have gone by and you haven'teaten and you don't even feel

(07:44):
hungry because you're just go,go, go.
I really love the pace.
That's definitely my speed.
And this is a pro and a con, I'dsay about emergency is that you
are only spending a few hourswith these patients.
So I personally love talking tomy patients, getting to know
them, and one of the things thatI feel is a big honor of

(08:09):
working in this department isthat I get to be one of the
first points of contact whenthey come in in a crisis.
So you don't come to theemergency room because you want
to.
You're not just strolling infor fun.
You're there because you'rehaving a crisis, you're having
an emergency.
It's in the name.
So to be that first point ofcare and to be that comfort for

(08:35):
that patient is a big privilegethat I don't take lightly and
something that I really loveabout my job.
But at the same time they'reonly there for a few hours, so
they're either discharged homeor they're transferred to a
different hospital If it'ssomething that we they need a

(08:59):
higher level of acuity orthey're admitted they're
admitted to one of the floors.
So you really you often don'tget the full story, you don't
get the, you don't get to hearhow it turned out.
So that I do think about eventhough I've only been here a few
months, I already have madeconnections and seen so many

(09:22):
things that I think about thesepeople sometimes and I wonder if
they're OK.
I wonder what happened,especially those patients who
got transferred out.
You just wonder what happenedand you don't get the end of the
story when, when you're in thisunit.
So that's something to consider.
You also really don't get tosee the progress of the patient.

(09:47):
It's just in and out superquick and a lot of people really
love that because, let's say,you have a patient who is more
challenging we'll saypersonality wise, they're gone
in a few hours.
But it's hard to you know, youform a relationship with each
patient but it's short lived, sothat that can be a challenge.

(10:12):
So I want to wrap with a fewmore stories, a few more quick
stories.
Then I just want to talkquickly about what season two
will be all about, because I'mreally excited about that.
So you know, the day onestarted with this cardiac arrest
patient who didn't survive andI was part of postmortem care,

(10:35):
which is when the patient diesis preparing the body.
And then, to close out, thatday we had this is just kind of
a crazy funny story we had apatient who had dementia and he
was moved to the hallway becausehe just kept getting out of bed

(10:55):
and he was a fall risk and itwas a challenge to constantly
keep an eye on him.
So we ended up he was movedinto the hallway and it was a
whole team of us that would justkeep reminding him to stay in
bed and he was taking off hisclothes.
I mean, this poor man justdidn't know where he was, he was

(11:18):
completely disoriented to youknow person, place, time, all
the things, and eventually hewas just naked and as much as we
tried to get him to cover him,he was just constantly taking
off the blanket, taking off thegown.
So eventually he was just kindof naked and we just let it be,

(11:41):
because he just kept takingeverything off and he didn't
know where he was and wasgetting very agitated.
And he stood up and before weknew it, this man was literally
pooping all over the floor andone person was holding him up
and the other person was tryingto catch the poop like in wipes.

(12:01):
At the same time we had anotherpatient who was brought in by
the police, totally drunk,belligerent, and he had come out
of his room literally at thesame time and started peeing all
over the vital side machines.
So we have one elderly dementiapatient taking a poop on the

(12:25):
floor with all of us surroundinghim so he doesn't slip in it,
and this other patient peeingeverywhere.
So you're trying not to getpeed on, you're trying not to
get pooped on.
And this is literally myintroduction to the emergency
department.
We are all just trying to keepa straight face because it was
funny.
I mean it was a crazy situation, but it was also kind of funny.

(12:50):
I mean how can you not laugh atthis?
Like the charge nurse issitting there, like trying to
put a diaper on this patient whowas pooping all over the floor.
Everybody else was trying toget this drunk guy back into his
room who was peeing everywhereand oh man, it was just such a
wild introduction and somebodyactually called the ED the Wild

(13:13):
West and they said welcome tothe Wild West and the other
residents that are in theprogram with me and I we all
just kind of walked out that dayjust a little bewildered but
ready for it.
You know we said this is nuts,but we're here for it, we're
here to learn and we're just soexcited.
So that was sort of my intro tothe ED.

(13:37):
There's a lot of days that arecrazy like that and there's a
lot of days that are just busy.
There's a lot of days that arescary when your patients are.
They come in either they'rehaving an MI or they're having a
stroke or something like thatand you have to really
prioritize.
Who do I see first?
You know, of course you'regoing to see the more critical

(14:00):
patients first and you can getbehind very quickly and it's a
lot of critical thinking andprioritizing and it's a lot of
just remembering what certainconditions are and what labs
you're going to be running andit is just.
It is such an intensivelearning experience and it is so

(14:24):
exciting and I'm so gratefulfor this opportunity and I
thought it would be quiteappropriate for season two to
share a patient with you eachweek, respecting their privacy,
of course.
I would like to, each week ofseason two, tell you about a

(14:44):
patient and I will give you adiagnosis.
We will break it down what isthe patho behind this diagnosis,
what are the labs we're goingto run and what happened maybe
in this particular case.

(15:05):
And then I will give you atleast one NCLEX style practice
question with each diagnosis.
So that is what I would like todo with season two.
We will be back to kick off thefirst episode in January and
that is going to be on end stageliver failure and ascites.

(15:27):
So I hope that you will tune inthen.
I thank you all so much for allof the warm, positive vibes for
season one.
I am just so, so proud of allof you, all of you future nurses
out there.
You're going to kill it, you'regoing to slay it, and I am so

(15:53):
glad to be here with you everyweek on this podcast.
Thank you for your ratings andyour reviews.
We are now at the end of our27th episode and I thank you so
much for your support.
I love you all and I will seeyou in January for season two.

(16:13):
Bye, bye.