Emergency Nursing: Teamwork, Laughter and Compassion
For Carol Tulley, RN, BSN, TNS, emergency nursing is all about teamwork.
"The emergency department must run with teamwork, often times in the midst of a chaotic environment," she says. Otherwise, patient care and safety could be compromised.
With nearly two decades of emergency nursing behind her, Tulley knows what she's talking about when she says, "I have the greatest job in the world." Emergency nursing is a nursing profession unlike any other. In addition to being a fantastic team member, it takes a special blend of efficiency, professionalism, and lightning-quick reflexes to handle the role. "A typical day in emergency nursing consists of a little bit of everything," says Tulley. "ER nursing is a fast paced, critical thinking environment where every second counts and can mean the difference between life and death for your patient."
Emergency nurses provide care to people across the entire lifespan. They must be experts in assessment and treatment for a vast scope of healthcare problems, ranging from earaches to heart attacks. At the beginning of a shift, it's impossible to predict how the day will unfold. "It covers the spectrum of holding a child's hand during a difficult procedure, or comforting a family on the death of a loved one," says Tulley. "It is the ability to switch gears at a moment's notice to hold the hand of a badly injured trauma patient, or laugh with your co-worker to relieve stress during a moment between patient care."
Laughter, she says, is the key to relieving on-the-job stress. "We laugh a lot to keep each other upbeat and positive during the most stressful times of the day. We are co-workers, but we are also all friends."
In her just-under two decades of emergency nursing, Tulley has observed changes in the way that nurses fit into the emergency department. She feels that in the modern emergency department, there is more emphasis on nurses as a center focus of patient care, and they are given more independence than ever. "I also feel that nurses have much more ownership of the department and are acknowledged for the role that we play," she says. "The ER is the best place in the hospital to be because of the independence we feel as nurses, but also the teamwork we show as we work together."
As with any job, where you work and who you work with makes a difference. The Emergency Nurses Association conducted a survey in 2006 to evaluate emergency nurses' perceptions of their profession. The survey found that the 2 top reasons for emergency nurse job satisfaction are patient interaction (93 percent) and camaraderie with fellow nurses (88 percent). Hospital administration also plays a large part in job satisfaction.
When it comes to Tulley's job satisfaction, she couldn't be happier. For the last 13 years, she's been on the emergency staff at Central DuPage Hospital (CDH), Winfield, Illinois. "We are fortunate at CDH to have an exceptional group of emergency physicians and nursing management team," she says. "They not only listen to us, but trust in our judgements, and work not only alongside us, but with us to give the best patient care possible." The nursing leadership team at CDH, she says, is behind the nurses 100 percent.
In addition to being members of the ER team, emergency nurses are also part of the entire organizational structure of the hospital. In their communications with other floors, they must ride a fine balance between urgency and diplomacy. "I wish you knew that even though we seem pushy in getting our patients up to you, it's because we have 15 other people in the waiting room that we want to help and are worried about too," says Tulley. "ER nurses are very compassionate and driven people. We may be fast paced and tough on the outside, but we are just as compassionate on the inside."
Sometimes it's a challenge to let that compassion come to the surface without breaking down. Tulley wishes she could explain this to patients. "Even though we may seem stoic while dealing with your dying family member, we leave the room and cry too...we are just too focused while caring for them to let our emotions show."
Despite the challenges of her job as an ER nurse, Tulley says she wouldn't change a thing. Even on the most stressful days, when she walks out of the hospital exhausted, she can't wait to come back and do it all again. And she congratulates new nursing grads who are choosing the emergency room. "Take a deep breath," she says, "you have just started the craziest, most rewarding career ever."
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