Sunday, October 6, 2019

Making a Difference as an ED Nurse #IMakeADifference


HAPPY EMERGENCY NURSES WEEK!!!!!

This could be you. This could be any nurse (ED or not) who makes a difference every single day. With humility, I acknowledge the privilege of touching somebody's life. That is why I am proud to be a nurse, more specifically an ED nurse.



As a STAFF NURSE in the Emergency Department, I made a difference when…
- I was the IV nurse to go to for the smallest and most difficult-to-access veins, long before those fancy vein-finder devices ever made it to production
- I volunteered to work another shift of overtime, even after a few hours of sleep from partying with friends
- I could last longer doing CPR than some of my co-workers who huffed and puffed after just three cycles
- I sang and danced to calm down a Down syndrome patient who was having a meltdown in the midst of a noisy ER
- I multi-tasked to cover another nurse who needed a little time to recover from a bad trauma case
- I helped out a tech who was busy elsewhere and did the EKG myself for a patient with an atypical presentation of chest pain (she had an MI)
- I intervened to prevent a fight between two intoxicated patients (I was almost hit by an errant left hook)
- I cross-checked the new nurse’s drug calculations and prevented a medication error.
- I triaged a quiet, stoic elderly man who sat patiently for his turn before a loud, obnoxious female who complained of having an asthma attack (while speaking in full sentences and clutching a bag of chips). He turned out to be in sepsis.
- I held my dying patient's hand so he didn't die alone.

And many more to mention…. I miss those good ole days.


As a NURSE EDUCATOR in the Emergency Department, I made a difference when
- I taught the nurses how to triage, to use across-the-room-assessments, and to trust their instinct, and to not be intimidated when the doctors questioned their judgments.
- I watched like a hawk and did not let the nurses pass competency until they can demonstrate setting up chest tubes and rapid infusers to my satisfaction
- I failed a nurse’s orientation because she did not meet her milestones, but most especially, she had the nastiest attitude toward her patients.
- I patiently counseled an earnest novice nurse who had the potential to become better but just needed a little guidance to boost her self-esteem
- I “saw” the “light bulb” in my students’ eyes when I taught them how to read the EKG
- I gave feedback with respect
- I challenged the nurses' minds so they would not accept things just because they're used to doing them
- I encouraged the nurses' aides and techs to study for their nursing degree
- I engaged my students in my class to participate in robust discussions
- I prepared specialty certification materials for the nurses and pushed them to go for advanced degrees.

I felt validated when I meet former students/nurses who told me that they learned so much from me.


As a NURSE LEADER in the Emergency Department, I am making a difference when…
- I closed the vacancy gaps and improved the unit’s staffing (I must say that this is a work in progress due to increased patient admission boarders)
- I promote nurse engagement, to improve retention and satisfaction; when they feel proud of being part of the work-family
- I collaborate with the interdisciplinary staff to improve unit processes and patient workflow
- I manage my budget but will always choose patient safety over not approving overtime when the ED is in a surge
- I manage up or acknowledge the staff when they are doing great or when they do a Great Catch (catching a near-miss or potential error). I will always find a way to nominate them for a Nurse Excellence Award or for a DAISY.
- I encourage advancement in the nurses’ practice by using evidence-based care
- I practice Just Culture when staff makes unintentional errors and still hold shared accountability when needed
- I listen with an open mind and do not cast judgments until I hear all sides.
- I give honest but constructive feedback but make sure that my expectations are clear and will be followed up
- I am fair, tough but compassionate.
- I care. I only want the best for the unit, for the patients, and for the staff.
- I still intervene during difficult patient interactions.
- I do not condone workplace violence. I am an advocate for patient AND staff safety,
- I sometimes cry with the nurse, when she/he needs a shoulder to cry on.

I am still learning…. My difference may not be as exciting and full of action as when I was on the front line, but I'm hoping that I make a difference to make life easier for those in the trenches of providing care. 

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