Emergency Nurses Week 2022

In 1990, the first time I stepped into a city hospital Emergency Department (ED) and saw nurses and doctors rushing by what I thought was a frenzied scene, I almost threw up and ran away back to the chronic care facility I came from. The noise from the monitors, the sirens wailing on the ramp, the ringing of the telephones, and the curses from the intoxicated patients.  “This is not my world,” or so I thought.

After one perceptive nurse noticed my pale face, she tapped my shoulder and made me sit by her side at the Ambulance Triage while I waited for the nurse recruiter to return from an urgent phone call. She gave me a glass of water and entertained me with funny stories about the ED. “You haven’t seen anything yet.”, she teased me in her slight Indian accent, “but you will love it here. And you will never leave Emergency Nursing.”

“Sanni” was absolutely right. It is difficult to believe that I survived thirty-two years in emergency nursing. And loved the hurly-burly and exciting life of an ER nurse. And appreciated my colleagues through the years.

Like an arrow to the heart, emergency nursing lodged itself in my heart refusing to let go despite the adversities. I loved the staff and even craved the chaos. I stayed at Elmhurst Hospital for 21 years. Then, I worked in other urban EDs where life was never placid, never dull, and the word “Quiet” jinxes everything. My stay at Maimonides Medical Center and Mount Sinai Morningside provided me with a plentitude of stories and a lifetime of memories that strengthened me more as a nurse and as a person.

Never did it occur to me to leave the scary world of emergency nursing. The nursing, medical and ancillary staff in the ED stood resilient through the vagaries of demands from the patients in agony and despair. It was a world with emotional rewards because we made a difference. My career brought me from the bedside to several leadership positions, and I can honestly say that I enjoyed leaving a legacy of hard work, integrity, and fairness, I try.

Then the Covid-19 pandemic wrought emotional scars that brought me to the crossroads of my career. I almost walked away from nursing. I was emotionally bruised from feeling helpless and staying strong was a challenge. My body was keeping score.

According to the book by Bessel van der Kolk, the effects of trauma affect the emotions, the mind, and the physical body. He described hypervigilance and hyperarousal as causing physical ailments manifesting in the bodies of those who continue to suffer under stress. The constant adrenaline rush was wearing me down. My body was definitely keeping score, and it was giving me dire warnings to slow down, maintain my work-life balance, and do my self-care.

Life presented many trials on top of all the stressors we suffered with Covid. Realizing that I have to love myself first, I gave myself time to heal. My worth as a nurse and as a person is not tied to the insincere approvals from anybody, but to the overwhelming support and love from those who matter: the nurses whom I work with.

In 2021, I published my book “ER Nurse: The Warrior Within,  Bruised but still standing". This year 2022, the Emergency Nurses Association is formally celebrating Emergency Nurses Week on October 9 through October 15. It seems surreal that this year’s theme is “Standing Strong”.

I looked back at the pictures I collected over the thirty-two years and I smile with pride for having worked with my sisters and brothers on the battlefields. There are many psychological land mines in this profession. We have survived the storms and we will continue to weather the unpredictable and unprecedented challenges that come our way.

I cherish the camaraderie with the staff. I remember the fun moments and the simple pleasures that lightened our load. I treasure the hugs after a difficult day. I celebrate the lives we have saved and the thanks from patients and families for whom we made a difference. And most of all, I honor my fellow nurses on the front lines who inspire with their courage and resilience against all odds.

So, let’s continue to take care of ourselves first, find the time to enjoy our co-workers, and rejoice for the grace and blessings of caring for the sick and the injured. To the new nurses, especially those that I have personally taught in a nurse residency course in my new job, please hang in there. I hope that, many years later, you will look at these memories with fondness in your heart and gratitude for having touched countless lives.

Happy Emergency Nurses Week.

 

My Favorite Things in the ER

I said I will only be staying for two years. Either I am a glutton for punishment, or just have an insatiable lust for adrenaline rush, or I really do love the ER. Twenty years later, the ER had taken a stronghold on me and I would never ever think of going anywhere else.


These are my favorite things:

1. EXCITEMENT GALORE- Nothing boring about ER. Every day offers something new and surprising, or out of this world. Days pass quickly, and however we try to manage our time, there's always something that needs to be done (including a bathroom break).



2. QUIET INTERLUDES, although infrequent, and temporary, are greatly appreciated and much-needed after a hectic day. Empty stretchers in the hallway are a welcome sight. This precious respite from the usual bombardment of patients allows time to sneak to the bathroom, catch up on each others' lives, and the chance to spend more time with our patients. Grab the moment to breathe because it means that a busload of patients are coming soon to break the peace.




3. HAPPY DRUNKS make up for the aggravation of having to fight off the nasty drunks. One day, a happy drunk masqueraded like a Luciano Pavarotti. His booming and impassioned O Sole Mio was surprisingly well-modulated and brought a smile to everyone, including our Alzheimer's patient, who stopped squirming in his stretcher. Somehow the familiar melody broke through the cobwebs of his mind, and he joined our happy drunk in total harmony.



4. LIVES SAVED We lose some, but most of the time we snatch patients from the brink of death. A 17-year old patient should have been a vegetable after a cardiac arrest, but we cooled him down and saved his brain. Five days later, he walked out of the hospital with full neurological functioning, ready to plan dates with his girlfriend again.



5. A SOILED METS CAP. A 9-year old boy felled by a direct blow on his chest from a baseball. He recovered from Commotio Cordis and came back to the ED to thank the staff. Pedro was in full Mets uniform, his blood-stained Mets baseball cap clutched in his tiny hands.



6. THANK YOUS.- A hurried discharge from a harried doctor left a patient and her family bewildered and frustrated. I spent just a few minutes to explain the discharge instructions. And I got a hug and a sincere thank you.



7. BULGING VEINS. Nurses always have a euphoric response to bulging veins, the ones which bulge before you even apply a tourniquet. No 22-gauge angiocathethers, no need for a vein probe, no need to call our vein expert. Just that quick pop, a gentle slide into a vein and Yes, you're home.




8. ELDERLY COUPLE HOLDING HANDS. The hopeless romantic in me triumphs at the sight of one elderly couple who held hands as they patiently waited for the ambulette we ordered to return them home. The husband comforted his wife with the sprained ankle. He catered to her unspoken needs. The wife soothed the husband who was getting impatient with the wait. I enjoyed watching them, even as I felt envious for the experience of spending a lifetime with a soulmate.



9. BABIES. Sometimes, babies are too eager to see the world and could not wait for the delivery room on the 5th floor . When the mother announces. "The baby is coming out!", the ED stops in anticipation and waits with bated breath. When the baby wails, the staff breaks into applause and coos as the baby is placed in incubator. Always a happy sight. We've seen enough deaths, so a new life reaffirms our purpose in being.



10. TEAMWORK. When the going gets rough, the ED staff gets going. Way past their scheduled off if the ED gets a call of a mass casualty. We trudged through several feet of snow, dodged drunks along the way, and stumbled through black-out streets. We held hands as we gasped in disbelief and watched helplessly at the horrifying scenes of 9/11 as played on tv. And then together as a team, we prepared the ER for the victims who never came. We hugged each other, and worked side by side to care for the rest of our patients.

Dog in the ER

“Woof!”

I am hallucinating. That couldn’t be a dog who just went through the revolving door of the ER and is now just outside my triage booth. No way!

The Waiting Room in the ER was quiet; at 3am, only the sickest of the sick venture out, and most come via ambulance. Adrienne had finished triage for all her waiting patients, and now the waiting room is like a ghost town with just a few family members staring blankly at the plasma tv screen.

Adrienne prefers being in the middle of the action in the Cardiac and Trauma Room. With nothing to do at External Triage, she was trying to stay awake through the questions for her nursing certification review. The coffee didn’t help; the words swam before her eyes.

“Woof! Woof!” The insistent barks pierced through her consciousness.

I’m not hallucinating. It really is a dog!

“Hi Adrienne! Is that your dog right outside your booth? ” The clerk came back from his break and saw the little Yorkshire terrier.

“Bill, I don’t know whose dog this is. I just saw him go through the door, right at the time when a patient’s family member went through.”

“Really? Are we accepting dogs now in our ER?”

Curious, Adrienne got out of her booth. A dog lover, she felt comfortable enough to approach the strange dog with the puppy eyes. The dog’s blue-black and tan coat was silky and appeared well-groomed; obviously not a stray dog. The dog whimpered as if in pain, and he shifted his weight off his right leg. Adrienne squatted down in front of the terrier who accepted a pat on the head.

Bill’s inquiries with the occupants of the waiting room were met with more blank stares. The dog didn’t belong to them.

Adrienne noticed streaks of blood trailing from the ER entrance to where the dog was sitting. Lifting the dog’s right paw, the triage nurse saw a piece of glass sticking out from the lateral aspect of the terrier’s right paw.

There was no other choice but to bring the dog to Fast Track. The medical resident on duty took one look; not his usual patient but he ushered the dog to a patient bed. Surprisingly, the terrier appeared to accept all their ministrations with just a soft whimper, but did not attempt to bite anybody. Two physician assistants held the dog as the medical resident pulled the offending glass.A quick wound clean-up was followed by a bandage on the dog’s paw.

Maybe as a thank you, the dog licked the hands of everybody in Fast Track. He happily accepted a piece of Adrienne’s hamburger.

Bill later reported that he could not find the dog’s owners either outside the ER ramp and entrance. The administrator volunteered to notify ASPCA, as soon as office hours open in the morning. Several nurses and PAs volunteered to take the dog home while the owner is being located.

The nurses named the dog Andrew in honor of the medical resident who removed the glass on the dog’s paw. Andrew the dog went home with a physician assistant. Sadly for Rochelle’s three young kids, the dog was reunited with the owner three days later.






Based on a true story.