If you’ve ever watched a series like Grey’s Anatomy or ER, you know that hospital scenes are always dramatic on screen. And if they’re in the emergency department—well, they pretty much always are. In real life, though, that’s not quite the case. Sure, there are times where the ER can get hectic. So to get the real truth in honor of Emergency Nurses Week, we decided to go straight to the source.
Sarah Emami, RN, BSN, CEN, CCRN, a staff RN in the ED at Sibley Memorial Hospital admits that she was surprised when she began working as an emergency nurse. “I thought working in the ER would involve a lot more Code Blue situations and ACLS [advanced cardiac life support] protocols. There are a lot of these situations, but mostly you’re preventing people from reaching a critical situation,” says Emami.
Emami, who has worked in the ER for six years, decided to work there because she loves a fast-paced environment as well as having a lot of autonomy as a nurse. Before working in the ER, she worked in the ICU and doing that gave her a lot of critical care experience, albeit at a much slower rate.
Even though she’s worked in the ER for a while now, Emami admits that there are still surprises. “Most people don’t think about the food that they eat: they eat junk food, processed food, and fast food a majority of the time, and they are surprised when they are tired, lethargic, and have GI issues,” she explains. Another surprise is that “people want a fast fix for chronic medical conditions.”
The biggest challenges for Emami about working in the ER are what she calls “boarders.” These are patients who are admitted to the hospital, but have to stay in the ER because there are no available rooms or there’s not enough staffing at the time. Emami also says that managing patient expectations can be tough—like the aforementioned desire for a “quick fix,” and teaching them that the best way to stay healthy is a combination of a good diet, exercise, and stress management.
When she can get through to patients about how to stay healthy, that’s the best. “The biggest rewards are when I can teach a patient something new about their diet, medication, or how to navigate the health care system,” says Emami.
On the one year anniversary of the horrific shooting at Pulse nightclub in Orlando, Florida, Trauma nurse Marisa Kreutzer reflects on her experience providing care for the victims admitted to Orlando Regional Medical Center. A lone gunman killed 49 people and wounded 53 others in an attack inside Pulse, the deadliest mass shooting by a single shooter in United States history. Thirty-five victims were admitted to Orlando Regional Medical Center – all of whom survived.
Nursing runs in Kreutzer’s family and as a big people person with compassion for helping others, she knew that nursing was the right career path for her. Kreutzer never saw herself becoming a trauma nurse, but when she was offered a position in a trauma ICU in South Florida, she immediately fell in love with the fast-paced, adrenaline-filled role and variety of patients that comes with working in trauma.
Kreutzer wasn’t originally scheduled to work the day of the Pulse shooting, but when she woke up and saw it on the news, she did what nurses do – she called her hospital unit. They needed all hands on deck and were thankful she was able to come in and help.
Recalling arriving at the hospital, Kreutzer says the amount of media surrounding the area was overwhelming. She was forced to take a detour around the police presence to get to the hospital and walked into a chaotic unit. However, Kreutzer also felt that the unit had gained some level of control by the time she arrived, and felt that her unit was prepared for the situation.
“In terms of preparation, I felt we were as prepared as we could be,” Kreutzer said. “We do practice mass casualty drills often. So we had the training and had the knowledge, but I had no idea what to expect when I walked in. I felt like we were prepared as much as possible; I just don’t think there’s anything, though, at least from the emotional standpoint that could prepare you for this.”
Dealing with her first patient is still vivid in Kreutzer’s mind. She jumped in to help with a patient coming back from an operating room who already had several nurses and physicians tending to them. However, the patient stands out because it was her first one that day and she became the primary nurse caring for the patient the next day. Her patient had sustained multiple abdominal and multi-organ injuries and was operated on several times in a 24-hour period.
That first day, Kreutzer remained at the hospital until about 7:30 pm. In the chaotic trauma unit, she was able to go into nursing mode and deal with the issue at hand, but once she got into her car to head home for the evening she experienced a flood of emotions that had been held back all day. She also experienced an overwhelming euphoria for the patient victories that the trauma unit had achieved.
Now a year later, Kreutzer reflects on the aftermath of the events of that day and the impact it left on her and her colleagues.
“I did not find it easy to move on,” Kreutzer acknowledged. “Even after the road by the club wasn’t blocked off anymore – like I said, I drive past that to and from work every day that I go in – it took me a long time just to be able to drive past the club without getting tears in my eyes.”
Despite the suffering she witnessed, the experience as a whole has reaffirmed that trauma is the right nursing focus for her. In the midst of tragedy, Kreutzer and her team on the trauma unit found strength and compassion, and came together to help their patients survive and begin the recovery process.
Each year the US Department of Veterans Affairs selects students to participate in its highly competitive Veterans Affairs Learning Opportunity Residency (VALOR) program. Over the summer, two Bachelor of Science in Nursing (BSN) students from Seton Hall University (SHU) were selected to participate in the ten-week program at the VA New Jersey Health Care System East Orange and Lyons campuses.
VALOR is a program designed to provide nursing students with a designated registered nurse preceptor who helps the student develop the competencies necessary for working as an RN caring for our nation’s veterans. The SHU College of Nursing was honored to have two students selected to participate, Kristin Donadio and Daisy Acevedo.
During the program, Donadio and Acevedo rotated through multiple units including intensive care, psychiatry, same day surgery, and long term care. As VALOR students, they also participated in the Nurse Practice Council, weekly educational programs, and delivered capstone presentations to the VA nurses and staff at the end of their ten weeks.
Donadio and Acevedo were thankful for the opportunity to improve their competence and confidence in providing nursing care through VALOR. In only ten weeks, the students developed personally and professionally, resulting in future plans to pursue professional careers in the critical care setting, ideally within the VA Health System. Both students noted that the values at the VA and at SHU are the same – nursing is all about ‘giving back,’ and showing kindness and respect to patients and staff.
The American Association of Critical-Care Nurses (AACN) recently announced the recipients of its annual research grants, and invited clinicians and researchers to submit projects for the next application cycle which has available funding of $160,000. For the 2016 year, AACN awarded three Impact Research Grants of up to $50,000 each and the AACN-Sigma Theta Tau Critical Care Grant of up to $10,000 in funding.
Annual AACN Impact Research Grants go toward supporting clinical inquiry that drives change in high acuity and critical care nursing practice. The grants are designed to ensure a source of clinically relevant research for creating evidence-based resources that influence high acuity and critical care nursing practice. Over the past five years, AACN has invested over $750,000 in nurse-driven research projects designed to improve critical care nursing practice and outcomes for patients and their families. Evidence from AACN-funded projects continues to influence care provided by nurses every day. [et_bloom_inline optin_id=optin_19]
The 2016 Funded Projects and Grant Recipients are:
Postoperative Respiratory Failure – Postoperative respiratory failure is the most common and severe postoperative pulmonary complication and this case-control analysis seeks to identify the impact of nursing care on potentially modifiable risk factors. Lead researcher Jacqueline Stocking, RN, PhD(c), MSN, MBA, NEA-BC, is a critical care nurse pursuing her doctoral degree at the University of California at Davis School of Nursing.
Arrhythmia Monitoring and Alarm Fatigue – Arrhythmia alarms alert nurses to changes in a patient’s heart rhythm, but a high number of alarms contributing to alarm fatigue is a known patient safety issue. Lead researcher Michele Pelter, RN, PhD, assistant professor and director of the ECG Monitoring Research Lab at the University of California at San Francisco will lead a research team in analyzing a large dataset of annotated arrhythmia alarms to assess clinical significance associated with serious outcomes. Results will provide guidance to manufacturers and hospital policy creators.
Moral Distress Consultations – The Moral Distress Consult Service at the University of Virginia (UVA) Health System is one of few programs that are multidisciplinary and institution-wide in scope for moral distress interventions. Lead researcher Elizabeth Epstein, RN, PhD, and Mary Faith Marshall, PhD, BSN, FCCM, will lead a team from the UVA School of Nursing and Center for Biomedical Ethics and Humanities to formally evaluate the consult service and its effects on moral distress and other elements of a healthy work environment.
AACN will award up to three $50,000 Impact Research Grants in 2017 and continue to offer their annual AACN-Sigma Theta Tau Critical Care Grant of up to $10,000 in funding. Principal investigators are required to be current AACN members with a master’s degree or completed candidacy requirements for a doctoral degree. Sigma Theta Tau International (STTI) members are also eligible to apply. 2017 funding applications are now open and all research grant applications must be submitted online by October 13. For more information, visit http://www.aacn.org/grants.
