As a nurse, you're on the frontlines of life's drama. Nowhere is this truer than in the E.R. Emergency critical care can be exhilarating--the best E.R. nurses are always on their toes, ready to meet whatever challenge comes their way. It's this fast-paced, challenging environment that led Laura Ralston to become a critical care nurse three years ago.
Laura Ralston began her nursing career in an accelerated nursing program. Having already completed a bachelor's degree in biology, she went on to become a Registered Nurse a year and a half later. The California-based nurse recently explained what it's like to be on the frontlines of medical care.
Describe a typical day in the Emergency Room.
Well, there's no such thing as a typical day--it can be busy, it can be slow. Your patients may be relatively stable or in critical condition. There's really no saying what will come your way.
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How does your day begin?
First, I meet with the outgoing nurse and learn the condition and history of my patients. Why did they come in? What has been done? What still needs to be done? Are there any orders for medication or tests pending?
How many patients are under your charge?
Usually about four. The law requires that you have no more than four patients to look after at a given moment during your shift. Since our E.R. tends to be pretty busy, I can usually expect the maximum.
What does critical care involve?
My job is to stabilize the patient's condition. This might involve putting in a catheter, drawing blood for a test, placing an IV, administering medications.
What about the new arrivals? Is there a different protocol?
In addition to monitoring my assigned patients, whose conditions are relatively stable, I may be called upon to respond to a "Code 3," a patient rushed in by ambulance. These patients need critical care, such as advanced cardiac life support: chest compressions, defibrillations, etc. Or I may put in an IV or draw blood for testing.
Are there any special requirements for working as an ER nurse?
There are a series of certifications required by the state: Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), and Pediatric Advanced Life Saving (PALS).
Also, all nurses have continuing education requirements. The State of California requires thirty hours every two years in order to maintain an active license. There are plenty of opportunities for 'CE' credits at my hospital--special seminars, for example.
Anything you'd like to add?
Working in the E.R. is not for everyone--you have to thrive under pressure and think on your feet. But if you are comfortable in this environment, it's an extremely rewarding career. I feel like the E.R. lets me make the most of my skills. The people I care for are those that need me the most--it's a great feeling to see a patient recover from a crisis.
