St.

Elizabeth Downtown ER Experience

Jacob Wagner

1.) Briefly describe the type of patients observed in the ER.

Today I saw a multitude of different patients ranging from generalized complaints to cardiac
arrests. Some of the patients presented to the ED with problems that they should have taken to
their primary care provider such as a sore neck. Another patient presented with shortness of
breath, however she had been having this shortness of breath for the past 6 months. However,
other patients I got to witness and be a part of their care was those of trauma (hypertensive
crisis) and cardiac arrests, whom needed rapid utmost critical care.

2.) Identify the members of the ER team and their role.

The members of the ER include the staff nurses, float nurses, triage nurses, LPNs,
doctors/physicians and their residents. The Staff nurses carry out all the orders, treatments and
labs that need carried out. This ranges from vitals, to lab draws, to insertions of IVs and
catheters. The float nurses assist with whatever needs to be helped with as well as covering the
nurses when they take a break. The triage staff screens and interviews each patient to get the
general complaint and background information. The doctors, physicians and their residents all
collaborate to determine the best route of care for each patient. The LPNs assist with whatever
is needed. There are also the charge nurses and techs whom help regulate where the patients
are going and help to streamline the flow of patients and care that is needed.

3.) Discuss the activities and importance of the triage area.

As discussed triage is very important to gather information about each patient and conduct
target assessments to help optimize care. Also through triage each complaint is rated in terms
of its urgency in order to help care for the people whom need it the most first.

4.) Describe the method/rationale for bed assignment in the ER.

Bed assignment is done so that each nurse has a varying type of patient load. The critical and
more demanding patients are equally dispersed to each nurse so that one is not forced to do
the care for 2 or 3 critical care type patients. Beds are assigned for those that need the most
care. Hallway beds are provided to those patients whom are there mostly for observation and
do not require much hands on tending to.

5.) Discuss the ER nurse’s role with patients discharged to home.

The nurses role with discharge of a patient is to provide them with the information and
education needed to help they properly acquire the care they need. Whether it be with a
referral to a doctor, or education on the condition they are presented with or the education of
the self care they need to manage their presenting condition. The nurse is required to also
quickly discharge patients so that the room can be turned over and used again for a new
patient.

6.) Discuss the ER nurse’s role with admission to acute care.

When admitting a patient to acute care an ER nurse must prepare the client adequately. To do
so an IV is inserted as well as foley insertions and connecting the clients to heart monitors. The
nurse must also give report to the floor to which the client is being sent to.

7.) Identify one potential ethical concern related to emergency care

One potential ethical concern that I witnessed first hand was that or when to call off a code. It
is up to the care team to come to a conclusion whether or not a patient will be able to come
out of an arrest type situation and still retain their cognitive function as well as assessing quality
of life once/if they are resuscitated. There is much ethical concern of making the proper
decision when ceasing live saving attempts.

8.) How was your experience overall? Would you recommend this experience for future
students?
Going into this experience I was very interested in the details of emergency care. I know I am
very drawn to critical care. However, after today I am equally drawn to ER nursing. I greatly
enjoy the flow of patients and seeing a multitude of patients. I enjoyed the quick pace which
made the shift fly by. I also really was drawn to the teamwork of the unit as a whole especially
in the case of the cardiac arrests. I got to enhance a great deal of my skills in just 6 hours of
being in the unit and I learned a great deal. I would greatly recommend this experience to
future students.