Complex Care ER Journal

Michael Bryant

Youngstown State University

 1) Briefly describe the types of patients observed in the ER: During my Emergency

Room experience, I provided patient care to 3 different patients with my assigned RN Lamb. Our

first patient was a middle-aged male who presented to the ED with complaints of chest pain. The

second patient was a 25-year-old female with complains of non-specific abdominal pain who

was 1-month post-cholecystectomy. The third patient was an elderly male with bells-palsy who

fell at home, lacerating his left eyebrow and bleeding.

2) Identify the members of the ER team and their role: The attending physician lead the

healthcare team in the patients overall care. The RN works with the physician to provide the

proper care for the patient. The social workers job is to help families and patients access support

and community recourses. The Nurse Case Manager helps with any concerns a patient or family

might have. There is also a respiratory therapist for patients with a breathing problem.

3) Discuss the activities and importance of the triage area: The Triage system organizes

patients by severity so that all patients can receive the proper amount and type of care. When a

person presents to the ED, they are given a triage level appropriate to their presenting complaint,

level 1 being life threatening all the way to level 5 (non-urgent) Its important for patients to be

triaged appropriately so that patients who are severe and require more medical help can receive

that help in an appropriate time frame.

Triage starts with an initial assessment. If patient is stable, they will be fully assessed. If

not, they will be admitted into a triage room. Triage rooms are reserved for patients in a life-

threatening state and can accommodate anything from child birth to emergency operations. They

are equipped with all medications and supplies necessary for life-preserving actions.
 4) Describe the rational for bed assignments in the ED: The nurses are assigned patients

so that each nurse has a similar workload/priority level. For example, one nurse would not be

assigned to 3 different severe trauma patients while another nurse has 2 patients with migraines.

The triage system is designed to be accounted for when bed assignments are made so that the

nurses have an even workload.

5) Discuss the ER nurse’s role with patients discharged to home: The Rn is responsible to

do any necessary teaching to the patient, including medication administration or general care.

They are also responsible for answering any questions the patient may have, as well as calling

patients back after discharge to follow up on their progress.

6) Discuss the ER nurse’s role with admission to acute care: It is the nurse’s

responsibility to properly triage patients so that they are admitted and cared for in a proper

manner. Its up to the nurse to recognize that a person with multiple stab wounds and signs of

circulatory shock receives prompt intervention over a person with a 3-hour hx of vomiting and

diarrhea.

7) Identify one potential ethical concern related to emergency care: It is common for ER

nurses to recognize some patients as “frequent fliers” and not provide the absolute best care,

especially patients who had a drug overdose(s). Its wrong to assume that the care you provide is

pointless because they will be back here in a week for their 6th overdose this month.

8) My experience overall was good. It was unfortunate that the ER was not busy and I did

not get to observe any trauma alerts. However I did get to start multiple IVs for the first time. My

nurse was very informative and extremely educational. She oriented me to the unit and taught me

a lot about ER nursing. She was an excellent teacher and I’m glad I was assigned to her. That’s
why I would recommend the ER experience for all future nursing students. Even if you miss out

on the big ER events like trauma alerts, you can still get experience with something that you

haven’t in your normal clinical rotation.