Essay On Clinical Experience

On October 27h, I had the opportunity to spend my clinical day in the Emergency Room, rather than on the floor on 8 South. I arrived at the site at seven and stayed until noon. I was introduced to the charge nurse Kim. Kim decided to place me with Megan for the day. Megan has worked in the ER for the past two years; however, she has worked at the VHA for the last 12 years. She worked as an LPN prior to becoming an RN. There is a large variety of roles that nurses fill when working in the ER. When I arrived on the unit, there was a whiteboard that assigned each nurse to various positions. The listed assignments are triage, observation, bays, and a heart and chest pain area. Triage is an important role where nurses use assessment skills and

There were not serious admits. According to Megan, the pace of the environment is often unpredictable. It is difficult to predict how many admits to expect and to anticipate the urgency of their needs. The pace for each nurse is also influenced by what role the nurse is fulfilling. Triage, for example, is fast paced with the responsibility of distributing patients, while those in observation have considerably stable patients. Additionally, it is influenced by the level of patient urgency. The VHA does not have a trauma center and generally only receives levels three through five. The ER is usually fast paced and requires collaboration across various disciplines. Megan states that collaboration is especially evident between the ER nurses, physicians, psych, social work, and even police officers. Those in the ER are also responsible for communicating with other hospital units. This becomes imperative with patient transfers to the wards, medical stepdown, or psych. While balancing patient care and this complex communication, nurses are still responsible for using good therapeutic communication. This was evident when Megan listened intently about one patient’s struggles with his housing situation, while providing holistic