Nursing can be stressful, no matter what area of the field you’re working in. But working in the Emergency Room (ER) or Emergency Department (ED) carries with it its own kind of stressors. Silver Powell, RN, at the University of Maryland Medical Center Midtown Campus Emergency Department, took to time answer our questions about what nurses regularly deal with in the ER/ED.

What follows is an edited version of our interview.

As a nurse in the ER/ED, what does your job entail? What do you do on a daily basis?

As an ED nurse, my duties tend to change. The majority of the time I circulate as either the charge nurse or the triage nurse. On a typical day as the charge nurse, the shift starts with taking reports from the night shift nurse on all the patients in the department, including the patients that are roomed as well as in the waiting area, and issuing assignments to the nurses circulating on the unit. From there, both charge nurses count the narcotics in the medication room and reconcile any pending discrepancies.

My next responsibility is to ensure that the nurses circulating have the support and supplies they need to properly care for the patients. This may include delegating tasks to other nurses or techs or being a liaison between the nurses and the physicians on the unit or the nurses on the other units. Responsibilities also include triaging patients that are brought in by ambulances and assigning rooms to all triaged patients. Often, the rooms fill quickly, yet it’s pertinent to initiate a work up on patients that are not roomed to eliminate any delays in process of the patient’s care.

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In the meantime, I am also responsible for ensuring the cleanliness and the safety of the department.

As the triage nurse, my responsibilities start with checking the functionality and presence of the emergency equipment. The next priority is to triage all patients that come through the main ED waiting area. The charge nurse relies heavily on the triage nurse for support; therefore, I am responsible for aiding the charge nurse with all duties whenever possible.

Why did you choose to work in the ER/ED? How long have you worked there? What prepared you to be able to work in such a stressful environment?

While in nursing school, I applied for a student nurse position here in the ED at Midtown and fell in love with the excitement of the department. I immediately connected with the staff and felt honored when I was offered a position right after graduation. I gladly accepted and have been working here at Midtown in the ED for 5 years. Although working in the ED is very stressful at times, my student nurse position prepared me well. I made a strong connection between what I was learning in school in my critical care course and put it into action.

How do you keep yourself from bringing the stress of the job home? What do you do to relieve your stress?

Many times, after having a stressful day, some of the other staff and I get together after the shift and have a debriefing. This allows us to express what we think contributed to the stress of the day and discuss what we could do differently in the future—so we can possibly alleviate having to face some of the same stress repeatedly.

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What are the biggest challenges of your job?

With so much autonomy as an ED nurse, one of the biggest challenges of the job is being able to recognize the priority problem for each patient and being able to meet their needs. With the population that we serve, patients often are experiencing multiple priority problems, which at times can make it difficult to meet all of their needs.

What are the greatest rewards of working in the ER/ED?

The greatest reward of my job is to know that I have helped someone, no matter how large or small their problem may be.

What would you say to someone considering this type of nursing work? What kind of training or background should he or she get?

I would tell anyone that is considering working in an ER/ED that although stressful, it is a very rewarding job. Each day is different, and there are so many things to see and to learn. In my opinion, there is no definitive training that completely prepares one for life in the ED, yet taking as many critical care courses in as many different areas as possible is always a plus.

Working in an ED entails working closely with many people from so many different areas of the health care spectrum; team work is incredibly important. We rely on others from all specialties to aid us in the care of patients to ensure optimal patient outcomes.

Michele Wojciechowski
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