Sometimes nurses start down one career path and life throws a curveball. One of the many benefits professional nurses have is being able to pivot and change their career focus when needed.

For Joel Myers FNP, CSPI, a career as a poison control nurse happened “completely by accident,” she says. “I injured my knee in nursing school, and I couldn’t do the heavy lifting. I had to steer toward things that didn’t involve heavy lifting because you can’t be in code and have your knee buckle.”

Purely by chance, Myers was at a dinner party and a friend suggested the path of a poison control nurse. She took a chance with no poison control experience but a commitment to a lifelong nursing path. She moved into a grad school track and worked part time at a poison control center in Philadelphia. Working for primary care and family care practices came next, and then Myers switched to poison control full time where she now works the night shift.

Although  Myers has been a poison control nurse for decades, she says the critical thinking and continual learning she does for her work keeps her job fresh. “The amount I have learned on the job is astounding,” she says, “and there are so many things I didn’t learn in school.”

Collaborative Atmosphere

As a poison control nurse, Myers appreciates the close collaboration she has with the rest of her team whether that’s the emergency department physician calling, the physician doing a toxicology fellowship, or pharmacists. “It’s very satisfying and gratifying,” she says. “The toxicology fellows trust us to talk to the public and are responsive to us. The nurses and pharmacists who are on the phone help each other. It’s a nice atmosphere.”

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And the collaboration helps manage patient levels in the ED. Of the 100 or so calls poison control gets in a day, 25 to 30 are coming from staff at healthcare facilities, she says. And she sees the work of poison control as helping keep the other 70 or 80 people from rushing to the hospital and overwhelming ED staff when it’s not necessary.

In many cases, the work is pioneering. Poison control nurses frequently work with unknown incidents. “A lot of what we do is discovered after the process,” she says. For instance, a patient may come in from an overdose, but may have other medical conditions that come into play. Or a call comes in and involve a new drug that there’s little poison control information for. “Data collection is an important aspect of this job,” Myers says, and with centers working through the American Association of Poison Control Centers, like Myers’s center does, the extensive network is extremely helpful.

Building on Layers of Knowledge

Because of the rapid pace of pharmacology advances and development and the seemingly infinite combinations of medical conditions people can present with, Myers makes a point to educate herself on developments in areas that aren’t directly poison control. She constantly learns about primary care, general medicine, and even ICU medicine for non-ICU professionals.

“I need to know what’s going on when we get calls from healthcare facilities,” she says. “If I get a call from a doctor in intensive care and I don’t know anything about that setting, that difficult.” Myers says nurses interested in poison control will benefit from getting some real experience on the floor so they develop an understanding of how units work. That work experience also fine tunes important skills related to history taking and communication with patients—both essential as a poison control nurse.

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Even with the many complicated calls, Myers says some calls to poison control centers are just soothing parents whose child ate dirt, crayons, or bugs, she says with a laugh. “A hundred years ago, people would run next door to ask mom what to do and people don’t have that anymore,” she says.

Before the pandemic hit, many poison control call centers operated from an area within a hospital, although many poison control nurses can work from home. That alleviates any physical demands, especially for nurses who have sustained an injury that prevents them from some of the more physical aspects of nursing work. Myers’s team began working from home a year before the pandemic. As she is based in Lowell, Massachusetts, the frequent snowstorms can cause travel problems for nurses getting to work, so the shift to home eliminated that problem.

And like any other nursing shift, Myers never knows what the hours will bring. “There’s no way to tell what will happen,” she says. “There are certain patterns to things. Medical errors happen first thing in the morning or at night. Kids get into stuff in the late afternoon. Over the holidays, it’s relatives visiting with medication and kids get into a suitcase and getting ahold of pills.” Then there’s the Christmas trees and wrapping paper at Christmas time, glow sticks at Halloween and New Year’s.

Calm Is Key

But whatever the call, Myers has to have the same calm, focused manner people who call poison control depend on. “People are in a panic,” she says. “It’s like calling 911 because something is going on.” She has learned, however, that getting the story is key. “People need to hear something three times before they really hear it,” she says. So when asking what happened, there’s a lot of whittling down information. When a parent calls and is frantic because their toddler downed a bottle of bleach, Myers says it takes many questions to get the actual story—that the child got into the recycling and put an empty bottle to their mouth and possibly ingested a bit of bleach, but not a gallon. “Cutting through that is difficult and takes finessing,” she says. “They can’t show me over the phone, so you have to focus in on what’s important. Those communication skills are more difficult to learn than the pharmacology.”

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The past year has been tough on poison control staff and on the medical staff they work so closely with. “Kids are having a hard time with the pandemic and the number of suicide attempts has skyrocketed,” she says. And that can impact the doctors who call her who may have seen their tenth overdose of the night and are stressed.

Myers acknowledges that burnout as a poison control nurse happens. “Sometimes there’s the feeling like nothing I am doing is helping and that things aren’t getting better,” she says.  But then she hears the gratitude in callers’ voices, gets a genuine thank you from them, and realizes how many people she can direct safely from the emergency departments and she realizes her work makes a big difference.

Julia Quinn-Szcesuil
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