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May 5, 2015
As an emergency room nurse, you never know what’s coming in that door next. It could be someone with stab wounds, a baby in distress, bus accident victims or an elderly man with pneumonia.
“The best part about being an emergency room nurse is that moment you know you’ve changed someone’s life. Sometimes, it is something small, not what most people think of as life-saving, but it’s lifesaving to that person,” says Barbara Weintraub.
She has been a nurse for 30 years, and now serves as manager of the emergency department at Community First Medical Center in Chicago.
“We take care of patients of every age from the moment of birth to grandmas and grandpas in their 100s,” she says. “There is no type of injury, medical, surgical, obstetrical, psychiatric or pediatric condition that we aren’t equipped to care for.”
Today’s emergency departments care for so much more than emergencies that some people have started calling them Everything Departments, Weintraub says.
“We care for everything. Regardless of what brings a patient to the ED, it’s my job to care for them,” she says.
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When Weintraub was working a few years ago at a Level 1 trauma center in Illinois (those are the places that take the most severely injured patients), she was put in the midst of helping a police officer who had been involved in a very serious motor vehicle crash.
“I moved to the head of the bed to assess his airway and secure his neck. As I looked down at this man – covered in blood, clothes cut away, broken bones, shattered glass all over – I hear this familiar voice say, ‘Barb, don’t let me die,’ ” she says.
She realized that he was a close friend of another police officer who she had dated, and most ER nurses know the local police well as they interact frequently.
“I promised him I wouldn’t let him die, although I knew that in spite of the very best care, his injuries were severe and promising his survival was beyond anything I could reasonably guarantee. But as with most emergency department nurses, we believe in the mind-body connection,” she says. “We’ve seen too many people die who should have lived but didn’t, and too many die for no reason.”
Her shift was ending, but she stayed with him for many more hours holding his hand as he went for more scans and tests.
“Although I spent all that time with him, I don’t think I provided any actual care – no injections, no wound cleaning, no starting of IV’s,” she says. “His injuries were severe, but he made it through surgery.”
A few days later his wife came down to the emergency department to thank Weintraub for saving his life.
“I told her it was a team, all of us. I’d done less than all my colleagues, really only talking to him and telling him he was going to be OK,” she says.
Four months later, a package comes in the mail.
“It was a gift from him again thanking me for saving his life. Through all the chaos and pain, he remembers me telling him I wouldn’t let him die – a promise I really couldn’t make, but did anyhow,” she says. “A year later almost to the day of his accident, this man came to see me in in his police uniform. It was his first day back on the job after his injury, several surgeries and extensive rehabilitation.”
When she saw him walk down the hall, she burst out in tears and gave him a big hug.
“He introduced me to his partner as the person who saved his life,” she says.
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She had already worked her 12-hour shift when the radio call came over. A pregnant woman involved in a motor vehicle accident was headed to the emergency room by ambulance.
“Another nurse and I offered to stay later to help the upcoming nurse with the patient,” says Dawn Lutecki, 42 year-old clinical nurse leader on the night shift at Hartford, Conn., Hospital’s emergency department.
She was about to witness something she had never experienced before in the emergency room.
“When the patient arrived, we were ready. We are a Level 1 Trauma center, so we had all the specialties in one place. There aren’t many places who can handle this kind of case. The ER staff and obstetrics/gynecological teams were in the trauma room,” she says.
The patient was around 30 years old but only 26 weeks pregnant.
“She had an altered mental status from hitting her head. They did a quick fetal ultrasound to check the baby. Initially, all seemed normal,” Lutecki says.
The patient was then rolled carefully to check for any further injuries. Suddenly, she let out a huge scream.
“We immediately rolled her back. OB/GYN did a second fetal ultrasound, and this time, we found the fetus to be in distress,” she says.
They announced that they would be doing an immediate cesarean operation in the trauma room to save two lives. She had never seen an emergency C-section done in their trauma rooms. In a matter of minutes, the room was filled with more specialists — obstetricians, more trauma team members and the Neonatal Intensive Care Unit (NICU).
“The NICU team setup in the next trauma room, so they would be ready when the baby arrived. Seconds later, an obstetrician performed the surgery. The baby was delivered and sent next door where the NICU staff was ready. Everyone’s energies were focused on saving these lives. It was amazing to be a part of this team,” she says.
Thankfully, both did amazing well and went home soon after, Lutecki says.
“This was one of those days that I will never forget. It could have been a really tragic event. But thankfully we have such great teamwork. It was a beautiful, happy time for us as healthcare workers and for this family. This is what it means to be a nurse,” she says.
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The emergency room is a well-orchestrated place, sometimes looking like coordinated chaos.
“It’s like a dance with a lot of adrenalin. Everyone has their steps they must do to make it all work,” says Jamie Hendrickson, registered nurse in the emergency department at Geisinger Medical Center in Scranton, Penn.
One night, a man came in the door who was very sick.
“I just had this feeling about him, and I knew I needed to stay at his bedside with him,” she says. “As I was talking to him, right way we got an IV in him and gave him antibiotics.”
The nurses and doctors triage patients very quickly, looking to see if there is some form of infection. They get blood drawn and get chest X-rays. Even a cardiologist had been asking this man some questions.
The patient, who was dealing with cancer, had been going through chemotherapy started to code.
“All of a sudden, he just stopped talking,” Hendrickson says. “I’m with three other nurses and the doctors, and they are all working on this patient. We already know what each other needs to do in these situations.”
They get out the paddles and shock him.
“One shock put his heart back into normal rhythm. He woke up instantly, and said, ‘What happened.’ ” Hendrickson says. “All of this happened within a two to five minute period, and then it was done. This person did very well. It could have worked out much worse.”
She says that the teamwork in the emergency department is a big part of what keeps her there.
“We work together. We get through these situations. Not every situation has a good ending, but we sure try,” she says.
Her emergency room sees 48,000 patients a year.
“There is a constant turnover of patients. We are transporting patients upstairs all the time once we take care of them here. The days go by fast. There are times we crave for boredom,” she says.
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Being an emergency room nurse means suspense, sadness, teamwork, drama, trauma, chaos, recovery and miracles. It also means split second decisions, staying calm under pressure and caring for patients who depend on your knowledge and skills to get them through some of the worse moments in their lives.
