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The Accidental ER Nurse

"Well, it wasn't an accident, but it was never part of my plan."

By Cailey Oates RN, BSN, CEN, BCLS-I

Falling Into a Job

The summer before I began nursing school, I submitted a general application for a position as a nursing assistant at two local hospitals.

I waited anxiously for what seemed like months and finally received a call for an interview. It was the Emergency Department calling...

Well, it wasn't an accident, but it was never part of my plan.

So I went to the interview and somehow managed to make it through the many questions for which I hadn't prepared. At the age of 18, this was my first "big girl" job interview and my first venture into the strange world of healthcare. Before I knew it, I was signing forms and donning the requisite blue scrubs.

That summer, I walked in through those ED doors asgreen as summer.

For the next three years, I spent 20 hours a week working alongside a group of dedicated ED nurses. It wasn't easy fitting this work into an already packed nursing school schedule, but it helped me connect the textbook and classroom to real life nursing. The things my professors taught me weren't just facts and theory; I could connect them with what I was experiencing. Like when my instructors shared the symptoms of DKA: I could easily recall the fruity-scented breath of the patient on which I checked hourly blood sugars the previous weekend shift.

When clinical time rolled around during nursing school, I felt more confident and comfortable talking with and caring for patients. Since I had already been in that environment for years, it just seemed to come naturally.

Those three years flew by quickly, and then it was my turn to become the nurse.

I took boards and found myself wearing the badge I coveted for many years... "Cailey... RN."

Falling in Love With a Calling

Thankfully, my team eased me into the role of an Emergency Department Nurse. I spent the first few months as an ED nurse working in urgent care– what we called the "Fast Track"– tending to patients with coughs, colds, sprains, and muscle strains. Of course, we had the occasional patient with a pulmonary embolism masquerading as bronchitis, or a patient complaining of shoulder pain who turned out to have a "bumped" troponin. These occurrences, although uncommon, gave me a taste of the adrenaline rush and really cool learning experiences ahead.

Did you know that ER nurses become certified to lead teams to run codes?

After a few months, I transitioned into the real ED. Emergency nursing has demands similar to all clinical settings–skipping meals, postponing bathroom trips–all while comforting patients, and trying to stay caught up on charting.

But the excitement of the unknown was what I loved. Each day was different.

Every time the code button was pulled, the field radio buzzed in, or someone ran into triage in distress, my pulse quickened.

Adrenaline rushed.

Within a single hour, I might triage and transport a woman in preterm labor, start an IV on a 5-month old baby with dehydration, collaborate with a social worker about the discharge needs of a patient in our mental health pod, and push adenosine to slow the heart rate of a patient in SVT.

The variety kept me on my toes, and I loved it! I was hooked.

Despite loving it, there were undoubtedly hard days. I attended my share of debriefing sessions following a critical incident, such as an unsuccessful code. These discussions helped our team to identify ways we could improve our team communication and care and also allowed us to process any difficult emotions that arose. There were times where I felt emotionally and physically drained. But ED nurses, just like nurses in all areas of practice, learn how to cope with the stressors of their particular role.

After several years as an ED nurse, I studied for, and I passed my Emergency Nurse Certification (CEN). Although I knew that there was still so much for me to learn, I finally felt like a full-fledged ED nurse.

Your Calling Might Find You

I wasn't looking to become an ED nurse. The ED found me, and I fell in love.

Maybe you have already found your calling within the wide world of nursing, or maybe your not there yet. That's okay. Every nurse's journey in their nursing career is different.

I found that the ED suited me well. The ED required me to flex my critical thinking skills and stay light on my feet, because things changed by the minute. I had to collaborate with many other departments and also function autonomously.

I had to be tough, but not lose the ability to empathize.

A first love stays with you. Fast forward a few years...even now, in a season of personal change, with the added challenge of caring for my young children and a need for more flexibility in my career, I still have ED blood coursing through my veins. My current job in Urgent Care gives me the occasional small boost of the adrenaline that I have grown to crave while giving me life balance.

I am still an ED nurse; it's a part of who I am now. I know one day I will return.

Maybe you've thought that ED nursing is for you, or perhaps you don't feel like you've found your calling yet. If you haven't found your nursing niche yet, think about your personality and interests, and talk with a trusted mentor or take a short "Find My Specialty" quiz. This will give you some ideas of what areas of nursing might suit you best.

But who knows, maybe you'll find that you've fallen into your calling too!

Guest Blogger Bio

Cailey Oates is a team builder with a passion for inspiring and supporting others in their nursing journey. When she is not balancing her work as a nurse and her role as 'mom', you’ll find her reading the latest evidence-based research or wrangling commas as a contract writer for My Nursing Mastery.