Emergency Department Nursing in 2021 (ER Nurse explains)

Emergency Department Nursing in 2021 (ER Nurse explained). How the Emergency Department works in 2021. ER Nursing

The ER is different than any floor you work on. Although each hospital runs their ER department a bit differently, they typically have the same stations. Here are the six “stations” or “sections” involved in the emergency department.

1) Triage

2) First Aid

3) Intake

4) Acute

5) Trauma

6) Medical-surgical

As you can probably guess each section has different types of patients. Each day you alternate in different sections of the emergency department. In this video I will talk about the different sections and explain how it works from a nursing perspective.

Triage Nursing

This section has the most senior emergency nurses. They have the responsibility of making one of the most important decisions in a person’s stay at the hospital. They decide what triage score a patient is to receive, which will ultimately decide where they will be placed for their stay at the hospital.

First Aid:

These are the walking wounded. Typically work injuries that are not severe, or patients who just need OTC medications and maybe XRAYs or stitches work here. The patients are typically CTAS Scores of 4-5. They must be able to ambulate and are quite stable. You basically are giving acetaminophen or ibuprofen to these patients and assisting the physician with procedures such as conscious sedation for reductions etc..

Intake:

These people require more in-depth investigation. They are ambulatory most of the time and may have health risks that require further diagnostics to understand what is going on. Typically the CTAS score is 2-4. Most of the time they are a CTAS score of 3 but can be 2 and 4 although this is rare. These patients are generally patients who have chest pain and abdominal pain. As a nurse you are putting in IV’s for imaging, assessing them, treating their symptoms and being vigilant as they can sometimes be a CTAS 2 but be triaged to CTAS 3-4.

Acute:

These people require a nurse to monitor their symptoms. They present with all sorts of conditions whether it is an acute situation of their chronic condition or a new and developing healthy problem which requires continuous monitoring. CTAS 2 are assigned for these patients. Typically patients who have hip fractures, falls hitting their head, strokes, infections – bad ones, uncontrolled atrial fibrillation, GI bleeds ect.. Are just some of the conditions that you see here. As a nurse you are assigned 3-4 patients.

Trauma:

These are the most sick patients you will get in ER. Typically these are patients who have undergone (as you can probably guess) a major trauma of some sort whether that is car accidents, acute strokes, overdoses or really bad asthma exacerbations requiring a nurse to have 1 to 1 monitoring. This is where you typically get to take part in cool procedures but it is quite a high stress environment as the patients are borderline ICU patients. These patients are CTAS 1 and typically you have an idea that this is coming in.

Medical-surgical:

These patients have typically been admitted but require a bed upstairs but there are none. These can be unstable patients that have been somewhat stabilized but just require further monitoring. Nurses who have not gone through a specialty training have been assigned to work in these assignments.

So now you know different areas where an ER nurse may work. ER nursing is awesome, it keeps you on your toes, you do everything from therapeutic communication for mental health patients to helping in trauma patients. You will never get bored of ER nursing and that is what drew me working there. Every day you get something different.

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