E.R. Nurses

1. Nursing is a calling that requires resilience and compassion

"I know I'm not a very good student, I write. I know I have shortfalls and shortcomings. What I do have is loads of experience."

Innate drive to help others. Many nurses describe feeling called to the profession from a young age, driven by a desire to make a difference in people's lives. This calling is often tested by the harsh realities of the job, including long hours, emotional strain, and exposure to human suffering.

Resilience in the face of adversity. Successful nurses develop a thick skin and the ability to bounce back from difficult experiences. They learn to find meaning in their work, even when faced with seemingly insurmountable challenges or tragic outcomes.

Compassion as a core skill. While technical knowledge is crucial, the ability to empathize with patients and their families is equally important. Nurses often provide emotional support and comfort in addition to medical care, serving as a lifeline for those in their most vulnerable moments.

2. ER nurses face life-and-death situations daily

"Working in the ER, you don't normally hear what happens to your patients. You certainly don't hear what happens to patients who are transferred to other hospitals."

Constant state of readiness. Emergency room nurses must be prepared for anything, from minor injuries to major traumas. They develop a unique skill set that allows them to quickly assess and prioritize patients in chaotic environments.

Split-second decision-making. ER nurses often have to make critical choices with limited information. Their decisions can mean the difference between life and death, requiring a combination of knowledge, intuition, and quick thinking.

Emotional rollercoaster. The high-stakes nature of ER work means nurses experience intense highs and lows. They may save a life one moment and lose a patient the next, requiring exceptional emotional resilience and the ability to compartmentalize feelings.

3. Flight nurses provide critical care in extreme conditions

"I'm a Black nurse. My pilot, Jackson, is Black, and Eddie, my paramedic, is white and gay and has earrings and pink hair."

Challenging environments. Flight nurses work in helicopters and small aircraft, providing advanced medical care in tight spaces and often turbulent conditions. They must be able to perform complex procedures while in motion and with limited resources.

Rapid response and assessment. When arriving at accident scenes or transporting critically ill patients, flight nurses must quickly evaluate the situation and begin treatment. They often work with minimal information and must rely on their training and experience to make life-saving decisions.

Diverse team dynamics. Flight crews come from various backgrounds and must work seamlessly together despite potential differences. The intense nature of their work often forges strong bonds and a deep sense of trust among team members.

4. Nurses witness both the best and worst of humanity

"I've never shed a tear in front of a patient before, but this time I can't help myself."

Inspiring moments of human resilience. Nurses often witness incredible acts of courage, love, and strength from patients and their families. These experiences can be profoundly moving and reaffirm their commitment to the profession.

Confronting human cruelty and neglect. On the flip side, nurses also encounter cases of abuse, violence, and willful ignorance that can be deeply disheartening. They must find ways to process these experiences without becoming cynical or losing their compassion.

Balancing hope and realism. Experienced nurses learn to navigate the fine line between offering hope to patients and their families while also being realistic about prognoses and outcomes. This balance requires emotional intelligence and strong communication skills.

5. The emotional toll of nursing can lead to burnout and PTSD

"PTSD in health care is real and gets overlooked. It needs to be discussed, especially because a lot of us don't have families, friends, activities, hobbies, or outlets where we can find relief, and over time that causes a strain on our personal and professional relationships."

Cumulative stress effects. The constant exposure to trauma, suffering, and death can take a significant emotional toll on nurses over time. Many struggle with symptoms of anxiety, depression, and post-traumatic stress disorder.

Importance of self-care. Nurses must actively work to maintain their mental and emotional well-being. This may include seeking therapy, engaging in stress-reduction activities, and maintaining a strong support network outside of work.

Institutional support needed. Healthcare organizations are increasingly recognizing the importance of providing resources and support for nurses' mental health. This includes counseling services, peer support programs, and policies that promote work-life balance.

6. Nurses must learn to compartmentalize emotions to function effectively

"I learn to compassionately compartmentalize. I try not to let tragedies enter my heart. I try to stay really present and in the moment."

Emotional distancing as a coping mechanism. Many nurses describe developing the ability to emotionally detach from difficult situations as a necessary survival skill. This allows them to remain focused and effective in high-stress environments.

Balancing empathy and professional distance. While emotional compartmentalization is important, nurses must also maintain their ability to empathize with patients and families. Finding this balance is an ongoing challenge throughout a nurse's career.

Processing emotions off-duty. Nurses often develop rituals or practices to process their emotions after their shifts. This might include talking with colleagues, engaging in physical activity, or seeking professional counseling to work through difficult experiences.

7. Teamwork and communication are crucial in high-stress medical environments

"There is something about the competence of a calm leader, no matter the situation, that makes you feel like everything really is going to be okay. It's all going to be okay."

Coordinated chaos. In emergency and trauma situations, effective teamwork can make the difference between life and death. Nurses must be able to communicate clearly and work seamlessly with doctors, technicians, and other healthcare professionals.

Non-verbal communication. Experienced nursing teams often develop the ability to communicate and coordinate their actions with minimal verbal cues, allowing for more efficient care in high-pressure situations.

Leadership under pressure. Nurses frequently find themselves in leadership roles during critical moments, directing the actions of other team members and making split-second decisions. The ability to remain calm and focused in these situations is crucial.

8. Nurses often advocate for patients beyond medical care

"I don't think patients know what ER nurses actually do for them. That we're their advocates."

Holistic patient care. Nurses often go beyond their medical duties to address patients' emotional, social, and practical needs. This might include coordinating with social services, providing emotional support, or helping patients navigate complex healthcare systems.

Bridging communication gaps. Nurses frequently serve as intermediaries between patients and doctors, helping to explain complex medical information in more accessible terms and ensuring that patients' concerns are heard and addressed.

Ethical advocacy. In some cases, nurses may need to advocate for patients' rights or best interests, even when this puts them at odds with hospital policies or other healthcare professionals. This requires courage, strong ethical principles, and effective communication skills.

9. The nursing profession offers diverse career paths and specialties

"I don't think people realize the fight that goes on in nurses' hearts — sticking to a hospital's legal policy versus acting on humanitarian impulses."

Variety of specialties. Nursing offers a wide range of career paths, from emergency and critical care to pediatrics, oncology, and mental health. This diversity allows nurses to find roles that align with their interests and strengths.

Advancement opportunities. Many nurses pursue advanced degrees and certifications to take on specialized roles or move into leadership positions. This might include becoming a nurse practitioner, nurse anesthetist, or nursing educator.

Non-traditional nursing roles. Nurses also find opportunities outside of traditional hospital settings, such as in public health, research, policy-making, and healthcare technology. These roles allow nurses to apply their skills and knowledge in innovative ways.

10. Nurses frequently encounter ethical dilemmas and difficult decisions

"Sometimes hope is all we have."

End-of-life care decisions. Nurses often play a crucial role in discussions about end-of-life care, helping patients and families navigate difficult choices about treatment options and quality of life.

Balancing patient autonomy and safety. Nurses must often navigate situations where a patient's wishes may conflict with their medical best interests or hospital policies. This requires careful consideration of ethical principles and effective communication with all parties involved.

Resource allocation challenges. In high-stress environments or during emergencies, nurses may face difficult decisions about how to allocate limited resources or prioritize care among multiple patients with urgent needs.

11. Continuous learning and adaptability are essential in nursing

"Nursing school doesn't teach you to be an ER nurse by any means."

Ongoing education. The field of medicine is constantly evolving, requiring nurses to continuously update their knowledge and skills. This includes staying current with new treatments, technologies, and best practices.

Learning from experience. Much of a nurse's most valuable knowledge comes from on-the-job experience. Seasoned nurses often describe how their intuition and decision-making skills develop over time through exposure to diverse cases and situations.

Adaptability in various settings. Nurses must be able to adapt to different work environments, from well-equipped hospitals to resource-limited settings or disaster zones. This requires flexibility, creativity, and the ability to think on one's feet.

12. Nurses play a vital role in bridging gaps in the healthcare system

"These people willfully abandoned a human being in the desert. What if she had kids? Maybe she sent her kids on with their dad or with what's called a coyote, a human smuggler."

Addressing healthcare disparities. Nurses often find themselves on the front lines of addressing healthcare disparities, working with underserved populations and advocating for more equitable access to care.

Cultural competence. As healthcare becomes increasingly globalized, nurses must develop cultural competence to effectively care for patients from diverse backgrounds. This includes understanding cultural beliefs about health and illness, and adapting care approaches accordingly.

Filling systemic gaps. Nurses often go above and beyond their official duties to address gaps in the healthcare system, whether by connecting patients with social services, providing education about preventive care, or finding creative solutions to overcome bureaucratic obstacles.

Last updated: January 23, 2025