Monday, November 03, 2014

how I became a bitch

This is a post I did about a month ago.  It was viewed over 23,000 times. It definietly struck a nerve. It got 160 comments. The comments were mixed with a lot of people agreeing with what I said and many saying I should get out of nursing. So here it is again. What do you think?

Working in the ER changes you.

It is unlike any other place in the hospital. You are dealing with a constant stream of people who are having some kind of stressful event in their lives.  We may not think it is a crisis, but for them it is.

The ER never ends. It never closes. Its 24/7.  There is never a break. It can be quiet one minute and chaos the next. You can be dealing with a stubbed toe and in rushes someone with a gunshot wound or a cardiac arrest We live our life on the edge.

You are dealing with everyone from A to Z.  Many of the people who frequent ERs are living dysfunctional lives. They bring that dysfunction into the ER with them. They can be drunks, junkies, criminals, the homeless, the mentally ill, the neurotic.  We deal with violent drunks, drug seekers,  homeless people who haven't bathed for months, out of control psych patients, manipulative people who can turn on a dime if they don't get what they want.

We work in a chaotic environment of ringing alarms, yelling patients, ringing phones, overhead paging... When it ramps up its overwhelming.

You know all of the above going in, or at least you think you do.  When you choose to take a job in the ER, you are the kind of person who thrives on chaos and crisis.  Bring it on.

Here's the thing about the ER that people don't get: It is not like ER on TV.  We are not constantly dealing with a car accident, a shooting, a cardiac arrest.  We get critical patients. Often. That's actually the fun part of my job. Ninety nine percent of the time it is routine, dull even.

My job is the everyday world of the ER: the abdominal pains, back pains, chest pains, mental health, etc. etc. etc. that make up the daily operation of an ER.  Its boring really.  Its predictable.

Being an ER nurse, you see a lot of tragedy.  Tragedy in the form of suffering people with cancer who are dying, terrible chronic diseases or conditions, unwanted elderly people..  People die.  Families suffer.  It is sad.

Then you see people who are such ineffective copers that a cold sends them over the edge and into the ER.  They are the type of people who will never have their own doctor.  There lives are such chaos that the concept is foreign to them.

Every day you deal with drug seekers in their various forms.  They lie and manipulate to get what they want.  You learn to recognize them a mile away.

Then there are the just plain mean people. You learn just how many of them there are in the world. They yell at you, verbally abuse you, threaten you, may try to hit you and succeed. They are the out of control people down the hall yelling at the top of their lungs because they didn't get what they wanted.

All this changes you.  Hardens you.  Makes you cynical..  You develop a shell that protects you most of the time. It changes your view of people, the world.   It exposes you to things most people don't see. It gives you a perspective on your own life and how it ain't so bad.

Being an ER nurse is so very difficult.  You cannot understand how difficult unless you do it. The only things that saves you is the occasional thank you, the thought that you made someone feel better or participated in extending someones life at least enough to get them out of the ER.

Last but not least, you will work with people who are hilarious, smart, dedicated and some of the nicest people you will ever meet.  They keep you coming back.


caffeine and xanx said...

Same thing in the ICU! I became a bitch, too. But a compassionate one. Usually. People want to see nurses as angelic beings of sympathy. But we're human. We can spot bullshit a mile away and we unfortunately have to deal with it for 12 hours straight. Our tolerance level leaks away. We are forced to set boundaries with manipulative or coercive behavior. We have to deal with strong personalities all day. We don't have the time or energy left over to be all smiles and sunshine.

Anonymous said...


Anonymous said...

I totally agree with you. We need that part of ourselves to deal with what we do. I believe that people who give you crap for what you said are people who haven't done the job that you and I do or deal with the patient population we do.

Anonymous said...

Thank you for being so honest. That shell you have put around you is an effective coping mechanism, and will most likely keep you sane. As nurses, we need to maintain a balance of self-preservation and compassion towards our patients.

Anonymous said...

Wholeheartedly Agree. I do not work in the ER but on the floor and everything you said is what I have experienced also. Let those people who criticize you do it for years and years and then they can have some idea what we deal with every day.

Caitlin Flynn said...

As an ER nurse, every bit of this is true