I get to the hospital around 6:45 a.m. to prepare for the 7 a.m. shift. To start the day, the nurses get a night shift report, where night nurses share a summary of patient care provided throughout the night and current patient conditions. As a charge nurse, I oversee all of the nurses in my department. Therefore, it is crucial to know what treatment has been provided throughout the night, and how patients are currently being treated.
After getting briefed on the night before and the current state of the emergency room, it is time to get to work. If the ER is full, nurses may have to jump right in. However, on slower days, nurses will take time to ensure the department is set up for when it does get busy. This includes checking machines and making sure all equipment carts are stocked. The job of a charge nurse is to manage the flow of the ER — and setting us up for success each day is key.
Focused on department management, as charge nurses we assess incoming patients, prioritize provider care, assign nurses and inform staff of critical information. While every day looks a little different, working in a small town there are some common cases in patients.In Shelbyville these cases are comorbidities. Comorbidities are when two or more diseases are present in one patient. A common version of this is patients experiencing both chest pain and abdominal pain. When a patient with comorbidities comes into the ER, nurses typically begin by treating the most critical symptom. Treatment for chest pain includes getting an EKG (a recording of the heart’s electrical activity) done within 10 or more minutes, drawing blood and setting up an IV. This requires multiple nurses, often three to four, which can make a charge nurse’s job of assigning nurses to patients difficult. Chest pains are also a scary symptom because they can escalate quickly. Chest discomfort can become heart failure in a matter of minutes. Nurses have to quickly begin providing emergency CPR in this situation, which also requires multiple nurses. If enough nurses aren’t available, it is the duty of the charge nurse to jump in and assist.
This is just one example of the complicated situations we regularly encounter in the emergency department.
The job is never easy. The day doesn’t end until 7 p.m., and between the long hours, stressful conditions and rapidly changing environment, it can be hard on you both emotionally and physically. On difficult days, it is comforting to have a close-knit team that has each other’s backs and will provide support if one of us needs a moment to breathe.
Working at a nurse-driven hospital like Vanderbilt Bedford Hospital also makes the job a little easier. Nurses are given every opportunity to become better nurses. The hospital provides tuition reimbursement and nurtures young nurses so we can rest in the knowledge that everyone is trained to handle any situation. The nurses also receive a lot of support from management to meet their needs — whether that be ordering new equipment or providing more staff.
Despite the many challenges, nursing is incredibly rewarding. Born and raised in Shelbyville, I love being able to support my hometown through my work. What nurses do is critical but often gets overlooked. We always appreciate it when people take the time to appreciate us and acknowledge how difficult our job is. Next time you meet a nurse, remember to thank them for the work they do to support your local hospitals and community.
