Friday, December 18, 2009

10 Things I have Learned/Learning in the ER: Some are easier than others!!

Things I have learned and or learning in the ER:

!. The definition of a fungating carcinoma (look it up and look at a picture)

2. That it is impossible to diagnose everyone with something…sometimes “of unknown etiology” is the best you can do…arrrrggghhh!!

3. If you can see a patient , get lab results and/or x-ray results, and get them discharged in under two hours…you have hit a home run!

4. That the patients WILL NOT stop coming in the door, therefore it is up to me to go get something to eat or go to the bathroom…because there will never be any downtime!

5. Just LISTENING to a patient apparently makes them feel better…I have had several patients and their families tell me I am a great listener and appear to care…of course all of the caring in the world is useless if I can’t figure out what is actually wrong with them!! (See number 2)

6. A seemingly harmless tooth abcess can actually turn into a major abcess that prompts the radiologist to call looking for the one (me) who ordered the CT of the head….lesson learned! If in doubt, order the darn test!! It’s never good when the radiologist calls to give the report over the phone instead of wait to dictate it!!

7. Just because someone doesn’t act like they are in much pain (even if a horse rolls over the top of them), they just might actually have their whole darn elbow broken off!! (Another lesson learned, don’t always trust a patient if they say they don’t really hurt)!

8. Apparently one can be too friendly to people (not patients)…and get themselves in trouble without even realizing what happened….(very hard lesson learned)

9. Do not EVER as a new NP pick up the chart that says room 1!! Room one if for the very sick and the trauma patients…embarrassing lesson learned!!

10. Having a background in women’s health has been what has made me feel confident on the days that I just want to go cry in the bathroom (and sometimes I do). My women’s health patients give me the incentive to carry on and hold my head up when I feel inadequate….


  1. Hi there!! My name is Brooke Walters and I'm a newly graduated Family NP in Oklahoma...I stumbled upon your blog and feel that it was absolutely heaven sent!! I start my new (first ever) job at a family clinic on Monday; I am scared beyond belief at times, thrilled at others. It's so nice to know that someone else is having some of the same feelings and experiences as me . . . I wish for you the best of luck in the ER!! Go get 'em!!

  2. Thanks Brooke!! I can't wait to read your blog....I am off to work right now, but will email you later.....I am still scared to death everyday in the ER! I don't care what school you graduate from, there is no way to prepare for the massive amount of information one needs to be a HCP....go home and read something every night!! Good Luck Brooke!! Thanks for the encouragement....

  3. Hello, my name is Natalie and I absolutely loved reading your journal! I am about to apply for Direct Entry NP and I am very nervous about the upcoming experience. Your journal gives a great insight. It is amazing that you decided to have both specializations - midwife and family. I'm still debating between the two. Was it a joined program or did you do each separately?


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