October 30, 2007, 2:57 pm

Emergency Nursing: A Pictorial Essay


I can just imagine the dialog for this photo:

“Why Bob, that Doctor Jones is just wonderful! He wrote this prescription for fifteen hundred tablets of Valium!”

Bob says, “Why that’s wonderful, dear!”

Bob thinks, “Oh, thank god! Now maybe she’ll get off my back and I can read my newspaper in peace!”

Better living through chemistry!


The life of an emergency department nurse is often chaotic and stressful. If “a picture is worth a thousand words”, let me take a moment to actually show you what a typical shift in a community ER might look like.

Disclaimer: those depicted in the following photographs shall remain nameless to comply with current HIPAA regulations regarding patient confidentiality.



Any visit to the emergency department begins with triage.

Here, we have a patient with a chief complaint of pain, nausea and feeling as though he is “full of air”.

The patient’s wife reports increasing incidents of the patient hiding behind chairs and flinging feces in her direction, thereby causing increased stress in the home.

It is important to note that although the patient is smiling, he reports pain to be a 10/10. Nurses must be careful to take the patient’s word and not make value judgments based on outward signs of pain or a lack thereof.

On arrival to the room, the patient immediately asked for something to eat. This is not an unusual situation, as 98.6% of all nauseated patients become hungry on arrival.

A banana was given.



Communication is the heart of collaboration.

Here, our intrepid emergency department nurse pleasantly explains to a primary care physician the purpose of the medication reconciliation form.

Dr. Primary is astounded at the amount of work the nurses do to make his job of ordering easier. He vows to make sure he completes the form in the future. Another ER success story!

I’m sure holding Dr. Primary by the back of the neck had nothing to do with it…



CPR certification is one of the more important requirements of emergency department nursing.

Here, we see one of the ER staff working diligently, practicing chest compressions on a colleague.

Uh oh! It seems that someone has forgotten the “R” of CPR and now their colleague is exhibiting decerebrate posturing.

No problem! It takes more than profound anoxia to keep an ER nurse down!

Our posturing partner finished the shift and managed to make it home before calling in brain-damaged.

The nurse was, however, counseled for not breathing on the job.



Technology plays an important part in emergency department medical records.

Computers have made it easier to read blogs on the job access patient’s medical records, thereby improving continuity of care.

Here we have Dr. PuterGuy and our hard-working ER nurse perusing the previous history of one of the patients in the department.


It seems this patient has a family history of feces flinging.



Ah, cameraderie! How would ER nurses survive without it?

It’s your coworkers who have your back, help you when you are swamped, fill-in for you when you are sick, take the feces-slinging patient when you’ve had enough and basically make coming to work a joy.

They also hold you up when you are sleeping at 0500, as is obviously happening with our hard-working ER nurse.



This concludes our pictorial look at a day in the life of an ER nurse.

In conclusion, when things get hairy, the department is bursting at the seams and you don’t think you can take another step or read another order…

…don’t forget to hug your administrative assistant/unit clerk.

They’re the ones who actually run the department, anyway.


No emergency nurses were harmed in the making of this pictorial.

All photos taken with an iPhone, which was not mine. Because I don’t have one. Yet.

This is dedicated to all the ER nurses who think the night shift doesn’t do anything. I hope this dispels any of those unfounded notions!


  • Dawn

    October 30, 2007 at 3:38 pm

    LMAO. I loved this. Great job. I think this is the best picorial I have seen maybe you should consider a powerpoint slide.

  • birdyrn

    October 30, 2007 at 4:11 pm

    Ha! I love it!

  • EMSJunky

    October 30, 2007 at 4:41 pm

    Absolute genius!

  • rlbates

    October 30, 2007 at 5:19 pm

    Love your pictorial. Looks like you had fun making it!

  • Awesome Mom
    Awesome Mom

    October 30, 2007 at 10:19 pm

    You crack me up Kim!!!

  • Beth

    October 31, 2007 at 3:30 am

    You ER nurses are always monkeying around on the job.

    (sorry. couldn’t resist)

  • nancy b
    nancy b

    October 31, 2007 at 7:05 am

    I have a special place in my heart for ER nurses. I love this. My daughter practiced ER nursing, now ped. ICU. I am a former nurse though no longer practicing.And my brother was one of the forerunners of emergency medicine, Ron Krome. He recently authored a book about practicing in the ER called the Floaters Log, from the “olden days”, by todays standards anyway.

  • Margaret

    October 31, 2007 at 8:51 am

    Very Cute!!

    Not so cute (an on a different topic) are the comments that seem to frequent your blog recently that appear to come from posters who don’t have much to say. Emergency Nursing, DFASTEST, Last Medical News, Fitnessbook.com on this page. What is up with those? does this have anything to do with the stack overflow at line 156 that I encounter each time I visit the comment section?

  • ERnursey

    October 31, 2007 at 9:19 am

    Too funny Kim, Thanks for the prehalloween laugh

  • Cathy

    October 31, 2007 at 9:56 am

    Great job, Kim. Loved this post.

  • Shane

    October 31, 2007 at 12:57 pm

    As Kim’s official Web Guy, I’ll step in and answer your questions for her 🙂

    Those pointless comments are called trackback spam. We try to keep them off, but they’re so sneaky.

    And the Stack Overflow should be fixed now. Not sure why it suddenly started happening, but I’ve removed the line that was causing it.

    Thanks for bringing these up!

  • Margaret

    October 31, 2007 at 2:06 pm

    @ Shane:
    Thank you for fixing it!! Nice not to see that stack overflow anymore. And I like your blog too.

  • Robert at Kintropy
    Robert at Kintropy

    November 1, 2007 at 3:37 am

    Nice job, Kim: fun to read.

    Your patient seems very happy by the end of day – 10/10 successfully reduced, apparently. Are he/her and the doctor related? Noticed a bit of a family resemblance.

  • Cinder

    November 1, 2007 at 9:32 am

    Very o read,thanks for the laugh!

  • Cinder

    November 1, 2007 at 9:33 am

    should say very fun to read

  • Tyler

    November 1, 2007 at 11:35 am


  • Kathy

    November 1, 2007 at 5:01 pm

    Great post!

    I heart my HUS’s & CNAs !

  • Azygos

    November 1, 2007 at 7:30 pm

    That first pic would probably be Miltown or phenobarb considering the time period.

  • linda-lou

    November 5, 2007 at 4:12 pm

    Actually, I’m a little disappointed that none of the ER nurses in the pictorial were wearing nursing caps rating 10/10 (on the ECRS). They need to set a better example.

  • Coursework

    January 28, 2008 at 1:14 am

    Frequently the reason behind the desire to write this type of paper remains unclear. However, once the events are recounted and recorded, it becomes clear that the writer is striving to find the universal truth.Coursework

About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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