Travel emergency room nurse, Courtney Deck, gives perspective on daily life in the emergency department and the things they face. She is a wife and mother of a 6-month-old baby, two german shepherds, and a cat. They all pile up and travel to different assignments in their RV. Her words are insightful and full of experience.
How did you become a Nurse?
I did not always intend to become a nurse. When I was younger, I planned to be a veterinarian or a fashion designer. After my senior year of high school, my mom was in a terrible car wreck. She was in the ICU for several weeks. During that time, I never left her side. I held her hand while she had her chest tubes removed. I cheered her on through hours of painful physical therapy. The nurses I came in contact with were excellent and taught me how to change her dressings and linens.
In time, I realized that I seemed to be the only member in my family who could not only stomach her injuries but also care for her despite knowing that care sometimes brought her more pain. In my mind, I was doing what was for her benefit, so I did what was needed, whereas other family members couldn’t. It was that experience that made me realize I was meant to care for people. But not just any type of patient. I wanted to care for trauma patients, the worst of the worst. I wanted to be a difference in those patients’ lives when they were most critical.
I started off my career by going to a community college. I took four years of basics and then applied to the community college’s two-year nursing program. The nursing program was difficult. Nursing school is difficult in general. There is so much information to be learned in such a short time. Then on top of that, you add clinical hours, check-offs, test exams, HESI exams, and precepting. I get anxious just thinking back on all the missed holidays, birthdays, and family gatherings because my nose had to stay in my books. Once I graduated, I knew it was worth it all. I worked as a nurse for about 3 years and then I went back to school to obtain my bachelor’s degree. Luckily, that was all online with very minimal clinical hours.
Every field of nursing has its own special certifications and requirements. Some of these are required to work in a specialty and some of these just give you a step above your competitors on a resume. My first job was in an emergency room in a level 1 trauma center. Since I worked in a busy emergency room, I was required to have both Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) certifications. Most ERs require this. I had to have my Pediatric Advanced Life Support (PALS) certification, the reason being that we also treated pediatric patients. Some ERs require a Neonatal Resuscitation Program (NRP). That is less common but definitely looks great on a resume.
I also have my Trauma Nursing Core Course (TNCC) certification which allows me to effectively care for trauma patients. It is also a requirement for working in most higher-level trauma centers. Another necessary certification for an emergency room nurse is the National Institutes of Health Stroke Scale (NIHSS) certification. This is highly recommended for most hospitals, but not always required. You are likely to see it in hospitals that are certified stroke centers. A few certifications I am hoping to obtain in the future would be my Critical Care Registered Nurse (CCRN), Trauma Certified Registered Nurse (TCRN), and Certified Emergency Nurse (CEN).
According to Vivian.com, Travel ER nurses average $2,423 per week. Most contracts are 13 weeks long totaling the end of the contract to make 31,499. Putting into consideration, you will take 2 weeks in between contracts. Most nurses will do 3 contracts a year totaling an estimated yearly cost of $94,497.
When ER nurses tell outsiders that they work in the emergency department, they are normally met with something like, “I could never do that.” or “Wow, I bet you have seen some crazy things.” Most of us generally reply, “Yeah, it’s never dull.” To tell others what a “typical” night is in an ER who have never been in that environment would be difficult because there is rarely anything “typical” about the ER. It’s truly something you just have to experience for yourself. I have worked in the ICU, Med-Surg floors, and even in Hospice, but I always come back to my first love, the Emergency Room.
They say Emergency nurses are “a jack of all trades and a master of none.” We thrive in an environment of controlled chaos. Every time we hit the time clock, we truly never know what will roll through our ambulance bay.
At any given time we could have a combative drunk patient in bed 1 who is yelling out for a sandwich and some pain medicine for his head laceration that he got from a bar fight.
In bed 2, we have a poor grandma from the nursing home that is here for a broken hip. She has dementia and keeps trying to crawl out of bed.
In bed 3, you just saw an ambulance roll in with a guy sweating, vomiting, and clutching his chest. You know from across the room without a doubt he is having a STEMI.
Never forget in the back of your mind that your old man in bed 4 is septic and on 4 medications that need constant monitoring. Some are for his blood pressure while others are to keep him sedated enough to tolerate his breathing tube. And you’re on the trauma team tonight when you hear overhead “Level 1, room D44”. You sigh, knowing you won’t have time to empty your bladder before the drop-off gunshot wound rolls through the trauma bay.
By the time you walk out of the trauma room, get bed 3 squared away, peak your head on bed 4 to adjust a few medicines, you see your drunken bed 1 running down the hall naked being chased by security as he sprays a fire extinguisher down the hallway. And no, I am not making this up. Thankfully, you see your co-worker in bed 2, comforting her and reminding her, for the hundredth time, she’s in the hospital. When you check your charting, you see your charge nurse was keeping an eye on bed 4 when they saw you go into bed 3.
You roll with the punches for twelve hours, you depend on your team to help get you through. Because in the ER, it truly takes a village. You become a family with these people. Countless nights of getting cussed out by disgruntled patients together who are tired of long wait times. Exchanging knowing looks when a patient is about to pass on, sharing countless slices of cold pizza between code browns and code blues. Then finally, right at shift change, bed boards give your patient in bed 4 a room assignment in the ICU. You hold your breath to call the report because you know the ICU is going to be angry that you are giving them a patient at shift change.
When you hit that time clock, your mind and body are tired and you shout out to your friends, “I’ll see you tonight!” On your way out, you see an old friend and catch up for a bit. When they learn you work in the ER they say, “Wow, what is that like?” And you go with your usual reply, “It’s never dull.”
It’s hard to choose a favorite thing about the ER. I enjoy the rush of getting a sick patient stabilized. I enjoy the bond I have with my coworkers and I enjoy the autonomy ER nurses have. Doctors trust our opinions and experience and give us more responsibility to help care for patients. I truly enjoy that.
I have trained several new nurses and I tell them all the same things.
1. Be a team player and go with the punches. My motto when I get a terrible assignment or a difficult patient is, “I can do anything for twelve hours”. Sometimes you just have to try to survive a shift. Now that I have more experience, assignments that used to be difficult and overwhelming to me, are now mere inconveniences. Don’t give up when things get hard. You will grow way more as a nurse from a difficult assignment than you will when everything is smooth sailing.
2. If you have techs in your department, be nice to them! Techs can make or break a nurse, and if you have their back, they will have yours!
3. My favorite thing to do as a traveler is to ask all my patients and my staff members, “What is your favorite thing about this area? Something I absolutely should not miss.” I have seen some amazing things that the locals have told me about that I never would have found on internet searches!
