ER Nurse

Who doesn’t want to read the career story of an ER nurse?  There is something very exciting about the ER department, and we here at are always excited to interview Emergency personnel.

Janet Johnson Deed, RN, MSN, MHA, worked in the ER for 15 years.  Later on in her career she transitioned to specializing in infection control and worked in that aspect of nursing for another 10 years.

Janet spent some time with us explaining the in’s and out’s of her career while working in the field of healthcare.   She gave us some incite as to how to get there, what it was like, and how we can grow as professionals by getting there.  Thanks Janet!

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How did you first come to work as an emergency room nurse?

I was working as a “floor nurse” on an OB/GYN unit and the House Supervisor saw my potential of being an ER nurse and encouraged me to apply for a position. The House Supervisor would allow me to go work in the ER when my unit was not busy to get a taste of ER nursing. Once I started floating down to the ER to work, I was hooked and knew ER nursing was for me.  I am so appreciative that the House Supervisor saw my potential and realized where I would fit in the world of nursing. I now realize that through my experience in the ER, I was able to mature as a nurse and develop outstanding critical thinking skills along with clinical judgment.

Was it difficult to get comfortable initially as an ER nurse?   ER’s in general can be hectic, was this atmosphere easy for you to acclimate to or did it take time?

The transformation for me was meet with great apprehension for fear of the unknown. I was a novice nurse and had been a Registered Nurse for only one year.  Prior to becoming a RN, I had been an LPN for four years. As I transitioned into my new environment, I worked with a LPN. The staffing ratio was 1 RN: 1 LPN per shift and at times we would run 30 patients through during an 8 hours shift. Keeping in mind, I started in the ER in the 80’s and times certainly have changed since then. This was absolutely one of the best experiences of my life. Not only was the LPN a seasoned nurse, but I learned so much from her and credit her for training me. The experience she exhibited gave me the knowledge and skills necessary for the critical care environment.

What are some of the greatest challenges you faced as an ER nurse?

Some of the greatest challenges were that of the sporadic and unpredictable environment that the Emergency Department can offer. These situations call for a prompt and accurate assessments and interventions.  Another challenge is that the ER nurse must know a lot of information about virtually all aspects of nursing. For example, the ER nurse must have good knowledge of the maternal-newborn setting to being proficient in labor and delivery.  Trauma nursing and dealing with trauma systems is a new aspect and has been a challenge to this area.  One of the most important skills for an ER nurse is resourcefulness.

Could you share with us any stories that were especially rewarding for you during your time in the ER?

Oh there are so many stories, but a couple always seems to stand out. On my first day to solo in the ER there was a “shooting” in a nearby community about 25 minutes from the hospital. With the hospital I worked at being the closest to the scene, there were two ambulances brought in with one victim on each. One patient was in full arrest and the other presented with 3 gunshot wounds to the chest.  The LPN, I worked with, took the patient in full cardiac arrest with a single gunshot wound to the chest and I took the other with the 3 gun shots to the chest.  On my first day ever to solo, I had to assist the surgeon to set up and insert 2 chest tubes and assist with other life saving measures. What a way to break in a new ER nurse.

Another incident, I will never forget, that made national headlines was a mass shooting at a local industry that brought in several victims to the hospital. There was so much mass confusion and chaos initially that it was hard to sort through.  I took care of the “shooter” with serious injury in the ER under armed guard. As a result of the incident, there were deaths, serious injury and disability and this event has left a permanent scar on the community.

And the one that haunts me still is the murder case of a beautiful young female that remains an unsolved identity case. This victim upon repeated visits over time to the ER for domestic abuse and addiction problems, I tried so hard to reach her without success.  Her identity to this day remains unknown.

How does a nurse get a job in the ER now a days?  What kind of experience or certifications would help get their foot in the door?

If a nurse’s desire is to be an ER Nurse, I would suggest preparing for the position by joining the professional organization that supports Emergency Nursing the Emergency Nurses Association (ENA).

Be prepared for the interview. Promote yourself for your abilities for good observation, assessment, and prioritization skills, multi-tasking ability, good interpersonal and customer service skills (a must), ability to maintain calm amidst chaos, good sense of humor, ability to think fast and on your feet.

Read emergency nursing publications that apply to emergency nursing and its principles and practices.

If you work in a facility that has an ER, talk to the director of the ER and ask if you can cross train and become a backup nurse for the department if needed.

Focus on developing the following critical skills for an ER nurse such as rapid and focused assessment, respiratory assessment, EKG interpretations, take ACLS and PALS, and become proficient on IV access skills.

Can you tell us about your transition into infection control?  Was there more education involved to enter this career field?

Yes, there were more education requirements for this position. During my last few years as an ER nurse I had worked toward and received my Bachelor of Science in Nursing degree which was the entry level degree for the role of the Infection Control Practitioner.

After being charge nurse in the ER for quite a few years, I wanted to put my education to work and advance to a higher position. The opportunity arose and I got the chance to change gears and focus on a totally different aspect of nursing.  This position also gave me the opportunity to continue my education and I worked hard on my education and received two Masters Degrees over the course of my Infection Control tenure.

Can you share with us what exactly a day in your life working as an infection control nurse entails?

As the Director of Infection Control the day consisted of surveillance of infectious processes through laboratory data, chart review, and consultation with patients, doctors and fellow employees. The Infection Control Practitioner is responsible in minimizing the morbidity, mortality, and economic burdens associated with infection through prevention control efforts in all areas of the hospital. Some of the delegated responsibilities were supervision of health promotion activities and the well-being of the hospital employees by overseeing a healthy atmosphere for employees who are at risk of acquiring infections in the hospital setting. Also act as a patient advocate, epidemiologist, educator, consultant, liaison, and change agent when needed.  As an Infection Control Practitioner, I was responsible for overseeing a facility of 700 employees, 120 physicians, and 90 axillary volunteers, in addition the allied health staff.


What are some interesting successes you have had as an infection control nurse?

Some of my proudest accomplishments were to increase the flu vaccination compliance rates and vaccination levels among staff.  Other successful components to this position were my participation in disaster management activities, established protocols for disaster management and wrote a disaster policy for the facility.

Do you have any final words of wisdom for aspiring nurses that are entering the career field of nursing today?

There are many opportunities for nurses in today’s world. I have always said that ER nurses are some of the most flexible nurses in the field since they have to be so versatile. With the ever changing and challenging environment of health care, we as nurses have to coach and mentor our new comers to the field of nursing. As this health care system evolves and there are great advances in technology, the system will become harder to navigate but nurses must continue to strive to make a positive difference. Ultimately, be involved, not only in your facility but in your community whether it is volunteerism or political action.