During a busy Sunday evening in my ER two weeks ago, while I stitched closed a laceration to the temple of a two-year-old infant who had run into a door, disaster struck. As is customary in these situations, my attendant nurse, a kind woman who is wonderful with children, had wrapped up the child in layers of sheets to prevent any unexpected movements of arms or legs while we performed the delicate procedure. Halfway through my sewing, our young patient stealthily managed to extricate a right arm from her wrapping, and promptly, before anyone noticed, the injured child delivered a full force punch to the face of my poor nurse.

The nurse assisting me rapidly developed a substantial bruise near her eye (believe me -- injured babies throw a mean punch!), but she never flinched, proceeding to calmly re-wrap the offending arm, and allowing me to finish suturing. Afterwards, to my chagrin, the parents of the injured baby ignored the nurse and the injuries she had sustained in order to help their child, while proceeding to thank me profusely for my care.

This episode got me thinking -- our nurses so frequently go above and beyond the call of duty, while receiving so little recognition for their amazing work and dedication. It is a situation I feel we all should do our best to improve, so without further ado, the top reasons why nurses are my true heroes of the Emergency Room:

1) Nurses regularly save us doctors when the going gets tough

Almost every doctor out there has stories, from their years in practice, about how an experienced nurse saved the day for them at some point. For me, the first time this occurred was during my residency, prior to receiving my license to practice.

I remember, during a night on call, seeing an older male patient who presented with suddenly elevated blood pressure and difficulty breathing -- the type of critically ill patient I would have seen only with a senior physician by my side during daytime hours. Being alone with this dying man, no other MD in sight, I froze, suddenly unable to recognize the clear diagnosis -- acute congestive heart failure -- that was in front of me.

As I watched my patient slipping away from me, rapidly running out of strength to breathe further, I felt a tap on my shoulder. It was one of the experienced nurses on the floor, a knowledgeable pro who had seen it all. She said to me gently, "I see you're here for the heart failure patient -- want me to draw up drugs x, y, and z?" Her quick, attentive action saved the day. With the correct diagnosis identified, and proper treatment started, the patient quickly improved. I learned a lesson that day, one that I have never forgotten: that nurses know their stuff, and that their enormous experience is an incredible asset to have by my side when faced with the most challenging patients.

2) Nurses take abuse and maintain their professionalism

Emergency rooms, due to the high-pressure, life and death nature of the work we perform, are very stressful places to be. Patients and their family members, as well as hospital staff, are frequently on edge. When tempers flare in the ER, nurses, as the workers in the ER who spend the most time with patients, frequently serve as proverbial, and all too often literal, punching bags.

In the course of my career I have repeatedly seen nurses assaulted by intoxicated, demented, and mentally ill patients, as well as verbally abused by patients and families upset with wait times and outcomes. A 2005 study found that 34 per cent of hospital nurses reported a direct physical assault from a patient within the past year. Despite this, I have observed nurses almost always maintaining their cool and remaining professional, even in the face of events that would result in police being called to almost any other workplace.

3) Nurses do all the dirty work that doctors don't

There is nothing pretty or glamorous about much of the work performed in a typical emergency room. Throughout a shift, countless tasks need to be completed that would curdle the stomach of any but the most hardened individuals. From diaper changes on elderly patients, to administering enemas, to cleaning bed bugs and maggots off of our homeless and less fortunate guests, the nurses I work with do it all, and it is a testament to their dedication that they rarely protest about it. In fact, I am constantly amazed at how gentle and kind they are with the patients whose illnesses require such unpalatable care.

4) Nurses work gruelling hours

The average ER nursing shift is 12 hours long, and usually starts at either 7:30 a.m., or 7:30 p.m. Most nurses work a staggered schedule of several day shifts, then several night shifts, followed by several days off. As a result, their bodies are perpetually in a state of shifting time zones and sleep schedules, with constant exhaustion as a consequence. Long-term, these types of shift work schedules can raise a nurse's risk of cardiovascular disease by 40 per cent and diabetes by 50 per cent -- a huge price to pay in personal health for one's profession.

Additionally, nursing schedules have little regard for social lives, family obligations or holidays. Without exception, the ER nurses I know regularly work Christmas days, New Year's Eves, Passovers, and the like. Wonderfully, instead of complaining about this, nurses in my department throw potluck meals during holidays and adorn the ER with impressive festive decorations, transforming a place nobody wants to be during these special days into a celebratory place for patients and staff.

5) Nurses get to know their patients better than any ER doctor can

During an average ER shift, I see a bare minimum of 30 patients, and on my busiest days, over 50 patients. This leaves me little opportunity to get to know my patients, answer their questions, or allay their concerns in any meaningful way. The nurses in my department typically get to spend time with patients both before and after I see them, explaining the tests I order, the diagnoses I come up with, and the treatments needed. The soothing, compassionate presence of my nurses, and the extra time they provide to patients, allows the people we care for to be properly informed about their illnesses, and to feel individually tended to, in a way that ER physicians only wish they could achieve.

6) Nurses are educated professionals with unique skill sets

Nursing requires an extensive knowledge base, and in today's hospitals all nurses are required to have either a college or university degree in their field. Additionally nurses are proficient in a wide array of clinical skills that are absolutely essential to the patients in any ER. When it comes to starting an intravenous line, drawing bloods, administering an electrocardiogram, and a wide variety of other tasks, the nurses I've worked with have unique skills that put mine to shame. In fact, I pity any patient that has their intravenous started by me instead of by a nurse!

So next time you or a family member are sick and end up in the ER, remember who the unsung heroes of the department are, and thank them for all that they go through and all that they do -- I promise they'll appreciate it deeply.

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