#AskOurNurses is an initiative where we invite nurses from various hospital departments to share more about the department, and what it is like to be a nurse in their respective departments.
We have Ms Rachel Lean from Tan Tock Seng Hospital Emergency Department to share about Emergency Nursing, and address some of the questions you have posted on our IG story. The following are the questions that our guest speaker have answered.
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Question: Describe ED in one word?
Ms Rachel: Teamwork.
Question: What made you choose to join ed?
Ms Rachel: I think [it] is the dynamic and exciting working environment in ED, yeap.
Question: So what are the qualities needed to join the emergency department?
Ms Rachel: I think you have to be resilient, [and] you have to have the ability to, you know, adapt to the changes. Yeap
Question: Are fresh graduates allowed to join the ED as their first placement?
Ms Rachel: Of course, always welcome. I was the first batch of fresh grads when I first joined ED.
Question: So what are your thoughts on the stereotype that says “ED nurses are disorganised-organised?
Ms Rachel: I think we are task-oriented people, so i think time is really [of the] essence in ED, and I would say we are task-oriented
Question: So how do you handle the stressful situations in ED?
Ms Rachel: I think you need to stay calm, don’t be panic, and ask for help if you need to.
Question: How do you train yourself to think quickly?
Ms Rachel: First of all, in order to think quickly, you first need to anticipate your problem, you know, you need to get more exposure, and anticipate, as time goes by you can think as quickly as you can with experience
Question: Are there any sub-specialty in ED nursing?
Ms Rachel: We don’t have sub-specialty, but we do have specialised competencies and points of interest. For example, we have disaster management, outbreak planning among many others.
Question: How do the new nurses adapt or learn when the first begin in the ED?
Ms Rachel: That is a very common question. I think [you] don't [have to] worry, we have buddy system. So what happen is, when a new nurse join us, we have a buddy that tags along with these new nurses, the senior nurses will be tagging along with you, and help you navigate through the system for the new nurses to learn about the process and new policies of the department.
Question: What are the opportunities like for ED nurses to progress further?
Ms Rachel: I see, so we have various training programmes, specific to ED nursing. So for example, we have triage course, we have orthopaedic, we have resuscitation, and ED nurses also learn about disaster management and outbreak planning, so as to respond to these disaster and outbreak situations. We will ensure everyone is well prepared and updated on the department policies, and also the plan for the department to handle these various response. And for external training, we do have Nanyang Polytechnic (NYP), which nurses can advance their studies in Advanced Diploma in Emergency Nursing. Also those who wanted to pursue master in Nursing, you can also go ahead with NUS Masters in Nursing, and you can be a registered APN (Advanced Practice Nurse).
Question: How is it like working in ED?
Ms Rachel: I think everyday in ED is different. ED nurses work very closely with the ED medical team and the allied health to provide optimal care and safe care for the patients. So i would say in the ED, we really require a good teamwork and good communication skills, [and those are] really important when working in ED.
Question: To what extent do ED nurses be able to make decisions when first receiving an emergency patient?
Ms Rachel: … From what I understand, ED nurses have a lot of empowerment [to make decisions]. So our decisions are based on the policy guided by the department. For example – the decision making power of the ED nurses when the patients arrive at the ED – they will have to take up the responsibility and do a proper assessment to assess the patient. Then ,they will decide which patient will be seen first by the physician. I think there is a lot of empowerment being an ED nurse!
Question: How do you cope with visually-disturbing trauma?
Ms Rachel: I do agree that the movies and dramas are sometimes very scary, but for me, instead of focussing on the trauma scene or wound, we will focus on the patient’s care. We always take the patient as our main focus and view them holistically. Also, we take it as a learning opportunity everytime we see trauma cases for us to know the patient better and how to handle the case. I don’t know maybe for those who are more visually traumatised by these scenes, watching dramas like ER. I like Bones, things like that, can help! At least these dramas can help you anticipate and see this is roughly what you can do and see.
Question: How is the working environment especially during this COVID-19 Pandemic?
Ms Rachel: As a frontline staff, we are currently working in the Personal Protective Equipment (PPE) for 8-10 hours per day. I think it is really tough especially for the new nurses that just joined us. In the initial phase of the pandemic there was also much uncertainty regarding the virus and fears towards our staff and their family members. However, as time goes by we are heading into our third year of this pandemic, I think we are getting more resilient and the nurses are also adapting to the new norm. What we do despite working in a very tough environment, is to look out for one another. We always see who needs help and needs support. For that, with the PPE, we will try to send our staff for frequent water breaks so that everyone can be well hydrated during their shifts.
Question: How do ED nurses usually prepare for critically-ill patients coming into the ED?
Ms Rachel: Upon arrival and assessment, the critically-ill patients will be sent to a Resuscitation Room where they will have close monitoring. These patients will receive immediate medical attention from the doctors and the ED nurse. The ED nurses working in these Resus Rooms are very well-trained and they know their respective roles very well and they work as a team [with others] to stabilise the patient.
Question: “ED nurses don't really get to know their patients” - how true is this stereotype?
Ms Rachel: Honestly speaking I don’t think this is true. I think ED nurses need to have very good communication skills so that we can quickly build a rapport with our patients in order to understand what is the reason they are coming into the Emergency Department. We also need to communicate with them to help them discharge back home safely.
Question: Any tips/advice for students who wish to join ED?
Ms Rachel: My advice to those of you who are interested to join the ED, firstly, you need to be brave to take up the challenge. If you really love to work in a fast paced environment and you like an exciting working environment do consider Emergency Nursing. Another thing is that in the ED every shift is not the same, it’s not a routine thing you do, everyday you will get to see different cases you will get to learn new things. To adapt well you will need to stay calm, don’t panic and keep an open mind. Everyday you’ll learn something new. Ultimately, if you don’t give it a try, you will never know. So for the students out there just give it a try, be brave and join us, after all, if you feel that the ED is not for you, there are always other options out there. My take on this is to take up the challenge and take it as a learning opportunity.
Ms Rachel: Just give it a try! #YOLO right, you only live once, if you feel that you really cannot cope you can always choose other areas. If you really like something not routine and mundane you can always try ED. I think we face different problems and patients everyday. It's something you can consider if you like something exciting.
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