Being a charge nurse in an inner-city ER can, on a busy day with high acuity patients, begin to feel a bit like what I imagine leading a field disaster unit might. You are literally running the whole show; controlling who gets seen and when, assigning patients to nurses and doctors, determining the course of action for each case – you are the last word and assume complete responsibility for everyone who walks through the door. Some of them go home, some are admitted, and some of them die. Sometimes you are triaging patients and making preliminary diagnoses guiding their care at the same time.
In ERs in the U. S., there is no limit to the number of patients we admit (mind you, I strongly believe this is a just law). We are bound by federally mandated legislation to accept everyone who walks in through the door (or is brought in by EMS). This can create some very dangerous and stressful dilemmas – you quickly run out of resources and then my friend, you are flying on your own. And it is a lonely flight – you spend every moment expecting and preparing for the next disaster and putting out fires.
Right now I feel like I’ve been beaten with a stick, like my brain is cotten candy, like I am so tired I can’t go to sleep. Today I was charge.
I am grateful and privileged to have my job, and I’m happy with every opportunity I have to help someone. I think we are all capable of rising to this level, whether we think so or not.
Charge – it’s a state of mind…