Nurses get special training class for hectic ER work

Valley Hospital running course

Labor and delivery nurses help bring babies into the world. Cardiac care nurses work with patients who have heart problems. Emergency room nurses deal with just about everything under the sun.

They need to be trained to handle gunshot wounds, broken bones, collapsed lungs, snake bites, overdoses, poisonings, stabbings, appendicitis -- the list goes on.

Valley Health System is currently training nurses to work in the fast-paced ER department. The class is led by Tim Vietmeier, education specialist for emergency medicine at Valley Hospital, who conducts the six-week classroom portion of the instruction.

A nurse for 14 years, he spent his entire career in the ER/critical care setting, including during the Rodney King riots when his hospital received 10 to 20 gunshot patients a day.

"Most people don't realize the amount of critical thinking required of an ER nurse," Vietmeier said. "A lot of people still see nurses as subservient to doctors but their role has changed. They have to look at a situation critically, play a Sherlock Holmes kind of role. Nurses are the gatekeepers, the safety guards for the patient."

At Valley Hospital, peak time in the ER can be any time, with the 3 p.m. to midnight shift getting a constant flow of patients.

The top three types of cases seen are cardiac and stroke patients, followed by minor trauma then abdominal complaints. The latter can be anything from appendicitis to food poisoning. It could also have nothing to do with the abdomen at all.

"Sometimes you'll get a guy in who tells you he's having the 'worst stomach ache I've ever had,' " Vietmeier said. "But he'll (act brave) and say, 'Just give me a little Maalox.' Well, chances are, that guy's having a heart attack. You have to be able to read people, read between to the lines when you're an ER nurse."

The students in the class range in age from 24 to 44 and the most experienced got into health care in 1987.

To be accepted into the course, nurses must have at least six months, preferably one year, of experience as a medical/surgical nurse or the equivalent of working in a high-stress area like a paramedic, nurse apprentice or licensed practical nurse.

Applicants are carefully screened to ensure they'll make good ER nurses. The class, which is offered twice a year, normally sees at least one student opt out.

Current students include: Dereka Martine , a recent nursing graduate who worked on a medical/surgical floor before joining the ER course; Janet Glenny, a new nurse graduate who was previously an intermediate medic with American Medical Response for four years; Ngaire McQueen, originally from New Zealand and had ER experience there but wanted this course to provide an easier transition to American-style medicine; Pamela Salas, a pediatric oncology nurse from New York; Robin Thompson who has been a nurse at Summerlin Hospital for four years and works on the renal medical telemetry floor; Maggie Ausburn, also from Summerlin Hospital.

Being an ER nurse requires a personality that thrives on action, plus the ability to multi-task. The course also demands they have strong muscles.

The text book, "Sheelty's Emergency Nursing," is a good three inches thick and the even thicker manual could be used by a physical trainer.

The women said they study between two and three hours each night without fail. Some postpone doing housework to commit the evening to studying, like Salas, who gets up at 4:40 every morning for household chores and lives by her to-do list.

"Between schedules with day care and school and studying, I don't have a lot of time," she said. "When I knew I'd be in this class, I went out and bought a crock pot."

Ausburn, the youngest student, already works with Summerlin's ER Holding patients. The term refers to an patient admitted to the hospital from the emergency room but they are awaiting a free bed in the hospital.

That, unfortunately, is a not an uncommon situation in a town with an exploding population.

"We're already specialized," Ausburn said. "But an ER nurse has to know how to handle a variety of areas, a mix of problems. I like the challenge. It keeps it interesting."

The students all said they like helping others, being thanked for little things like supplying a warm blanket or just taking the time to talk with patients.

"It (nursing) gives you a human perspective on life," Thompson said. "You see babies being born and you see people die. The knit-picky things in life don't matter."

In addition to doing their clinical rotations in the emergency department, students also spend time in the intensive care unit and the cardiac catheterization lab to experience the continuum of care.

The Valley Health System offers the Adopt a Student program. Anyone who has been accepted into the nursing program at the Community College of Southern Nevada can apply for up to $2,000 of financial assistance per semester. The program will go into effect at UNLV in the spring. For more information, call 388-4926.


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