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An Intimate Glimpse of Emergency Nurses at Work

Molyneux, Jacob

AJN, American Journal of Nursing: September 2020 - Volume 120 - Issue 9 - p 46-47
doi: 10.1097/01.NAJ.0000697648.35428.79
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Michelle Lyon, RN, an ED nurse at the University of Kentucky Albert B. Chandler Hospital, Lexington.

The work of nurses in the ED turns out to be inherently gripping when seen up close on film. Even the moments in between, when nothing seems to be happening. Good film editing helps. But it's primarily the people. Nursing seems to bring something essential in a person to the fore in a way sitting at a desk in an office simply doesn't. You just can't hide it from the camera and the interviewer.

On October 14, for the start of Emergency Nurses Week, the filmmaker–producer team of Carolyn Jones and Lisa Frank will release In Case of Emergency (https://incaseofemergency.film), their latest film profiling nurses (their previous films were TheAmerican Nurse, which portrayed nurses across the country, and Defining Hope, which dealt with hospice and hospice nurses).

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A child cradled in his mother's arms is straining for breath, small chest rising and falling rapidly, the mother obviously upset by her child's condition. In the film, nurse Jennifer Hanks of UnityPoint Health, Finley Hospital, Dubuque, Iowa, is seen soothing the mother's concerns and establishing a rapport with the child as she adeptly gathers assessment information and then treats the child with a nebulizer. Says Hanks, reflecting on such moments in the daily life of an ED nurse, “It's that human component that makes all the difference.”

Made with support from the Emergency Nurses Association, the film introduces us to individual nurses in EDs across the country. The filmmakers have shared photos from the shoot with AJN; we're printing five of them here (and one on our cover, of nurse Rabih Saad, RN, Ascension St. John Hospital, Detroit, as he treats a gunshot victim).

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“Your ability to care for a person in their greatest moment of need is in an emergency department,” says Cathlyn Robinson, RN, St. Joseph's University Medical Center, Paterson, New Jersey. Robinson, an articulate and confident presence quoted throughout the film, works in the “third-busiest freestanding emergency department in the country.” It's clear that for Robinson, ED nursing is a vocation. “I know the first day,” she says, “whether you're going to make it in this work.”

This film is also a portrait of our society. The theme returns like a refrain throughout: ED nurses reckon daily with the people our communities are failing, the mentally ill, substance abusers, the very old, the uninsured, and those lacking primary care. Says Cathlyn Robinson (see photo above), “If we could have caught them in the community with resources and support, then we would have been able to avoid this visit to the emergency department, and possibly a hospital admission. . . . We are kind of the catchall for people who have nowhere else to go.”

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According to the Agency for Healthcare Research and Quality, the rate of visits to the ED for mental illness/substance abuse increased over 44% from 2006 to 2014. Many ED nurses feel overwhelmed by the lack of adequate resources to respond to the increasingly urgent needs of these populations. In this photo, a woman who has attempted suicide lies on a gurney in the hallway of the ED.

COVID-19 has reminded us of what's at stake for ED nurses, and how much we depend on them. And despite the issues raised by this film, the sheer vitality of the individual nurses leaves a hopeful impression. In one poignant scene, a nurse sings a country song to a developmentally impaired man to calm his fear of needles. In another, a nurse recalls why she became a nurse. Describing time spent in the hospital as a child, she says, “The feeling that I had when the nurses took care of me, that is what I wanted to do with my life.”—Jacob Molyneux, senior editor

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A curiously pensive moment, shared with a patient: In this photo, nurse Nancy Pitcock of Texas Health Presbyterian Hospital, Dallas, works with a patient to find resources to help her with a behavioral health issue.
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