High-octane nursing

Fast paced and "action packed" describe more than the latest blockbuster. They also fit emergency nursing.

High-octane nursing

If you're an adrenaline junkie seeking a lifetime of adventure, look no further than emergency nursing, where you could work to save lives in high-pressure situations. Here's a look at some of the aspects that set this niche apart.

The Thrill of the ER

According to Carol Howat, RN, BSN, a nurse in the emergency room of Northwest Community Hospital in Arlington Heights, Illinois, for more than a decade, it's adrenaline that keeps her alert to respond to the volume and variety of patients moving through the ER.

"You hear the overhead page ‘trauma alert, three minutes,' and in those three minutes your heart starts beating faster," says Howat, a certified emergency nurse (CEN). "You don't get nervous, but your adrenaline starts pumping."

High overhead, Teri Campbell's blood is flowing as she leaps into action. Campbell, RN, BSN, CEN, is the chief flight nurse for Air Angels, a critical-care transportation provider based in West Chicago, Illinois. She and her teammates, one paramedic and one pilot, respond to emergencies in a Bell 222 EMS helicopter. "We're adrenaline junkies," she says. "We love the excitement of not knowing what's coming around the corner."

Ready for Anything

Having a wide range of skills at the ready is a must for emergency nurses, since they're called upon to respond to a range of medical emergencies. "We have any type of bizarre thing you can think of," Howat says. "Chances are in your career in the ER, you will see those rare things that you only see in textbooks." Howat has encountered parking lot births, foreign objects lodged in every place they shouldn't be, motorcycle parts stuck in legs and mental cases who truly thought they were on a bus to Sesame Street.

Whether landing in a cornfield or at an industrial complex, Campbell says a flight nurse must know how to adapt. Her team unexpectedly discovered injured children as the wreckage of a car accident was being dismantled. "All of a sudden, our whole scene has changed," she says. "We have to instantly change our plan, change our equipment, change our medication."

The Know-How

Responding to life-or-death scenarios means less direct supervision. "We have a high level of autonomy, and the doctors expect us to function on a lot of standing orders and not wait for them," Howat explains.

This independence comes only after extensive advanced training. "We're often doing extra education, extra certification," Campbell says.

A career in the ER requires a lifelong commitment to learning. "We like a lot of variety, we like a lot of stimulation, we like to know a lot about a lot of things," Howat says. "If you don't like to learn, this is probably not the best place for you."

Demanding and Rewarding

Campbell works two 24-hour shifts per week, and 12-hour days are common in the ER. Howat, who can work up to 10 hours without a break, says the emotional demands are just as great. "When those really serious things come in, the things other people don't have to look at, that gets to us," she says.

Campbell says that even when she knows she's done her best to save a life, she still goes home worrying about a patient's survival. But the job has rewarding moments, too. "Four months later, we've had people walk into our heliplex, and they are now walking, talking, breathing," she says. "They come to give me a hug, because I'm the person who participated in saving their life."

Got What It Takes?

Flight nursing, emergency room nursing and other similar positions are highly coveted. If you want such a job, you'll need to stand out and be experienced. Howat's hospital looks for nurses who already have at least two years of ER or critical-care experience. You'll need at least five years of experience in an ER or ICU to get airborne.

Applicants for emergency room positions should have basic CPR training in addition to advanced life-support training and pediatric advanced life-support (PALS) training. Campbell says applicants for flight nursing positions need "an alphabet soup" of certifications, including not only CPR and PALS, but also ACLS (advanced cardiac life support), PHTLS (prehospital trauma life support), NRP (neonatal resuscitation program), TNCC (trauma nursing course certified) or TNS (trauma nurse specialist).

But for those who choose this career, it's all worth it. "Just knowing you made a difference and that you made someone's pain go away or someone's fear lessen -- those things keep me coming back," Howat says.