A Perspective on Emergency Nursing for Emergency Nurses' Day 2018

As an emergency nurse, every “emergency nurses’ week” over the years has had great meaning for me. But this year, as the Emergency Nurses Association (ENA) President, this week takes on even more significance. 

Over the past year, I have had the opportunity to see the best of emergency nursing and unfortunately, the less then desirable part of emergency nursing as ENA President.

I got to see the best of emergency nursing when I visited Las Vegas in November of 2017 and met with hundreds of nurses as I toured the hospitals that responded to the mass shooting event one month earlier. I shook the hands of nurses who cared for more then 200 gunshot patients in less then eight hours on a single shift. I thanked them for their heroism that night and in true emergency nursing fashion, I was quickly corrected. These nurses did not want to be called heroes, they were simply doing their job that night. This is the best of emergency nursing.

But I have seen the worst of nursing as well. I have watched my own emergency nursing peers attack one another. I have seen them post negative things about one another on social media, write nasty letters to the staff of ENA and work to undermine the efforts of their peers. On far too many occasions, I have found myself apologizing to others for the actions of my own emergency nursing peers. I have seen lateral violence up close and it is not pretty. I am happy to say however, that it is truly a minority of our nurses who undertake such behavior.

This position has given me the opportunity to experience the incredible collegiality of emergency nursing in a way I have never experienced it before. The Presidency not only allowed me to meet nurses in nearly every State in the Union, but I have gotten to meet with nurses from the Netherlands, Poland, Iceland, Norway, Mexico, Canada and Australia, to name a few. What amazes me as I have traveled this country and this world is how the stories that are shared with me about the things emergency nurses love and find frustrating about their jobs rarely changes. We all face the same challenges wherever we work. Not enough staff, rising patient acuities, boarding, workplace violence. It is encouraging to know that we share the same problems regardless of where we practice, allowing us to work together to solve those problems.

I have seen the hurt that emergency nursing brings. In May, at the ENA Day on the Hill event, I asked 175 nurses in attendance to raise their hands if they have been the victim of violence at work. Nearly every hand in the room shot up. This should not have surprised me, for one of the things I did as ENA president this year was to reach out to emergency nurses that I learned of that were the victims of workplace violence to offer my support. I have had to make far too many calls this year, listening to one story after another of a nurse who was bitten, kicked, slapped, punched or in some other way assaulted while trying to care for a patient. I am reminded of the dangers we face every time I go to work.

So what has the ENA Presidency taught me about emergency nursing? How do I summarize my experience on this day that celebrates who we are? I have learned that we are an incredible bunch of people who have been given a gift, the gift to go to work and make a difference every day. Sometimes that means doing incredible things like responding to a mass shooting event, other times, it simply means consoling a child with a wound or helping an elderly patient get dressed for discharge. But every time we go to work, we influence someone in a positive way.

I have learned that lateral violence is alive and well in our profession, that nurses have an incredible capacity to care for others but don’t always extend that to each other. Lateral violence is cyclical. It will only stop when we, as a profession, take a stand against those who perpetrate violence against their own. We must not “like” nasty posts on social media, we must stand up for the nurse who is bullied at work, we must call out nurses who undertake demeaning behavior if we are to break the cycle. No one but us can bring about this change.

I have learned that we are a strong group. We are opinionated and when our voices join together, we can influence change. The “show me your stethoscope” movement was proof of what nurses can do when we work together. 

I have also learned that we are vulnerable. Our workplace causes us to face the worst of humanity at times and people will take advantage of our vulnerability through violence. It is our responsibility to insist on a safe workplace, one with security and training on how to deal with violence. It is our responsibility to report ALL acts of violence, whether verbal or physical, to law enforcement even if we don’t feel supported. This is the only way to effect change. 

I am proud to be an emergency nurse, prouder this year then ever before. Join me in holding your head high, proud of what you do and who you are. But join me in continuing to be a voice for the challenges we face, amongst them, lateral violence and workplace violence. Together, we can make this incredible profession even better! 

Jeff Solheim MSN RN CEN TCRN CFRN FAEN FAAN