David Daniels, RN, knew he wanted to be an emergency department nurse. He went to school and landed his dream job at an academic hospital.
His 32 years and counting as a nurse primarily in hospital EDs has been chaotic at times -- brutal, frustrating and demoralizing, with extreme highs and lows. Like many nurses, Daniels has thought about leaving the profession. [caption id="attachment_55146" align="alignleft" width="125"]
David Daniels, RN[/caption] But the 61-year-old nurse writer of the new book "Oh, Nurse! One Man's Journey Through the Nursing Life, a Personal Account of the Highs and Lows," said despite it all, nursing is a sacred profession. "It's a very demanding job if you take on the responsibility," Daniels said. "You're present at a birth. You're present at a death. You're dealing with people who really aren't having the best day in their lives at all. You deal with injury, death and addictions. And it's really the ER nurse who holds all of that together. It's challenging, and it can be thankless. You could be working with staff members or physicians who can be very condescending and [you think] why would I do this to myself?" Even though he regularly deals with tragedies at work, Daniels confirms being a nurse still is the greatest job in the world.
Suited for the ED
The nurse writer said he thrives amid chaos. "It feeds into my mania or something. The busier it is, the faster I'm working, the wider the smile on my face," he said. While working in an academic ED, everything flowed like a well-run machine, Daniels said. The physicians were passionate and brilliant, which helped to create an ED culture in which physicians and nurses were always learning and worked as a team. "It was just a great place to work," he said. His career also has included nursing jobs at hospitals where the culture was very different.
"I really bounced around and got to some places that, to work in that environment, I just couldn't do it," Daniels said. "I worked in one emergency room where I had never been around a more dysfunctional group of individuals."
He said he could never understand some colleagues' behavior of allowing charts to stack up and not bringing patients back. "The truth would be that the one thing they had in common was that they all hated the patients," the nurse writer added. Daniels said he doesn't have a poker face, and when he'd voice his opinion colleagues could see the displeasure with the way patients were being treated. "It didn't serve me well," he said.
How nurses can make a difference
The nurse writer shared one of the saddest stories of his career happened one Christmas Eve. He had finished his 3 to 11 p.m. shift and was leaving to assemble presents for his kids, when Daniels' manager said they were short-handed and asked if he could work a double.
"It's Christmas Eve and I wanted to go home, but they were stuck -- and I have a hard time saying no -- so I said I'd do half the shift," he said. "Just about that time the paramedic radio went off and it was a young little girl in cardiac arrest. She had severe hypovolemia and electrolyte imbalance and she arrested in her father's arms."
Her parents brought her to the ED, where Daniels and the staff did everything they could to resuscitate the child, without success.
"I ended up staying until 7 a.m.," he said. "I was with the parents. I sat with them and we talked. We really couldn't make sense of anything. But I got them to the point where they were able to get out of the hospital and into their car and leave without their daughter. Somehow, I was able to facilitate that transition for them." That story is one of the reasons nursing is the most sacred profession, according to Daniels.
Nursing -- the best job in the world
Daniels said a manager once asked during an employee evaluation how the employer could make things better for him.
"I just told her you give me a good day's pay for a good day's work. I bring my own water and coffee, I'm happy," he said. "And her jaw hit the floor."
One of the reasons Daniels loves the job is because of the relationships he has built with coworkers and patients. "I want to be a good nurse," he said. "For some reason, I've been blessed with the ability to become a good nurse. When I'm taking care of a patient, I look at them straight in the eye and they look at me. They know they've got somebody who is caring for them. Whatever I'm doing in my time here on earth, I'm doing my best to help others. I find it very gratifying." Relationships and bonds with coworkers have been invaluable, he said. He describes working with a string of friends over the years as "phenomenal," despite the sometimes trying circumstances.
"The environment was less than optimal -- with the chaos and all the grief and the stress -- but when they come back and say, 'Dave, when I worked with you, I knew it was always going to be a good day,' that stuff is like nectar," Daniels said.
Some of those coworkers inspire Daniels to want to be better. Also, physicians who exemplify medicine in their passion and professionalism guide Daniels, he said. "Even though their knowledge and skill could highlight my own inadequacies, I found that could be so motivating and inspiring," Daniels said. "I wanted to go home and read more and learn more, so I could work productively beside them and even anticipate what their next move is going to be. To work hand-in-hand like that is really cool."
Advice from a nurse writer
Ms. Rae, one of Daniels' nursing school instructors, told Daniels to take time to refresh and care for himself because nursing would chew him up and spit him out once there was nothing left of him.
"I didn't get it at the time, but I certainly get it now," he said. "So take time to refresh yourself. Do those things that fill your soul. Get a thick skin and learn not to take anything personally, because that's where you get in trouble."
The nurse writer said he hopes "Oh, Nurse!" becomes required reading in nursing schools, offering a real look at some of the ups and downs of the career. Because, according to Daniels, anybody can become an RN but not everybody is going to be a nurse. There's a difference. He also hopes the book prompts nurses and physicians to look at how they might be treating one another. "Nurses, doctors, other healthcare providers, they pride themselves on the great care they give their patients," he said. "Maybe they should extend that same care to their colleagues."
Take these courses on the ED:
A Valid, Reliable Triage System Can Help You Better Assess ED Patients' Acuity (1 contact hr) This module provides nurses with an understanding of the history, types and methods of ED triage, with an emphasis on the five-level triage systems. Families in the ED: Helpful or Harmful? (1 contact hr) As nurses, we know that family members are included in our care of the patient. However, we may ask, "Should family members be allowed to watch a resuscitation?" and "Should they be able to touch the patient?" These questions surround the issue of family member presence during code situations and invasive procedures. By being familiar with the history of family presence and the concerns, legal implications, and policy recommendations surrounding it, nurses will be better able to advocate for patients and families. Cardiac Resuscitation in the ED (1 contact hr) This module applies the 2015 updated CPR guidelines to help "resuscitate" nurses' knowledge and skills of evidence-based practice and reviews the most recent recommendations. The directive to "look, listen, and feel for breathing" is no longer recommended to help the recognition of arrest. However, the main principles of CPR remain the same with slight alterations in compression and breathing as well as medications.
