November 14, 2014
Mary Dimeo, RN, MN, NP-Adult, ENC(C)
A Typical Day in the Life of a Nurse Practitioner in a Downtown Toronto Emergency Room
Our typical day starts with a quick review of the patients who are registered in the Rapid Assessment Zone of our Emergency Department… then it’s off to the races! On average, my two NP colleagues, and I will each see 10-20 patients a day. Patients present for a variety of reasons, ranging from sprains, broken bones, cuts, falls, to returning for antibiotics or blood thinners. Although the reason for presenting is often repetitive, no two people are the same and that’s what makes it fun and interesting. We mostly see our patients independently but sometimes consult with our physician colleagues to discuss a referral, to sign off on pain medication, or to review an aspect of a case. Not typical of NPs, we do all of our own nursing care as we find this provides continuity of care and expedites service. We all love our job because despite our short interactions with our patients, we find it incredibly fulfilling and meaningful work.
We have had NPs in our department for well over ten years and have found we have a positive impact on improving patient’s access to care, reducing time to being seen, decreasing length of stay, and reducing number of patients leaving before being seen. Furthermore, we have been key in implementing best practice guidelines, counselling, and helping to navigate care for patients starting on blood-thinning medications and patients who have had body fluid exposure (an anxiety provoking situation which requires much counselling and teaching). Aside from our clinical practice, we are also involved in research, teaching, and committees. The predominant part of our non-clinical practice is mentoring NP students. We provide them with a unique work environment where they can learn to manage an undiagnosed patient; this requires that they learn skills such as identifying potential dangerous diagnoses, taking an excellent patient history, and doing a thorough yet focused physical exam meanwhile interpreting lab tests, x-rays, and negotiating a plan of a care.
All in all, we are happy to have the opportunity to combine our love of Emergency medicine with our advanced nursing knowledge and skills to provide care to a wide array of patients.
