FRONT-LINE MEDICINE: EMERGENCY NURSES RECOGNIZED

In a three-hour period on a recent shift of emergency nurse Robert Grayhek, the St. Francis Medical Center emergency department handled eight trauma patients brought in by three helicopters and five ambulances, two heart attacks plus a nose bleed, a couple of colds and a belly ache.

While that's busier than usual, Grayhek said, it demonstrates how emergency nurses must be ready for anything.

Emergency nurses were honored Wednesday during Emergency Nurse Day. Mayor Al Spradling III issued proclamations and toured the emergency departments of St. Francis and Southeast Missouri Hospital as a way to recognize these nurses.

"Emergency Nurse Day is a recognition day, a way to say thanks for being there," said Pat Pennington, nurse manager of emergency services at Southeast Missouri Hospital.

Emergency nurses don't always get a lot of recognition, said Marcia Abernathy, director of emergency services at St. Francis Medical Center. She said trauma and extremely ill patients often don't remember much about the care they received in the emergency department.

Patients who have less serious problems may only remember the wait they had to endure since emergency patients are seen in order of the severity of the problem, not first-come, first-served.

"Everybody who comes in the emergency door perceives themselves as ill, whether it's a parent bringing in a child with a cold or an ambulance bringing in a car wreck victim," Grayhek said. They all deserve the best care you can give them, he said.

But constantly moving from one situation to another can be stressful for nurses, Abernathy said.

"One of the biggest stressors is the flux of emotions when you change from something like taking care of a sore throat to treating a trauma case," she said.

"Emergency nurses have to have a personality that can deal with the unknown and high stress because you never know what's going to come in," Pennington said.

She said working in emergency requires being able to think on your feet.

"You have to be able to analyze the situation and jump into action at a moment's notice," Pennington said.

That's been the case for the 23 years Pennington has worked in the Southeast emergency room and the 20 years Abernathy has worked in emergency at St. Francis.

While the dedication of the nurses has stayed the same, much around them has changed in that time.

Pennington said 23 years ago, doctors came from their homes or offices to treat emergency cases. Today, emergency rooms have full-time physicians who specialize in emergency care.

Technology has also brought changes, Abernathy said. There are clot-dissolving drugs that can stop a heart attack. Portable X-ray machines and in some rooms standard X-ray machines that mean patients don't have to be transported around the hospital. There are more sophisticated monitors and diagnostic equipment.

All are meant to get patients faster, better treatment.

It's also meant more specialized training for emergency nurses, Pennington said.

Emergency nurses get specialty training in cardiac life support, pediatric cardiac life support and trauma training. Plus emergency nurses attend numerous educational training seminars every year.

To help with training, local emergency nurses are organizing a southeast Missouri chapter of the Emergency Nurse Association, a national association that has about 50,000 members.

Grayhek, who is president-elect of the local chapter, said the organization's main function is to offer continuing education programs and certification exams.

Continuing education is especially important for emergency nurses because of the range of patients they must treat.

"Our speciality is dealing with what walks in the door," Grayhek said.

"We have to be ready to handle anything," Pennington said. "Because you never know hour to hour what's going to come in."