She has been vomited on, urinated upon and has treated a patient with his head split wide open.
For Jami Skinner, 37, an emergency room registered nurse, it’s all part of her everyday work.
Skinner hits the ground running three days a week at 7 a.m. at McLaren-Flint’s Trauma and Emergency Center, where she begins her long shift early enough to go over patient stats with the night staff just ending their shifts.
For the next 12 hours, she’ll be going “full throttle,” treating patients with possible heart attacks and strokes, respiratory distress, abdominal pain, etc., plus a few broken bones, stitches and other less severe injuries.
Skinner is usually in charge of four patient rooms in the main area of the ER.
“I like to multi-task,” said Skinner of Fenton. “I love the high-pace environment and the critical thinking that’s required. The ER brings in different people each day with their own set of problems.”
What she is adjusting to are the smells and “stickiness” of the ER, including phlegm and vomit. “When people throw up, I try to stand back so I don’t get hit,” she said. As the mother of five, she is already accustomed to some of these aspects of ER nursing.
In a typical 24-hour period, McLaren-Flint will see between 160 and 190 patients through the doors of the ER. Of that number, between 40 and 60 patients will be admitted for further treatment.
“We’re the ‘stroke hospital,’” Skinner said. “So we see a lot of people with chest pain, stroke symptoms and sepsis.” In life-threatening cases like these, she said, patients are seen right away. “Every minute amounts to loss of heart muscle,” she said.
But the most common reason for an ER visit, in Skinner’s experience, is abdominal pain. It could be a kidney stone, gastroenteritis, a bladder infection, even a pregnancy.
Deciding the best place for treatment within the ER is the job of the triage nurse, who determines the treatment priority of incoming patients, based on an initial assessment and monitoring. Critically ill or injured patients are always given top priority.
The Fast Track area is for non-life-threatening illnesses or injuries, to quickly treat patients with mild ailments like cuts and colds, broken bones, etc., without interfering with the treatment of seriously ill patients.
The Short Stop area is for patients with abdominal pain and similar issues, who may need additional testing. The main ER is for patients with chest pain, stroke symptoms, trauma or older patients with abdominal issues.
If you find yourself or a family member in need of emergency care, Skinner said people should know that it’s not always going to be fast. “People think they’ll get in and out. But you might have to wait on labs or X-rays. Be patient.”
Many ERs, including McLaren, do have online ER check-in so you can register into the ER system, yet wait at home.
Sometimes the reason for long wait times in any ER is that people often use the ER as their doctor’s office, especially if they don’t have health insurance. “Other people have to wait longer then,” Skinner said.
She added that time-management is an especially important tool for ER nursing. “It’s super crucial,” she said. “It’s all on you. You’re going to be behind if you don’t learn it.”
She feels especially suited to ER nursing compared to being an ICU (Intensive Care Unit) or floor nurse because of the personality traits she has for the ER. “I love it,” she said. “It’s crazy down there and I wouldn’t trade it for anything.”
Local emergency rooms include:
Ascension Genesys Hospital in Grand Blanc Township
Level II Trauma Center (able to initiate definitive care for all injured patients)
Hurley Medical Center in Flint
Level I Adult Trauma Center (comprehensive regional source capable of providing total care for every aspect of injury, from prevention through rehabilitation).
Level II Pediatric Trauma Center
Level III Trauma Center (able to provide prompt assessment, resuscitation, surgery, intensive care and stabilization of injured patients and emergency operations)
Should I go to the ER or Urgent Care?
• Urgent care can fill in for your regular doctor on evenings and weekends, for routine injury treatment and acute medical care that a primary physician would typically perform in their office. For example, this means colds and flu, earaches, sprained ankles, minor cuts that require stitches. Some may offer routine X-rays and simple labs.
• ERs are for emergencies, the “bigger stuff” that require immediate care through surgery, labs, CAT scans and MRIs, ultrasounds and access to doctors’ expertise across a variety of disciplines. If you’re experiencing chest pain or weakness on one side of your body, definitely go to an ER via ambulance.
Which hospital ER should you go to in an emergency?
• Understand your insurance policy before an emergency actually happens. Know your co-pay and co-insurance and what your plan will cover if you’re not admitted to the hospital. Your insurer can also tell you which area hospitals take your insurance. Ask the billing department at your hospital of choice whether the ER doctors participate in your insurance plan.
• Know how your insurer covers medically necessary ambulance rides and how your plan defines that term.
• If you call 911 and request an ambulance, it’s the ambulance staff’s call for where they will take you and it’s usually the closest hospital properly equipped to treat you.