of course: every part of nursing has its's dangerous patients. However: I knew I would work in the ER when I was 5 years old. When I actually did, I was prepared. IF you like routine and boredom, DON"T WORK IN ER. If you like randomness, spontaneity, stabilize and transfer'em , then do ER. All patients are dangerous at some point: you will be dealing with OD's(especially now with fentanyl- the drug itself is more dangerous than an addict who is hallucinating.), GSW, stabbings, beatings, suicide attempts, head trauma (depending on what level ER. I worked in a level 1 trauma slot which is the highest level).
You will also have psych patients who were brought in from the street and prisoners who are handcuffed and "suddenly need medical care prior to booking".
The hospital police will always be there to help keep you safe BUT, your safety is your responsibility. NEVER under estimate what a patent is capable of.
You will also have excitement; you will have the best assessment skills of any nurse other than ICU; you will have a lot of independence and teamwork with the doctors(they actually trusted my assessments and diagnoses.) We are allowed to order blood work and x-rays prior to the MD assessment. This helped decrease the time the patients had to wait in the ER. I had trust and respect from the MDs. I had my share of codes, I did triage and made decisions if the patient could come back to the clinic the next day or if it was urgent. I could remove sutures but back then,(vintage 80-90's). we weren't allowed to put them in, now, you could probably do that.I was allowed to start aminophylline drips on asthma patients when they didn't respond to the nebs and allowed the MD to write the order after wards! I did postmortem care and had the responsibility for calling the relatives to come to the hospital as quickly and safely as possible. I did something different and intense everyday. Be prepared to be independent when you apply for the job. this is acute care: anything can happen. You will need your BSN.
I worked in a Psych ER and, yes, it was dangerous at times. Often, police would send us people they didn't want to arrest. These were not psych patients; they were individuals on drugs who should have been arrested for disorderly conduct. They didn't want to be held in the Psych ER, so they would try to fight and flee. Fortunately, we had decent security guards and mental health techs.
I think to some degree it really depends on the type of ER you're talking about. There is a range of settings and trauma levels to consider. A small town ER at Level 2 or 3 could be less of a problem as compared to a level 1 ER in a large city. I do think based on my own experience that ER nurses face a higher risk of assault than others (at least prior to COVID). Nowadays though I don't think it's just the ER at risk.
Dangerous how? The only danger I felt was is when I had a four patient assignment and they all had sepsis or were all acuity 4s. It's hard to be in four places at once and meet the time demands required for these diagnosis. I had three sepsis patients at once and it was difficult collecting all the specimens, assessing, infusing the appropriate fluid replacements rapidly, and starting multiple antibiotics on all three. If you don't work in hospital that pays attention the the acuity of the patients they give you then you have a problem unless there are floaters who can come and assist you. Charge nurses have to pay attention to these things. Some patients can be aggressive but you just contact security for help. Magnet hospitals are good to work for because they usually have excellent protocols and practice guidelines that keep you safe.
