Be Proactive, Not Reactive!

Setting up the room at the start of the shift, gathering what an intubation will need before it happens, and the two questions to ask for every patient.

Be Proactive, Not Reactive

As an ER nurse, you should always strive to be proactive — not reactive. That means preparing for critical situations before they happen. When things get chaotic, the nurse who prepared ahead of time is the one who can stay focused and effective.

Prepare Your Rooms

Have your room ready at the start of your shift. This includes: • A bag-valve mask (BVM) at the head of the bed • Suction connected and tested • Supplies to connect the patient to the cardiac monitor • IV start supplies readily accessible • An IV pump and pole (especially if the gurney doesn't have one) • Ensure the point-of-care glucose monitor is charged and functional There is always something to do — setting up your room properly saves precious time when seconds matter.

Anticipate the Needs of Your Sickest Patients

If you know your patient is likely to be intubated, start gathering: • Urinary catheter supplies • OG tube supplies • Soft restraints • Post-intubation sedation medications Be ready to administer what's needed after the airway is secured — not just during the procedure. If you anticipate: • Fluids -> Spike the bag in advance • Vasopressors -> Mix and label them early • Central or arterial lines -> Gather the required kits and equipment • Chest tubes or paracentesis -> Prep the supplies ahead of time The more you anticipate, the smoother the care will be.

Ask the Right Questions

For every patient, ask yourself: • What are the possible complications? • How can I monitor for them or prevent them? Example: Your patient arrives with a GCS of 3 from an opioid overdose, requiring Narcan. • Complication: Narcan may wear off, leading to respiratory decline or arrest. • Proactive monitoring: Stay at the bedside and observe for equal chest rise and fall. But if you have multiple patients and can't watch continuously, consider using end-tidal CO2 monitoring. It's a powerful tool for tracking respiratory effort and early signs of decline. There is always something to do. Anticipate. Prepare. Stay ahead. Be proactive — not reactive.

Be Proactive, Not Reactive!