Perry Horne, RN, decided the neuro ICU did not have enough adrenaline, so he transferred to the emergency and critical care departments at Randolph Hospital in Asheboro, NC, where he's been for 15 years.

In addition to the high-test environment and patient contact involved with emergency and critical care nursing, Horne enjoys teaching others, especially in real-time.

"A lot of my job is unit education and clinical management," he said, "but I love to jump in when it's busy to help with the flow and everything."

Mondays in the Randolph ED are anything but dull. "Monday is usually our busiest day," Horne said, recalling one particularly stressful day.

"We had a nurse who called in, and we had to send another nurse home because of illness, so we were short-staffed. The hospital was full, so we were holding patients in ED. They kept rolling in, and we went to our same-day surgery unit and pulled their stretchers into ED. We had beds everywhere."

During that crazy day, Horne briefly wondered why he got into this profession. "But when it was all over I had the best feeling because of the teamwork. We were short two nurses, and having everyone pulling together really gives you a good feeling.

"I'm just awed by is the camaraderie between all the staff members. It is the greatest group I've ever worked with."

Special Populations

Horne has lately turned his attention to caring for older adults who present to the ED, especially those with Alzheimer's or other dementias.

"My mother has been diagnosed with Alzheimer's, so I'm taking a different look at those patients who come in from nursing homes with dementia and Alzheimer's. That population really sparked a new interest in me."

Horne and his colleagues discuss how they can accommodate these patients' special needs. Many times, a patient has to wait for transportation back to a skilled nursing facility, which can create boredom and agitation.

"We will sit them at the nurses station and give them trays with papers and pens, so they think they're working. That has helped, because it opens up a room, and also someone is watching the patient."

Self-Motivation

Self-motivation is the key to working in an environment like Horne's. "You have to be kind of a gung-ho person and willing to jump in when needed."

A bachelor's degree also is beneficial, said Horne, who is pursuing the degree. "I'm enrolled in BSN program, but I thought for years an RN was all I needed. But after starting the classes, I found a BSN will take you even further. I'm thinking differently since I started the program."

His colleagues have nothing but praise for his nursing skills.

"He may not be a staff nurse, but still has the skills to help anyone and will," says one. "He goes above and beyond every single day for everyone in this department, whether secretary, tech or transporter. He is working full-time and still is going for his BSN full time. He loves being a nurse and tells everyone that every day."