Q&A with ER Nurse Manager Annette Soborowicz, RN

SoborowiczWhat does an ER Nurse Manager do?

The primary role is to help with the day-to-day running of the department, making sure that it’s staffed appropriately and that we have tools and resources needed to provide good patient care. There are also other parts of the job as far as budgets, policies and procedures, keeping staff updated and informed and encouraging educational opportunities for staff so they are able to keep their skill sets up. An ER Nurse Manager needs to lead by example and be a mentor, as well as have the ability to be flexible and work staff shifts including weekends and night shifts if need be. My philosophy as an ER Nurse Manager is that in order to truly evaluate the patient experience and my staff experience, I need to be able to understand it and in order to do that, I feel like I need to work alongside my staff so I can do an appropriate evaluation. One thing I don’t ever want to lose is that connection with patients because I really enjoy that piece. If I’m here, even on office days and if it’s really busy, I just jump in.

What do you enjoy about your job as the ER Nurse Manager?

I enjoy it immensely. I really like being able to implement new initiatives and change. I enjoy working with the team, both the frontline staff and administrative staff to bring updated evidence based practices to the community to serve our patients. I think we have a very good team here from our staff to our providers but more importantly, I feel that we have a great leadership structure which is something I feel is unique to this institution. I’ve been in leadership positions before and I’ve never felt that true support or guidance that I feel here. I really feel for the first time I am at home in leadership. I think that speaks volumes for the administration but more importantly, the environment that’s here throughout all departments and entities. It’s been exciting, especially with our new stroke initiative that is up and coming and getting telemedicine here is going to be a great tool to the care we provide. We are going to be starting it out with telestroke because that’s our primary focus right now; but to have telemedicine available to our patients in all entities is going to be great and will hopefully keep more patients in our community versus having to transfer.

When a patient comes to the ER, what information should they bring?

Patients should bring their current medication list, allergies and vaccine records, names of their primary care providers and any pertinent health information. It’s also important to bring a support person with them because when you’re not feeling well, having a second pair of ears is helpful. Finally, patients should make sure they have their current insurance information with them.

What can a patient expect during a visit to the ER?

Although everyone believes they have an emergency and would like to be taken care of first or in the order that they arrived, often this is not the case. When you arrive at the Emergency Room, you will be seen by a triage nurse who documents your concerns and condition. Then, according to what is currently taking place in the ER or Urgent Care and the urgency of your condition, you will either be placed in a room to be seen by a provider or placed back out in a waiting area until a room and provider are available to care for you. Once you are placed in a room and seen by a provider, you are the most important part of your care. The provider will order tests to rule out urgent and emergent conditions. The provider will treat your pain or condition as medically necessary. Your care should be specific to your short-term needs. You will be asked to follow up with your primary provider for future evaluation and treatment.

What are some questions a patient should consider asking when they visit the ER?

They should always make sure they understand what tests are going to be done and why. If medications are going to be given, they have every right to ask what is it for and how it reacts. They should also ask if they are going to be admitted or discharged and make sure they have a thorough understanding of their treatment plan. We have implemented follow-up phone calls the next day to make sure they’re doing okay and to see if they have any questions since their return home.

What is the largest misconception you think patients have about coming to the ER?

The largest misconception is that the Emergency Room will provide a complete diagnosis and treatment for chronic longstanding problems. The ER will treat flare-ups of a chronic issue and stabilize the immediate condition, but chronic health issues should be followed by their primary doctor. The second misconception is ER has all your medical records. The truth is we do not–not all electronic medical records talk to each other. You need to bring a medication list and know your health problems. Patients believe they can dictate tests and medications and the provider has to order it, this is not the case. Every provider treats patients based on their training and expertise as well as the standard of care.

What is the difference between the ER and Urgent Care?

Urgent Care is for something a patient would normally go to their primary care provider for so; minor illnesses and injuries including sore throats, earaches, sprains, strains, colds, coughs, and minor lacerations and fractures. If it is a problem needing a larger work-up, for example, abdominal pain because that may need a CT, those types of complaints would be taken care of in the Emergency Room. Because we are within one entity, our providers work together along with the nurses. Whether you are seen by a nurse practitioner or physician’s assistant in Urgent Care versus a physician in the ER is based on criteria from the standards of care and the triage guidelines. Urgent Care is open 10 am – 10 pm every day. The reason we set those hours is for people who are in pain or feeling sick after hours or on weekends or holidays, we can get them in to see someone right away. Urgent Care is also here for people who can’t get in to see their primary care provider and they need immediate attention. We have some primary care providers in the area who actually work in Urgent Care so even though you come to Urgent Care, a physician could potentially see you. People should still contact their primary care provider first because of that continuity of care and because their physician knows their medical history.

What’s the one piece of advice you’d give patients to improve their overall health?

See your primary physician regularly, follow their advice, exercise at least 30 minutes each day and eat a healthy diet. Take responsibility for knowing your health problems, medications and living healthy.