Angels and Tough Guys, Part 2

June 23, 2010
Gerald O'Malley, DO

Male nurses have to be the toughest guys in the ER but they also have to know when to turn it off. The meanest, saltiest, crustiest ER nurse becomes a quiet, tender bodyguard around a sick or injured kid.

A lot of the nurses and techs that work in the ER are men - far more than you will find anywhere else in the hospital, including the OR. It makes sense: ER nurses are the equivalent of top gun fighter pilots. They are the best of the best. In terms of nursing jobs, the closest thing to an ER nurse is an ICU nurse, but what an ICU nurse does for one patient at a time, an ER nurse does for four...while wrestling a drunk. In addition, ER nurses need to understand all the arcane hospital rules and regulations to keep themselves and the doctors out of trouble.

Male RNs in the ER are a lot like cops. Many of them have law enforcement or military backgrounds. They walk an incredibly thin tightrope, having to master the increasingly complicated skills of emergency resuscitation, often correcting the young physicians that are supposed to know more than them.

I’ve witnessed male nurses rescue patients from incompetent male and female physicians half their age, all the while being dressed down by the doctor. Those lessons in professionalism and self-control stay with me and inspire me when I’m faced with hostile, irate, irrational people in my own life.

Male nurses take a lot of crap from just about everyone - patients and their families, doctors, paramedics, and each other. Male nurses have their masculinity mocked by men that beat their wives, abandon their children and have no jobs. Male nurses stare down crack-mad psychos and weapons-wielding gangstas hopped up on PCP - circumstances in which doctors, male and female, go running for cover.

I’ve never seen a female nurse take the low road and malign the masculinity of a male RN in the form of an insult or even in playful teasing because they know that too often, the male nurse will be the first line of defense between them and a drug-crazed maniac or alcohol-fueled felon.

Male nurses have to be the toughest guys in the ER but they also have to know when to turn it off. The meanest, saltiest, crustiest ER nurse becomes a quiet, tender bodyguard around a sick or injured kid.

I won’t say that I prefer working with male ER nurses, but I notice a more relaxed, almost locker-room atmosphere when the crew is mostly men. There is more joking and sports-talk and less complaining and tension. (That sentence is sure to get me in trouble.)

As I mentioned last week, I’m changing jobs soon. I find myself reflecting on the eight years that I’ve worked here (12 if you count residency) and the number of times that one of the nurses took a punch for me, or corrected one of my medication errors, or watched my kids when the babysitter bailed, or drove to New York when my father died, or catheterized me when my kidney tumor exploded and I had a bladder full of blood, or wrapped up a kid while I wrote the death certificate, or sang an old Pogues song at the bar after a particularly heinous shift.

Some of these men and women have been closer to me than my own family and leaving them is devastating. I don’t want to say those goodbyes but I know I have to.