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6 skills that amplify a nurse’s sixth sense

It takes a remarkable amount of education and training to become a nurse or a physician—especially in the ER, where staff has to be prepared to handle anything and everything.

Of course, there are still some skills, as imperative as they are, that can’t be gleaned from an 800-page textbook or countless hours in the classroom. Instead, many of these qualities are inherent. Meanwhile, others come with experience.

Curious to learn more about these unofficial offshoots of medical expertise, we sat down with both NY Med star and emergency room physician Dr. Debbie Yi and former colleague Katie Duke to have a little chat.

Together, these accomplished women crafted a list of six all-important qualities that a physician or nurse, especially one braving the ER, will call upon daily to get the job done.

Here’s what they had to say.

 

1. Bull**** detector

Patients are constantly trying to fool doctors and nurses in the ER. Sometimes it’s rooted in embarrassment, other times addiction…the list goes on, but the outcome is almost always the same:

That’s because many a patient fails to recognize that ER nurses and physicians come equipped with highly efficient internal lie detectors—lie detectors that function well beyond the realm of the pregnant “virgin.”

 

2. Common sense

You can refine your judgment, you can accumulate experience, but you can’t exactly learn common sense. If you could, the hospital would no doubt be seeing far fewer patients—especially those whose decision-making process looks a lot like this:

Fortunately for them, doctors and nurses have more than enough to go around, even when they don’t have enough of themselves to go around, which is critical, especially in the ER.

“People hate the emergency room because they hate the loss of control,” says Debbie. And it’s true—everybody knows the emergency room can be a real wellspring for pandemonium. 

Who’s first? What’s next? How is that even possible?

It’s a melting pot of questions and needs, but with lots of logic and levelheadedness, physicians, nurses and aides can work together to navigate even the most turbulent of waiting-room waters. 

Which brings us to our next quality….

 

3. Being okay with chaos

It’s nearly impossible to envision a frazzled Dr. Debbie, but there’s a reason why the imagination comes up short. “If you’re going to succeed in the ER,” she tells us, “you have to be okay with a lack of control.” Beginning, of course, with the patients.

In a rapid-fire, back-and-forth exchange, both Katie and Debbie describe a familiar scene:

“The patients are everywhere. They’re not in a room; they’ve dragged chairs into the hallway, they’re at the bus stop, they’re outside smoking.”

Everywhere and nowhere all at once…

Then, of course, there is the information. Or, to be more precise, a lack thereof. “The ER is a team sport, and we are all detectives,” Debbie explains. “It could be something so simple, but we are always detectives.” 

A patient in critical condition with no medical records? No known name? It’s up to the doctors and nurses on duty to sort it all out—and sort they do.

“It’s fascinating,” Katie adds, “because other people in that same situation would lose it. They would completely lose their minds.” But not in the ER, where there’s no such luxury. Not if you’re okay with chaos. 

 

4. Trusting your gut

Knowledge is key, and so is skill. But instinct? Instinct is the secret weapon that good physicians and nurses rely on (both inside and outside of the ER) to make the most out of all that knowledge and skill…even when they’re sometimes at odds.

“In the ER, we’re visceral people,” Katie explains. “You just have a feeling.” When skeptical of a diagnosis, a seasoned nurse or physician knows to listen, and listen intently, to his or her gut—to dig deeper. And if they’re convinced that something isn’t quite right, they stick with their guns. They’re patient and they observe.

The result? A combination of intuition and critical thinking that looks a lot like this:

Which is to say, a whole lot of hard-won wins.

 

5. Ability to block out sounds

When the pace really starts to pick up in the ER, everybody needs you, everything is important and nobody wants to wait.

Voices, pagers, sirens, chaos…it takes a well-trained ear to tune out all the clatter and home in on a single, sleepy heartbeat. Luckily, ER nurses and physicians are masters when it comes to selective hearing, so that the sounds being heard are in sync with the priorities of that moment.

 

6. Great (maybe even too great) sense of smell

Sometimes, an accurate assessment can be as quick as…

“Yep, it’s the kidneys.”

That’s because a nose belonging to a nurse or a physician is like no other. Just as an engineer can actually hear flaws in a new design, or a chef’s palate can detect too much of this or too little of that, a nurse’s sense of smell (though often unwittingly) can play a key role in identifying the source of a patient’s complaints.

From body odor to breath, the funkier the smell, the clearer the cause, and a nurse’s willingness to get up close and comfortable has expedited many a long (and expensive) process of diagnosis elimination.

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