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The nursing staff are the backbone of the department and some of them have many years ED experience. You may find initial observations, ECGs, bloods and cannulation are done by the nurses, although you should not assume this will happen. In addition, the Emergency nurse practitioners (ENP’s) treat the majority of minor patients themselves.

The nurses will also suture, plaster and apply dressings, but, remember, the department works as a team and the nurses are NOT there to clean up after you. In particular, procedure trolleys should be cleared by the person performing the procedure, even if someone says they will do it for you, you should remove all the sharps yourself. 

At times there are more doctors than nurses, who are consequently stretched. Asking 'for a set of obs' in these circumstances is not likely to be appreciated. If you make the effort to get the obs trolley and drive the machinery yourself, put your own sheet on the bed or run through and put a bag of fluid up etc, not only will this earn you a great deal of 'brownie points' but the patient will be sorted out much quicker, which is-after all- your priority. If you do this then the next time you need help, you will get it much quicker. It is a team, and NONE of the doctors should be too proud to muck in. Many of these skills, such as dipping urine, doing a BM etc could be tested in the MCEM OSCE exam, so if you are used to actually doing them you are more likely to  sail through.

The nurses are encouraged to question you if they feel you are not doing something according to normal practice – listen to what they have to say, they are probably right. If you are unsure speak to a senior doctor. To reiterate, please, if the Sister says "Are you sure you want to....." ALWAYS think twice and get advice. Once again there is no place for pride in this A&E.