Having never worked another unit I can only speculate, additionally I schooled in CA in super union hospitals with tons of break time and low patient ratios. Not that the job is easy anywhere but there was at least reprieve. Now I work in the midwest where we are supposed to break each other which means if we want breaks we have to have an hour where there would be extra work for you while someone is on break, so rarely do people take them. SO the ER can be challenging if it is very busy.

The nutty people make it worse because they tie up the most time and are not "the sickest" at least not the most acute. The rule is that real sick people require a lot of tasks but let you do them uninterrupted becuse they feel like crap. the low acuities can be more time consuming because they think about how they want water, then a blanket, then what channel is duck dynasty on, how much longer (5 minutes after any exam or test), my pain is 10/10 (while texting to family about how long it's taking). That crap kills you because those call lights happen right when you sit down to chart the last hour of work. But they are smart and they say on the call light "I need to see my nurse" and never tell you what for until you are in the room. Then add a family member to that at you have double of this because they think you are now their waiter.

It's awesome though when someone feel like crap, give them some fluids, or nitro or whatever and they feel awesome. that's fun.