Why are emergency nurses not considered critical care nurses?

[JessicRN]

Just an observation but why are emergency nurses not considered critical care nurses? Who deals with more critical patients? We work on the same patients although we take care of more critical patients at one time on many occassions. We do the many of the same procedures (internal pacemakes, arterial lines,burr holes). We give the many of the same drips (dopamine,neosynephrine). We have the same education need the same prerequsites (ACLS PALS, arrythmia interpretation). If you work in an ED that has Pediatrics dept then you need to know more because we are dealing with completly different group of patients with different needs. We monotor many of our patients on telemetry and have no telemetry nurse manning the central monitors. I also can't tell you how many times we have kept patients in the ED because "they were not stable enough to go to the ICU". We are not allowed to sent patients to the ICU with critical low vital signs until we stabalize them. We have to do most of the admission orders before we send them. (put in central lines, start drips,give all IV meds, if we start blood we keep them one hour after we start. We have to address all abnormal blood values).Many times we board ICU patients in the ED many times we recover patients from the OR because there is no PACU nurse afterhours. I love it when an ICU nurse is floated to us. Half the time we give them the most critical person then devide the rest between us because they are totally overwhelmed. I am not saying we are more special then ICU or PACU or NICU nurses but we should at least be considered one of them.

[tridil2000, MSN, RN]

Just an observation but why are emergency nurses not considered critical care nurses? Who deals with more critical patients? We work on the same patients although we take care of more critical patients at one time on many occassions. We do the many of the same procedures (internal pacemakes, arterial lines,burr holes). We give the many of the same drips (dopamine,neosynephrine). We have the same education need the same prerequsites (ACLS PALS, arrythmia interpretation). If you work in an ED that has Pediatrics dept then you need to know more because we are dealing with completly different group of patients with different needs. We monotor many of our patients on telemetry and have no telemetry nurse manning the central monitors. I also can't tell you how many times we have kept patients in the ED because "they were not stable enough to go to the ICU". We are not allowed to sent patients to the ICU with critical low vital signs until we stabalize them. We have to do most of the admission orders before we send them. (put in central lines, start drips,give all IV meds, if we start blood we keep them one hour after we start. We have to address all abnormal blood values).Many times we board ICU patients in the ED many times we recover patients from the OR because there is no PACU nurse afterhours. I love it when an ICU nurse is floated to us. Half the time we give them the most critical person then devide the rest between us because they are totally overwhelmed. I am not saying we are more special then ICU or PACU or NICU nurses but we should at least be considered one of them.

i've been doing critical care and ed for 20 years and have my cen and ccrn certifications.

er IS critical care and i'll go head on with anyone who doesn't think so.

[RN34TX]

As a former ICU but now PACU nurse, I feel your pain.

Like you in the ER, when the ICU's are full, our PACU is the ICU overflow.

I take ICU overflow patients almost every shift I work.

Our PACU consists almost entirely of ex-ICU RN's.

The ICU charge nurses and managers have no problem with telling me "you should be able to take this patient" when the mood and convenience suits them.

They seem to have all the faith in the world that the PACU should be able to take train wreck ICU patients, yet we are still somehow not real ICU nurses anymore once one of us moves to PACU.

I say that if we as PACU nurses somehow aren't "real" ICU nurses then we shouldn't be taking any of their patients.

[TazziRN, RN]

My understanding of a critical care nurse is anyone who is trained to deal with pts on monitors and drips and needing life support. That covers ER, ICU, tele, and PACU.

[nuangel1, BSN, RN]

i agree with tazzi 100 %.i have done er pacu and icu/ccu.

[debbyed]

:welcome: The only difference I see is attitude.

ER nurses look at the critical problem, stabilize it and than treat and street or treat and ship; Whereas Critical Care nurses look at the whole patient, the why's and wherefore's.:studyowl:

We the ER nurses just try to keep the really critical patients alive long enought for you the critical care nurses to cure them if you can.

Without one you can't have the other.:caduceus:

[EDValerieRN, ASN, RN]

I think we are critical care nurses... but we are also urgent care nurses. I'm sure all of you have had those nights with an acute MI in one room and a broken wrist in the next... I'm thinking that we may not be considered critical care because it isn't all we do, all the time. Something else that may play into it is technically, we are supposed to be sending our pts up to the ICU ASAP, so in theory we don't spend much time with the sickies.

We all know that isn't true, I got off a shift last week where I had 2 ICU patients my entire shift. Only ICU nurses are allowed to float to our department for this reason.... it beats me.

[TazziRN, RN]

Last Saturday I got a 73-yr-old man with heat exhaustion. By helicopter. Ended up transferring him out for cardiac involvement. The next day I got two more helicopters with two firefighters with heat exhaustion from fighting a brush fire. One ended up admitted. The second one almost did. The day after that I was off but another helicopter arrived with another heat exhaustion pt. My firsst day back to work I got yet another helicopter with a drowning victim that we transferred out. Don't tell me I'm not a critical care nurse, I'm liable to bop you upside the head!!!

BTW......our pad usually only sees helicopters that are taking our pts out. Only once or twice a year do they bring us something. Five in one week had us walking around dumbfounded.

[Kymmi]

I havent figured out how to paste someone elses reply here along with mine but Im trying to say Debbyed is exactly right. What I really want to know is why the OP is wondering....I mean each even though Im considered a ICU nurse and someone else might be a ED/ER nurse that is basically because thats the department that we work in. I float to the ER at times and we've had ER nurses floated into ICU and other than the title we've given each other (ER vs ICU nurse) we are all trained to care for the same patients/situations/equipment/medications.

[shelle001]

I havent figured out how to paste someone elses reply here along with mine but Im trying to say Debbyed is exactly right.

Kymmi,

As per the above deliberate example, the way you do what you're after, is to hit the quote button directly underneath (and to the right of) the post you want to quote. Not hit the reply button at ultimate bottom of thread/page.

[Lurksalot, BSN, RN]

Where are they not considered critical care nurses? They have to be nurses of practically every specialty. I've seen an ED nurse have four critical care patients all waiting for beds in the CCU, but the ED was not allowed to send them because it would be too many patients for the CCU ratios??!! So if anything, I think ED nurses are multi-specialty.

Is there a real sort of classification system or something, or is it someone saying person-to person that ED nurses are not considered CC nurses? Really curious about this, off to the professioanl organization sites to read...

[sjt9721, BSN, RN]

AACN recognizes that critical care nurses work in several types of areas, including the ED, Radiology, PACU, etc, etc.

To the OP: Who told you we weren't?