Should Emergency Nursing be part of the Critical Care Nursing Specialty on this site?

[loricatus]

This issue has been much discussed under the Emergency Nursing Forum prior to the new upgrade. With the upgrade making Critical Care Nursing a link in the above tab, do you think it is time to move emergency nursing to that subspecialty?

I certainly do. Great arguments have been made (in the Emergency Nursing Forum)to support it being a critical care specialty.

[sjt9721, BSN, RN]

Does the organization of a internet bulletin board really matter in the long run?

I was an ED nurse that maintained CCRN status. It doesn't matter a hill of beans to me where the "Emergency Nursing" thread is...just as long as there IS one!

Turning the argument around...We (as a whole) complain about people abusing the ED for primary care needs, pregnancy tests, and narcotic fixes. Can we really say we're "Emergency" nurses, when a good portion of our patients aren't true emergencies?

Go ahead...I'm wearing my bunker gear for the flames!

[ThrowEdNurse, BSN, RN]

I say, until we start doing Swan's, and shooting cardiac outputs, and titrating fluids to the CWP and/or balloon pumps or managing ventricular shunt drainage for more than a couple of hours, it is not "Critical Care".

At times the acuity can elevate to critical care levels for a while, but it doesn't remain there.

Oh, and if you ARE doing all the above in your ER, you need to be very careful of your practice of nursing, cause you probably don't get the required inservicing or continuing education/competency training to do the above.....

ER (actually ED) is it's own niche I believe, it is a mix of:

(1) Primary care

(2) Acute care

(3) L/D-OB/GYN

(4) Peri-op

(5) Psych

(6) Peds

(7) Trauma

(8) Some Critical Care.

If you look at the CEN (Certified Emergency Nurse) core competencies, they don't even go into central lines and such. Pretty much the only critical care there is vents and ACLS type critical care. I reference the Emergency Nursing Core Curriculum because if you were to write a job description and competencies, something like that would be your guide.

The fact that we manage the care of pts who are so acutely sick that they need and eventually will have the above interventions mentioned, and despite the fact that I don't have the benefit of having these specialized devices activated yet, that aid in pt care via accurate and sophisticated monitoring equipment and aid in myocardial tissue to pump, etc, etc, etc confirms in my mind that I do treat critical pts, necessitating that my nursing be called critical and "specialized."

Also, at my hospital a central line isn't such a big deal that it is placed and managed only in the ICU. Some of your other examples are bogus because they would only be placed after or during a special procedure and not done at the bedside. This means they are done out of the ED and the pt wouldn't return to the ED for the ED nurse to manage, making it irrelevant to her practice and therefore her supplemental education.

Have you seriously never boarded multiple ICU pts at the same time in the ED over the course of days? A nurse, is a nurse, is a nurse....

And one more time, my ER triages many not-sick-non-emergent-pts but that doesn't mean that they are ever in any of my beds. My pts are always SICK!

[Iam46yearsold]

Actually ED should be in its own spot, neither critical care nor nursing specialty. We deserve our own section as we are all so obviously one of a kind.

[MN BigJ]

Maybe Critical Care shouldn't have it's own special spot under specialties. After all, they are just another specialty with the rest of us. Click on specialty tab and the list comes up with ICU, CCU or whatever CU's you want under the same as the rest of the specialties.

Maybe the real question is, Why are they more special than the other specialties?

[loricatus]

Maybe Critical Care shouldn't have it's own special spot under specialties. After all, they are just another specialty with the rest of us. Click on specialty tab and the list comes up with ICU, CCU or whatever CU's you want under the same as the rest of the specialties.

Maybe the real question is, Why are they more special than the other specialties?

You make an excellent point

[sjt9721, BSN, RN]

I think a lot of hairs are being split for no reason.

[shodobe]

I have always thought over the years it was strange that someone had to distinguish areas. What makes anyone working these areas more "special" than the other areas? I personally think it belittles areas such as L&D, Pysch, M/S as being inferior when it comes to patient conditions and care. I would like to ask the people who run this site to do away with this separation issue and just clump everyone into one area, "Patient Care". I work in the OR and even though there are many times where real critical care doesn't come into the picture, there are times when you have a case that makes the hair stand up on the back of your neck.

[JessicRN]

The American Association of Critical Care Nurses defines critical care nursing as the "specialty within nursing that deals specifically with human responses to life-threatening problems...responsible for ensuring that acutely and critically ill patients and their families receive optimal care." Critically ill patients are often unstable, with complex healthcare needs that require intense nursing care. Critical care nurses and nurse practitioners often work in intensive-care units (ICUs), including medical, surgical, pediatric, and neonatal ICUs, cardiac care units, cardiac catheter labs, telemetry units, progressive care units, emergency departments, and recovery rooms.

So with that desription what do you think now ?

[Babs0512]

ED is not considered critical care, it is it's own speciality. ED don't get CCRN they get a different certification, CEN?

Just my 2 cents.

Actually, several of the ER nurses I worked with for 8 years had their CCRN and CEN.

Your right, many of the patients who come in to the ER aren't critical. However, we see EVERYTHING, traumas, knife wound, gun shot wounds, acute MI's, CVA's, CHF, Etc... I often floated to ICU to help out, but they wouldn't take an assignment in the ER if floated there - the ICU nurse's were "uncomfortable"

So, I believe the ER is NOT ONLY critical care, but a sub-specialty in and of itself - as the majority of other critical care nurses would NOT take an assignment in the ER.