Critical Care vs. ER Nursing

greenjanell · Mar 6, 2006

critical care nursing is more like the ICU or the Cardiac ICU. Or surgical ICU. The emergency room deals with everything, and then some. The patients are only on the ER (typically) untill they are stabalized, and then they are transferd to another specialty unit, (burn, ICU, CVICU or Trauma recovery). Then the critical care nursing kicks in, and these patients are cared for in the unit they are in on an IN hospital basis, like an inpatient. The patients in the emergency room are cared for by critical care nurses as well, but not on a long term basis. However, in some very busy hospitals, there is inpatients in the ER that sit for days in the ER waiting for a bed to become available. They are both Critical care nursing areas, and both require a lot of knowledge and stamina, but both are very different types of nursing. It is hard to explain. Its one of those things that you have to actually see and work to know the difference.

clee1 · Mar 6, 2006

In a nutshell, ER nurses have to think on their feet and react quickly.... adrenaline junkies only need apply.

CC Nurses have to be coldly analytical and detail oriented. Also, they must be able to stand the possibility that a good percentage of their patients won't make it long term.

Both units require excellent nurses.

mandana · Mar 6, 2006

CC Nurses have to be coldly analytical

Well, that proves it - I'm meant to be an ICU nurse. I've been accused of this more than once.

Amanda

delmar · Mar 6, 2006

In a nutshell, ER nurses have to think on their feet and react quickly.... adrenaline junkies only need apply.
CC Nurses have to be coldly analytical and detail oriented. Also, they must be able to stand the possibility that a good percentage of their patients won't make it long term.
Both units require excellent nurses.

"Both units require excellent nurses" Interesting concept.

One would hope that all clinical settings require "excellent nurses".

In fact, one would hope that ANY setting which requires

the skill-set of an RN, ie Case Management, Psych/Mental Health,

Long-Term Care, Public Health, Hospice, Home Health Care,

Nursing Education, Nursing Administration, Forensic Nursing,

School Nursing (K-College), Ambulatory Care, Oncology (including

Radiation Oncology) HIV/AIDS.., Occupational Health. I'm sure of missed some other "specialties", but having worked in most of the ones

mentioned, I consider myself an "excellent" nurse.

Forgot to mention, I do have trauma ICU/"Critical Care experience,

and there is nothing "Critical" about it, except in certain circles,

elitism !

Trauma Columnist · Mar 6, 2006

And I'm a self-confessed adrenaline-junkie. That's what so cool about nursing - we can all do what we do best!

clee1 · Mar 6, 2006

Well, that proves it - I'm meant to be an ICU nurse. I've been accused of this more than once.
Amanda

:rotfl: :rotfl:

You say that like it was a BAD thing!

A MD friend of mine has said (more than a few times) that the ideal CC nurse would be one of those "Star Wars" type androids. :chair: The sad thing is that he told me, once I started nursing school, that he thought I was ideally suited to the ER now, and would be a perfect CC nurse when I got older. I didn't know whether to be flattered or insulted! :uhoh21:

delmar · Mar 6, 2006

In a nutshell, ER nurses have to think on their feet and react quickly.... adrenaline junkies only need apply.
CC Nurses have to be coldly analytical and detail oriented. Also, they must be able to stand the possibility that a good percentage of their patients won't make it long term.
Both units require excellent nurses.

"Coldly analytical and detail oriented"

One also hopes that the "excellent nurse" does

not forget that there is a real patient hooked-up

to the monitor and drips, whilst you are filling in

your Flow sheets. Also, when dealing with

end-of-life care issues, one hopes that the

"excellent" nurse realizes that there are family members

of the dying patient who have spiritual and psycho-social needs...

clee1 · Mar 6, 2006

"Both units require excellent nurses" Interesting concept.
One would hope that all clinical settings require "excellent nurses".

Well....yes.... in an ideal world, you'd be totally correct.

However, as a nurse of some extended experience, you undoubtedly know more than a few nurses that, while they do an adequate job, they are a long way from "excellent" status. Heck, I'm not even a nurse yet, and I know more than a few that fit that description. Let's be brutally honest here - it does NOT take a rocket scientist to administer immunizations an a Public Health Clinic all day. Not knocking those that DO that valuable work, just they don't HAVE to be top-notch to do it.

There is no industry/profession I can think of that doesn't have some differentiation of skill level in its workforce. There is a place in medicine/nursing for "average" types; I feel that the "excellent" types belong in the more "critical" clinical areas.

clee1 · Mar 6, 2006

"Coldly analytical and detail oriented"
One also hopes that the "excellent nurse" does
not forget that there is a real patient hooked-up
to the monitor and drips, whilst you are filling in
your Flow sheets. Also, when dealing with
end-of-life care issues, one hopes that the
"excellent" nurse realizes that there are family members
of the dying patient who have spiritual and psycho-social needs...

100% agreement here.

delmar · Mar 6, 2006

Heck, I'm not even a nurse yet, and I know more than a few that fit that description. Let's be brutally honest here - it does NOT take a rocket scientist to administer immunizations an a Public Health Clinic all day. Not knocking those that DO that valuable work, just they don't HAVE to be top-notch to do it.
There is no industry/profession I can think of that doesn't have some differentiation of skill level in its workforce. There is a place in medicine/nursing for "average" types; I feel that the "excellent" types belong in the more "critical" clinical areas.

Your comments truly reflect the fact that you are "not even a

nurse yet" Have you done your Public/Community Health rotation

school yet (in the inner city of Detroit, CHicago, Harlem NY, Oakland

or LA ?) I seriously doubt it. I've said it before & I'll say it again,

there is NOTHING "Critical" about Critical Care Nursing; ALL

Nursing and Caring IS Critical though! Health Promotion (ie Diabetic Teaching)

is just as "critical" as monitoring the patient in acute renal failure on dialysis in CHF, on the vent for resp failure due to pneumonia, and

adjusting his insulin drip. Perhaps if the patient had a Nurse

advocate in a Public/Community Health setting in the first place,

he would not have ended up in your very 'critical' of "critical"

care units. Of course, all of this would take a bit of "critical"

thinking skills for you to comprehend !

clee1 · Mar 6, 2006

Your comments truly reflect the fact that you are "not even a
nurse yet" Have you done your Public/Community Health rotation
school yet (in the inner city of Detroit, CHicago, Harlem NY, Oakland
or LA ?) I seriously doubt it. I've said it before & I'll say it again,
there is NOTHING "Critical" about Critical Care Nursing; ALL
Nursing and Caring IS Critical though! Health Promotion (ie Diabetic Teaching)
is just as "critical" as monitoring the patient in acute renal failure on dialysis in CHF, on the vent for resp failure due to pneumonia, and
adjusting his insulin drip. Perhaps if the patient had a Nurse
advocate in a Public/Community Health setting in the first place,
he would not have ended up in your very 'critical' of "critical"
care units. Of course, all of this would take a bit of "critical"
thinking skills for you to comprehend !

I don't intend to argue with you, Delmar.

I was a military medic and civilian EMT-I for many years; I have seen (and cared for) many, many "critical" patients. Sorry, but the person needing an immunization or the diabetic needing teaching does not rank as high on the "critical" chart as the acute renal failure you mentioned, IMHO. It may not be critical thinking to you but it certainly is prioritization to me.Nor do you have to BE a nurse to know hundreds of them or be able to differentiate the "competent" from the "excellent".

Regardless, eveyone in entitled to their own opinion; I have mine, and you have yours. Have a great evening and a nice life.