ED nurses with critical care knowledge & experience?

[matthewjdouma]

Hi everyone,

Our busy inner city ED sometimes boards ICU & CCU patients for days. We often resuscitate pt's and hold onto them for a long time. We're a tertiary care center with about 55 beds. I want to know how many departments out there provide their nurses with proper critical care orientations? Is it considered part of your ED orientation? Do you just learn it on the job? Does anyone cycle through the ICU & CCU as a part of their orientation? Anyone out there belong to a critical care float pool that includes the ED? Where/how did you all learn about central venous cath's? arterial, CVP & swann lines? vents? EVDs? intubations? inotropes & chronotropes? bypass? dialysis? etc etc etc

Thanks for your help

Matt

[Lunah, MSN, RN]

I pick the brains of my coworkers -- lots of long-time ICU nurses among them. My ED orientation focused on the ED ... everything else has been OJT.

[GilaRRT]

I did not do proper critical care until I started flying. In fact, I am only now learning just how complex ventilator management is. I did central & arterial lines as an ER RN; however, that was about it. Often, my vent strategy consisted of placing a patient on a transport vent for a trip to CT. This consisted of a fixed FiO2, dial a Vt & rate, CMV mode, and a pop off of 60 cm/H2O. Of course, early into my flight career, I thought I could manage every patient with SIMV.

I was lucky enough to manage multiple drips and infusions as an ER nurse. Never saw a ballon pump or LVAD until I started flying, and never managed ICP with an IVC until about a year ago.

[Mike A. Fungin RN]

If a patient like that is going to be in our ED more than a few hours one of us floats down from the ICU to manage them.

[MissDoodaw]

Wow, I guess I'm lucky. My Ed sent us to critical care training for a week -class room and simulation with new ICU nurses to learn the basics of all that... I did seek out the ICU educator and strt asking her some of my questions -so that might have facilitated this type of training.

[nuangel1, BSN, RN]

none i had 12 years icu experience prior to becoming ed nurse 7years ago.otherwise our nurses learn as you go.

[JStyles1]

i had 3 months training in an icu before going to work in the er

[DCR RN]

Does your hospital not have an Education Department? We frequently board pts but usually not more than 24 hours and mostly we have house float nurses that will take those pts so our staff can continue caring for the inbounds.