Emergency Room NPs?

ANPFNPGNP · Dec 5, 2008

I'm currently weighing my options and want to hear from those that are ERNPs. I work in a level 1 and am contemplating going for my ERNP (that offers the FNP cert along the way). A few questions:
Jobs? Easy to find, expected pay? What about using advanced skill sets? I'm not cut out for clinic work, I like the acute care setting. There's also an ACNP program nearby. Any thoughts regarding one versus the other? Thanks!

I work in 4 different ER's and my job description is different in each one. Some ER's have a fast track and others don't. We're supposed to see level's 4 & 5 (basically people without a true emergency), but I see a lot of level 3's as well b/c sometimes that's all there is to see.

We make $60/hr and it doesn't matter whether you're a brand new NP or if you have 20 years of experience as a PA...everyone makes the same where I work. I don't think that's fair, but whatever. If you can be flexible, you can pick up a lot of last minutes shifts for time and a half. In fact, I'm working for someone tonight and I'm getting paid $90/hr.

Be careful about completing a dual FNP/ERNP program. There are some states that won't accept it and they won't even let you practice as a FNP (even though you'll be board certified as one). I know this b/c one of my schools had that exact program and 2 of the graduates moved out of state and they weren't recognized as a NP. I believe those states were Oregon and Washington State...not 100% sure though. It was horrible b/c that program was by far the most difficult. It required a minimum of 5 years of experience as an ER nurse, 850 clinical hours, advanced skills, etc.

I couldn't imagine going through all of that and then finding out that the new state I just moved to wouldn't let me practice as a NP.

As far as using your advanced skills, I know they teach those in that type of program, but I would be surprised if you would ever actually get to use those skills in the real world. It may happen somewhere, perhaps in a rural hospital, but I've never seen it.

Trauma Columnist · Dec 5, 2008

I work in a community hospital ER and I work in the ER not the fast track. I work side by side with physicians and per my credentialling, my role is to push these pts through the system. I do the initial H&P, order initial testing, interpret the testing and then must "staff" with an attending. I get paid comparably to above poster. I am an adult health CNS who practices in IL.

magnolia nurse · Dec 6, 2008

are you saying FNP is the way to go instead of ER?

Dr. Tammy, FNP/GNP-C · Dec 6, 2008

are you saying FNP is the way to go instead of ER?

By far, for the NP tracks, FNP is the most universal. Always exceptions, though.

just_cause, BSN, RN · Dec 6, 2008

Is ER an actual NP certification - or referring to an NP who is either FNP or ANP/PANP dual certified.

Which of the two varieties of certs you require to work as an NP in the ER capacity depends on your hospital and more so on your state's BON.

v/r

Trauma Columnist · Dec 6, 2008

Exactly - much depends on what your state BON demands in the ER.

UVA Grad Nursing · Dec 7, 2008

At the UVA Medical Center, they use both FNPs, PNPs, and ACNPs in the ED. PNPs and FNPs serve in the fast-track areas (there is a separate ped ER there). ANCPs treat trauma and serious cases. UVA is a Level I Trauma Center, so there is a lot of serious cases coming in.

My school used to prepare ENPs in the 70s and early 80s -- but ended that program nearly 25 years ago. Not we prepare a number of trauma-focused ACNPs.

undrtow · Dec 9, 2008

so is there an NP program specifically for the ER, such as an ENP, or is it just ACNPs for the most part?

ANPFNPGNP · Dec 9, 2008

so is there an NP program specifically for the ER, such as an ENP, or is it just ACNPs for the most part?

There is a dual FNP/ACNP program at Vanderbilt that has an emergency room focus. It is listed as an ER NP, although there is no ER NP certification available at this time. Be careful about going through a dual program, b/c your state may not accept it. I graduated from a dual Adult NP/Gerontological NP program and became certified through the ANCC in both, however the TX BON wouldn't accept both, so I chose to become certified as an Adult NP.

If you're going to work in the ER, you need to be a FNP. You will need to see patients of all ages including pregnant patients.

undrtow · Dec 9, 2008

thanks for the reply.

I may be wrong here, but I've read a lot of people saying how FNPs are not technically certified to work in the ER, or that they only work the fast track as a way to side step that issue. Couldn't you also do ACNP and only deal with adult patients, or would that just be too much of a hassle? thanks again

just_cause, BSN, RN · Dec 9, 2008

I believe it depends on the state BON. I have read of those who can work with an FNP or those that have a dual adult and peds Acute cert.

v/r