Published Jul 18, 2004
this has always puzzled me. i searching most schools for crna admissions, they do no accept ER as critical care.
have a minimum of two years as an RN in an adult critical care setting (e.g., ICU, CCU, SICU, MICU, etc.)
as overcrowded as we've become, we hold ICU patients in the ER for at least 25% of their stay in the hospital.
traumaRUs, MSN, APRN
You are absolutely correct. I work in Peoria, IL at a level I trauma center (8 years of this plus several more years in ICU) and no - it doesn't count for critical care experience. Several of our RNs have gone to CRNA school and they have all worked in one the of ICUs while working full-time in the ER to gain the experience. Several people have gone to CRNA school with just ER experience but I guess this is quite rare.
you are correct. most crna schools want icu experience and don't count er as critical care. alot of the even prefer (not required) cvicu for the experience of "recovering" a post anesthesia pt and working with (pa, art, & la) lines. i think sometimes it gives you a better picture of what anethesia does to people!!
even though i consider some er's as critical care, (you get codes, trauma, resp distress) you don't usually see the long term effects (complications). i guess that is why some anesthesia schools require icu experience.
teeituptom, BSN, RN
Thats just because we are too special
Most ERs do not insert Swan-Ganz catheters or run balloon pumps. Many alos do not insert arterial lines. The CRNA programs want you proficient with invasive lines, hemo-dilution, etc.
One fo my firends worked for over 10 years in a PACU that was definitely more of an ICU, patients on pumps, new cranis, AAAs, etc. She took care fo patients with PA catheters on a daily basis. But the anesthesia programs require ICU experience. So she went to one of the facility's sister hospitals and for over 5 months that she remianed there, never had one patient with a Swan-Ganz catheter.
Bottom-line, if you want anesthesia school, then you ned to jump thru the hoops that they want. :)
Tom - I agree with you - we ARE special!
Perhaps it's a ratio thing. I while in crit care I had 3 and 4 hemodynamic pts a night (fun work if you like to use your brain). In the ER, I see a lot of scum that should be at home with Band-Aids and Motrin. I look forward to chest pain 10/10 sweaty and gonna die. Usually it's just pt's with BS.
I agree with the above. When was the last time you did wedges all night in the ER?
When was the last time you had a GSW to the chest come in CPR in progress. You crack his chest and get blood and fluids in. Get him resuscitated and off to the OR and get to see him walk out of the hospital 12 days later.
Yes everything else is BS, but I just call it inbetween stuff. waiting on the good stuff.
ER nurses are very special.
As an ICU/CCU/SICU nurse I am in awe of you who take whoever comes in.
Floating to ER is very stressful to me because i don't have the competence.
We do a couple times a year crack a chest in the room, usually already a post heart.
Also help patients and families between the ER and/or OR and med surg.
How about getting a gsw to chest while your newly tubed/vented pt in room 2 (also your room) decides to now show that lovely s-t elevation and get a syst pressure of 74, oh yeah, he has no contraindications to thrombolytics, and the patient in room 3 (you guessed it, mine too) who's been waiting for a unit bed for 6 hours wants to join in the fun with 8-10 beat runs of v-tach. Who would be the brave individual to walk up to me and say "oh, this is not critical care."
EmeraldNYL, BSN, RN
I think ER nursing is critical care!! Some CRNA schools will accept ER experience if it's a level I trauma center, but the reason they specifically want ICU experience is because they want you to have experience with vents, PA catheters, pressors, and hemodynamically unstable patients. Not that you don't ever see that in the ER, but in the ICU you see those things in more depth. I would call up the CRNA schools you are interested in and see if they will accept your ER experience-- if not, you may have to transfer to the ICU to get their required experience.
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