ER/ICU Cert-Contract-Should I?

Nurses General Nursing


I am getting ready to enroll in a program at my local College that will earn me a Certificate in ER and Critical Care Nursing. It will take me some time to earn as it is 11 College Credit Hours and I can only take one or maybe two classes at a time. I have a family and a FT job. My FT job is pretty easy IMO compared to past jobs working in home care (doing high tech visits), and in hospital positions. I have not worked in a hospital for a year now and don't plan on returning to floor nursing...ever. I have Critical care experience but that was over 10 years ago. I have minimal ER experience also but not recent. I worked MICU for about a year and wanted to transfer to SICU but the hospital wanted to keep me in MICU so they didn't let me transfer, so I quit. In nursing school all my instructors, mentors, and the nurses in the units said they thought critical care would be my forte' and I agreed. Dreamt of working in ER but never followed my dream b/c of other opportunities and also the ER nurses told me to forget about it, not worth it, etc. More recently, I have experience doing chart reviews and care planning in ICU. My skills are great. Like ridding a bike. Can stick with the best, tube the rest, etc. The clinic I now run gives me limited availability to perform the high tech skills, but does allow me to triage emergency situations constantly. My assessment skills are also very good. I think that with my background and years of experience, coupled with the certificate and ACLS is enough to work in the ER or other critical care area. BUT, I do have reservations about just jumping into the ER or ICU to work without formal orientation. I'm brave and confident but not totally stupid. I do not plan on quiting my current job at the clinic.. I love it too much but the pay is awful! I need to make a little more than I do and thought I'd contract myself to the hospitals, no agency, and work 1 shift per week. I don't think I'll get an orientation without becoming a FT employee but I have a feeling they'll contract with me b/c the local hospitals are hurting so bad for nurses especially in the ER and ICU's. I'd like to hear your advice, opinions, ideas, encouragement, and thoughts on all of this. Please don't flame me, please! The reason I'm posting this is b/c of my own reservations. 15 years ago there would've been no way that I'd get a job in those areas without recent experience but things are different now. Is this opportunity or the beginning of a bad plan? Thank you to all who reply.


409 Posts

Specializes in Float Pool, ICU/CCU, Med/Surg, Onc, Tele.

I say if it interests you and lights a fire in your soul, chase it down and don't let anybody stop you. Inspiration is a wonderful thing, don't let it go to waste.


89 Posts

you may want to reconsider agency. If you contact yourself, you must pay all the taxes yourself and have your own .That means you must keep this in mind when negotiating with the hospital for your hourly rate. If you are only planning to work one shift a week, it probably won't be reasonable. Per diem is also an option.

ER and ICU are two different worlds. The college course you metioned, is it accepted by the ENA and AACN? If not, you may be wasting your money. I work per diem in both ICU and ER but I have 10 years recent experience( as you know, I stopped fulltime nursing last May). I only work one to two 4 hour shifts a month,one in each unit. Talk to the nurse managers in the units you are interested in and explain your goals and skill levels. They may be willing to work out an orientation schedule for you. In this time of Nusing Shortages, managers are more open minded and willing to work with staffs request. Best of luck.


381 Posts

NurseWeasel, Love the encouragment. Thanks!

montroyal, Thank you for the speedy reply! I'm not sure if the courses (actually 2 certificates, one for ER and a seperate one for Critical Care) are accepted by ENA and AACN. I'll check. Your idea sounds better anyway, opens an immediate door. I had not thought to talk to the NM's but I will now! I'm sure I need my ACLS and PALS too.

I have experience with owning my own business. I should be able to write off enough of what I earn to make it worthwhile to go that route. Already have malpractice. I know the taxes are higher when paying self employ rates. I'll have to run some numbers to see what works best. Your right though and thanks for making me think this through further, the extra work involved in doing it as a business may not be worth the difference in pay at the end. Since I need an orientation, I'll be restricted to per diem anyway. I have some time to think it through before I'd be able to do self contracting. I'm still going to take a course to brush up my skills reading strips. And, I could still take those classes at the college for my own benefit as well. hopefully while working in the ER! Thanks Again!

Trauma Columnist

traumaRUs, MSN, APRN

97 Articles; 21,237 Posts

Specializes in Nephrology, Cardiology, ER, ICU.

I'm an ER nurse in busy level one trauma center and I'll be honest - we have everyone do orientation of 6-8 weeks due to liability reasons. I think maybe looking at smaller ER first might be better, especially with your time constraints. For certifications, I would recommend ENPC which is te Emergency Nurses Pediatric Course, put out by ENA - it is much more comprehensive than PALS. Also - consider TNCC which is the Trauma Nurse Core Curriculum - again an ENA course - but provides a concise assessment course to the trauma pt. Our hospital offers a "Walk in my Shoes" option too which allows outside nurses to come in (not paid) and follow a seasoned ER nurse for half a shift. That gives you a great feel for the hospital and unit - also the pace - which can be brutal. I wish you luck - we sure need more ER nurses.

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