ER Nursing, Is it considered critical care?

wonderbee, BSN, RN · Aug 10, 2008

As long as state boards of nursing issue separate certifications for each specialty, then I guess they will be recognized as separate. I don't think I could have functioned in the ED as well as I did on an ICU. The pace is much different. Though yes, I do see where there is an overlap.

loricatus · Aug 10, 2008

An emergency room nurse is eligible to become board certified in both Emergency Nursing and Critical Care (CEN & CCRN)-therefore, ER nursing is a critical care specialty. I have had more ICU patients (includes trauma and ICU holds) in a single shift than I have had in while doing a shift in the ICU. The amount and degree of critical care found in the ER is mainly dependent upon the hospital's trauma level & teaching status.

mwboswell · Aug 11, 2008

An emergency room nurse is eligible to become board certified in both Emergency Nursing and Critical Care (CEN & CCRN)-therefore, ER nursing is a critical care specialty. I have had more ICU patients (includes trauma and ICU holds) in a single shift than I have had in while doing a shift in the ICU. The amount and degree of critical care found in the ER is mainly dependent upon the hospital's trauma level & teaching status.

I wouldn't use your comment above as a true definition.

ANY RN from any work setting is eligible to become CEN.

Likewise ANY RN can sit for the Flight Nurse exam.

I'm sure there are other specialities that are open to ANY RN in any setting.

So board eligibility alone wouldn't define critical care.

-MB

mwboswell · Aug 11, 2008

As long as state boards of nursing issue separate certifications for each specialty, then I guess they will be recognized as separate. I don't think I could have functioned in the ED as well as I did on an ICU. The pace is much different. Though yes, I do see where there is an overlap.

What state board of nursing are issuing specialty certifications???

I thought the state just issued a "license" to practice.

-MB

NicNac · Aug 11, 2008

:typingThanks Everybody for all the info. Yes I was asking because I would like to continue my education to become a nurse practitioner, however I really want to work in the ER:heartbeat. I'm not sure if aspiring nurse practitioners tend to lean toward one area or another and was just trying to see what the story is.

MAISY, RN-ER, BSN, RN · Aug 11, 2008

Well, unless ICU/CCU is performing direct admits, patients start somewhere, perhaps in the ED? :rolleyes:

Since these same patients are vented/(come in on vents), central line insertions, stabilized, and all care initiated/sometimes maintained(due to lack of unit beds)....I'll take a stab and say CRITICAL CARE.

I know when I have had up to 4 unit patients, all orders including hourly labs, 15 minute vitals, fs, and whatever else was expected to be done. Amazing that I can handle 4 huh? Am I saying that we are able to do the kind of intuitive, notice of slight changes in condition care that ICU provides-ABSOLUTELY NOT(with 4 patients)-however, being able to maintain stability, comfort and orders. It's a special balance that only a critical nurse can achieve.

As always,

JMHO

Maisy:heartbeat

mmutk, BSN, RN, EMT-I · Aug 12, 2008

Yes absolutely the ER is critical care. It has the capability to be critical care all the time. But it just adapts for those less than critical care and yet an ER Nurse can break out the Neo, Cardene, and Dopamine when needed.

mwboswell · Aug 12, 2008

Dear NicNac,

this is EXACTLY what I did. I had been an ER Staff RN for a few years and was continuing on into grad school for my MSN-NP. I KNEW that I wanted to work ER as an NP when done, and I also KNEW that it was VERY hard to find an ER NP job w/o experience as an ER/NP...!!!!

So what I did was EVERY single clinical hour besides my mandatory OB, Peds, etc, I spent in the ER with my preceptors. When done, I had logged nearly 1,200 hours of clinical in the ER (my residency) and it was those hours I used to justify to a prospetive employer that I "had" ER experience.

Thus, I did wind up getting my "dream job" over 8 years ago and I believe all that dedicated ER clinical time on my portfolio made the difference.

Good luck to you!

:typingThanks Everybody for all the info. Yes I was asking because I would like to continue my education to become a nurse practitioner, however I really want to work in the ER:heartbeat. I'm not sure if aspiring nurse practitioners tend to lean toward one area or another and was just trying to see what the story is.

MAISY, RN-ER, BSN, RN · Aug 12, 2008

Unfortunately, each program has requirements and groundrules set by, THE POWERS THAT BE....THOSE WITH LETTERS BEHIND THEIR NAMES.....ALWAYS SCARY!

Truthfully, expectations, requirements and ideas of what a program should be is created by the people who have a specific idea what their "ideal" should be. If those academics or those on the board have never worked ER, how can they know what is involved in a typical day? As a matter of fact, with the continuing hostility against the ER how can they be unbiased when creating programs?

If you consider the continued thread of us vs. them, I am amazed that any program allows ER nurses as critical care. They out number "us" by quite a bit! :rolleyes:

Anyway, Yeah ER as critical care! :yeah:

Maisy

mwboswell · Aug 12, 2008

I hear your point, well said.

And that being said, then the way for "us" to lead is to GET INVOLVED through your professional associations! Or State Organizations.

I have slowly worked my way "up" through the ranks of the ENA and I'm sure if I keep doing what I'm doing, one day I'll be in a position to advocate for change and improvement.

But you gotta start small and work your way up....

I tell everyone, GET INVOLVED! that way WE can then be the THEM!!

Good luck!

Unfortunately, each program has requirements and groundrules set by, THE POWERS THAT BE....THOSE WITH LETTERS BEHIND THEIR NAMES.....ALWAYS SCARY!
Truthfully, expectations, requirements and ideas of what a program should be is created by the people who have a specific idea what their "ideal" should be. If those academics or those on the board have never worked ER, how can they know what is involved in a typical day? As a matter of fact, with the continuing hostility against the ER how can they be unbiased when creating programs?
If you consider the continued thread of us vs. them, I am amazed that any program allows ER nurses as critical care. They out number "us" by quite a bit!
Anyway, Yeah ER as critical care!
Maisy

NicNac · Aug 12, 2008

As a matter of fact, with the continuing hostility against the ER how can they be unbiased when creating programs?
Maisy

Maisy, what is the hostility against ER nursing?

MAISY, RN-ER, BSN, RN · Aug 12, 2008

All I can say is read the threads dealing with ER and the floors. I have heard many disparaging remarks from nurses regarding the ER and its staff. It's really a shame, I try to make patient care seamless and easily continuous for the floor nurses....there just seems to be a hostility towards us. It's heard in the voices on the phones, its heard during report, its felt delivering patients with a drip.....there's just something unspoken, and unfortunately palpably felt.

It's a shame when former schoolmates feel the need to say to their workmates "oh, she's not like that'' I say "like what?" "you know, like the other ER nurses" NO I DON'T KNOW...I THINK MY COWORKERS ARE GREAT!

Anyway, you can't appreciate it until you feel it or face it. I just muddle through....I am determined that whatever issue is there, I don't let it color my relations with the floor.

JMO

Maisy

PS NicNac whatever you choose to do as a nurse, do it well wherever that is! Good luck.