ER Nursing, Is it considered critical care?

Specialties Emergency

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I am a first year nursing student. I do not have any experience in the health care industry. I am wondering if ER nursing is considered critical care? Also, what areas are considered critical care?:typing

Specializes in ER.
Case in point,

ACT 1:

yesterday fellow nurse has ICU hold patient who is incontinent....THE ER WAS ROCKING! It was crazy, no breaks, call outs, short staff, I was in our regular medical and had 6 patients! My friend, brought her admit to ICU monitored, and with open diaper.....ICU nurse freaked out! Mind you, all orders complete...patient clean and on bed....Like some Joan Crawford nightmare (No wire hangers ever) "We don't use diapers ever, you all give crappy care!" WHAT!:eek: S replied perhaps if she had one patient with a technician she could change the bed 50 times daily, but was this nurse kidding? She wasn't..

Act 2:

S gets another emergent patient, junctional rhythm-vomiting/diarrhea-basically looks like St Peter's calling....as the multi doc brain trust musters about....patient prepped, drips everywhere, foley in, patient cleaned a million times, blah blah blah....bed opens in ICU as patient has a stable time-orders still being written....bed ready....GUESS WHO IS RECEIVING?...ICU nurse from first ACT! S brings monitored patient over, with residents and every imagineable implement for resus with her....the first thing ICU does is start screaming that the ALMOST COMPLETED ORDERS (THEY ARE STILL WRITING) have not been implemented! AGAIN, WHAT!:eek: Orders aren't even on the chart yet. This nut went on and on!

S is such a gentle, sweet nurse who busts her butt, I "strongly" encouraged her to report it. This is horizontal violance and unacceptable. I can't stand nurse who are that pushy....nursing is a 24 hour job...that's why we are here....that's why need to work together.

This is just two patients, it's not just ICU, it's everywhere....the thing that bothers me is that I am always pleasant on the phone, address everyone respectfully, and usually send my holds with a majority if not all orders implemented. I think a majority of my peers perform the same way. We all have work to do....I know I don't sit on my butt, but I think nurses who have never worked ER do!

I know, kind of off topic, but answering a question.

Maisy:wink2:

my first thought: this ICU nurse had to *itch about something.... I would tell her: look at the orders that have been completed, this patient is an INTENSIVE CARE UNIT admit, where addressing the PRIORITIES are a priority. HAD I had the time, I could've done "blah blah blah" whatever... the bum issue was... It's nurses like that who REALLY need to come to the ER to get a heavy dose of reality to shut them up!

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Specializes in ER/EHR Trainer.
my first thought: this ICU nurse had to *itch about something.... I would tell her: look at the orders that have been completed, this patient is an INTENSIVE CARE UNIT admit, where addressing the PRIORITIES are a priority. HAD I had the time, I could've done "blah blah blah" whatever... the bum issue was... It's nurses like that who REALLY need to come to the ER to get a heavy dose of reality to shut them up!

You know, my problem lies in the fact that the orders aren't even complete! Obviously, tons of things have been done in the ER, what gives her or any other nurse the right to question their peer in such a manner? And so disrespfully, it's truly despicable behavior! This is more than an itch..it's more like a ...itch!

Again, we all have our jobs to do...I'd love for us to work as one....maybe patient care and the profession would be highly regarded again.

JMHO

Maisy:redbeathe

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Specializes in ED, ICU, PACU.

It appears that some just seem to forget (or just don't care) who is taking care of the critical patients when their floor is full or their nurse to patient ratio (1:2) has been met.

Now, for the aspect of specialty: When I do ICU, I am also a psych nurse moreso than in the ED because of the intense family dynamics that exist when you have a critical patient. I am also a GI nurse because of all the GI related issues for the standard critical patient. Oh, and I am also a cardiac, tele, med-surg (gotta take care of them before they go to step-down), wound care, pulmonary, office (paperwork issues) etc, etc, etc. Come on-----Critical Care nurses incorporate much of the other specialties, too.

As for the statment that physicians don't banter about like this, I whole heartely agree. They RESPECT each other, even if they know they have an incompetent amongst them-they just cover his/her bottom to try and keep the standard of the profession high. It is a crying shame that nurses cannot figure this out. Imagine how it looks to doctors to see all this belittlement, backstabbing, competetiveness and false pride that runs rampant in our profession-no wonder many tend to treat nurses the way they do. Sometimes, I think we deserve it because if we cannot learn to respect each other, why should we be entitled to others' respect? :spbox:

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Specializes in ER, ICU, Education.
I can understand having ICU experience for CRNA school in regards to meds - such as you write, since working in an ER you don't have that time to pore into detail regarding drips and multiple meds and s/e, etc.

In defense of ER nursing - you get very good at triage, quick decision making, critical thinking, and the ability to juggle many balls at once. And actually I think it should count toward CRNA - In fact it used to but it seems at least some of the schools have become more selective, perhaps because the demand is up.

After having worked both ICU and ER I can say that I've enjoyed both but they are different worlds.

The ER is fast paced - think on your feet, occasionally rough and tumble, exhilarating and the most interesting of places. It's a great place if you are an adrenaline junkie, like I am at times. :up:

The ICU is usually more controlled, precise, methodical, somewhat repetitious (for example CVICu where you see the same thing over and over again), but it's place where you can become very specialized in certain things like managing drips, vents, and invasive lilnes. It's the place for those of us who are control freaks. :rolleyes:

For me the ER is the best fit. As I get bored easily and I like a fast paced, ever changing atmosphere of ER. I like the thrill of not knowing what will come through the door next. That said, I will be a better ER nurse now then I was 15 years ago - largely due to my time spend in ICU. But also because I am returning as a seasoned nurse.

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:eek:Wow!!! I have to say when I posted my original question (Whether ER nursing is considered critical care), I was expecting one or two responses with a more yay, nay answer. I had no idea there was so much tension and debate regarding who's who in nursing.

One thing I am happy about, it seems that everyone here obviously takes a lot of pride in the work they do. I have not seen too many fields in the corporate world where individuals poor so much of themselves into what they do on the job. :yeah:This is definitely what I've been looking for.

:rolleyes:(Sans the mild :argue: cattyness of course)

:heartbeatThank you ladies and gents.

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Specializes in ER.
What is your problem? If you choose not to answer the question then don't.

Don't worry, you're "critical care kingdom" is not in jeopardy from this "ED Specialist". We'll keep sending them to you to receive care from the critical care specialists.:bow:

where is this term "ED specialist" coming from, anyway? Never heard of it. Some PC person is trying to change things - just like calling a patient a "client." It's just stupid and silly.

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I don't know where it comes from; hence the quotes around the phrase.

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Specializes in ER, telemetry.

I have found that emergency nursing is it's own entity. We stabilize critical care patients, but most of the time do not monitor them over any length of time, unless there are no beds in the unit available. Not that we, as ER nurses can't take care of ICU patients for a long period of time. Most of us don't want to. It takes us away from taking care of the more emergent patients coming in the ambulance bay that we find more exciting and challenging.

And, the way we take care of emergent critically ill patients is completely different than the way it is on the floors. We are the code team in the ER, we handle every emergent situation possible as a cohesive team. We adapt to everything and anything. ER nurses are a very special breed.

I am proud to be an ER nurse, and I do not want to be labeled as merely a critical care nurse. I do so much more than that. As someone has already posted, on any given day, I am a peds nurse, an OB/GYN nurse, a critical care nurse, a telemetry nurse, a clinic nurse, a psych nurse, etc....so trying to label emergency nursing as one or the other is not giving us ER nurses the proper credit we deserve for all the roles we play.

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Specializes in ED staff.

Having worked in CCU and the ER, I consider ER critical care too however, I've worked with other nurses who were going back to school to get their CRNA and you have to have critical care experience and the place where they were going to school (UAB) didn't consider the ER criitical care.

A patient comes to the ER with SOB, ends up on a ventilator, BP goes south we put him on dopamine but also has pulmonary edema so we give him lasix. Because we want to monitor his UOP we put in a foley. We give him morphine so he doesn't fight the vent so much. He's on the monitor and starts ahving SVT so we give him adenosine. If this isn't critical care, I dunno what is!

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It is all rather amusing. We are like little kids arguing on the playground. "My dad can beat up your dad." Hmmm...so, if spider man and bat man got into a fight who would win? Now that has been the source of many playground arguments.

Well...my ER can do better critical care than your ICU.

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Specializes in ER, SANE.

At our place, it is according to day and incident! Any moment may be critical care or it may be another day at the office. The main concern is that the ER nurses are prepared to be critical care on a moments notice! Switching hats with the next heartbeat if you will.

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