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ER Only Background for CRNA??

SRNA   (11,212 Views 17 Comments)
by edrn21 edrn21 (New) New

edrn21 specializes in Emergency.

445 Profile Views; 1 Post

I have been an ER nurse for almost 3 yrs now- have worked in 2 different hospitals. I typically work in the "ALS" or critical side of the ER and also do charge so attend many codes/care for many ICU pts before they are tx to the unit. My question is whether anybody knows of specific schools that count ER nursing as meeting the "critical care" requirements. AM competent with vents and many gtts but do not have experience with Swans, weaning from vents etc. Also to the CRNA's out there do you feel this is enough critical care experience or do I really need to go to the ICU for a year?? I love the ER and do not really have the ICU mentality but will do what I have too!! THANKS

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ready4crna? has 5 years experience and specializes in ICU, currently in Anesthesia School.

218 Posts; 2,830 Profile Views

The best advice I can give you is this:

Getting one year of ICU experience will open the doors of every program. So, you can try this year to get into a program that accepts ER, and while you are on that quest... transfer to your ICU. That way, should this application cycle prove unfruitful, more programs will be open to you next time.

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Sean04 specializes in ED,CVICU,MICU, SRNA.

23 Posts; 966 Profile Views

I worked ER at a level one trauma center for 3 years before transferring to our CVICU. I LOVED ER, but I really didn't realize how much I didn't know until I transferred to the unit. I actually have time to know what is going on with my patient! The patients I deal with on a daily basis are so sick. I had sick patients in the ED too, in between patients with back pain and vaginal discharge!

I think ICU experience is invaluable and besides a year or two goes by really fast. With that being said, I do know that Marshall in WV will accept acute care, including ED.

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71 Posts; 1,905 Profile Views

depends on the school..wayne state university and detroit mercy in michigan accepts er experience..

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1 Article; 1,905 Posts; 15,869 Profile Views

I am not a CRNA; however, ICU will provide you with a very different experience. ACLS and codes may be similar; however, I think CRNA programs are looking at experience with hemodynamic monitoring, ventilator management, multi medication drips and titration, critical care surgical patients, and invasive cardiac care.

While some ER's may provide some of this care, the goal of the ER is to stabilize and either kick to the curb, or send the patient to another unit for ongoing/definitive care. Most of the ER modalities are geared toward initial stabilization and transfer.

As a CRNA, I would expect that you will provide anesthesia, airway management, and critical care for the duration of the case, then possibly supervise the recovery process. Many of the techniques encountered are not encountered in the ER.

While ER experience is great, I think the ICU provides much needed background critical care experience that the potential CRNA can use as a foundation for their future experiences.

Even commonly encountered problems associated with surgery and anesthesia (problems during the recovery process for example) would not be encountered in the ER environment.

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17 Posts; 1,046 Profile Views

Re: ICU or ER

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I personally came from an ER background and to this day find the skill set I learned in the ER to be invaluable. Rapid assessment, quick thinking, improvisation, a cool head under fire, being able to roll with the punches, prioritization, decision making are all assets learned in the trenches of the ER. and will serve any CRNA well.

That being said, there is a definite advantage to the icu because the icu is the realm from which most CRNAs were born and therefore can most relate. Common traits among CRNAs are type A personalities and anal retention, two qualities well suited to an icu type environment as well as the OR.

People tend to make a big deal about drips and lines in the icu; however, the pharmacology, physiology, and technical skills learned in anesthesia school take one to an entirely different level so as to negate any advantage of prior knowledge.

Unfortunately, schools are showing less and less inclination to accept ER as acute care experience making icu the preferred route. IMHO, this is folly on the part of acceptance committees as the ER skill set is an asset in the OR. I thank my lucky stars everyday I go to work that I am no longer in the ER, but wouldn't trade those skills for all the icu gtts and lines in the world.

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1 Article; 1,905 Posts; 15,869 Profile Views

Good points and from the horses mouth so to speak.

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jen123321 has 2 years experience and specializes in SICU; Just accepted to CRNA school!.

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Re: ICU or ER

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I personally came from an ER background and to this day find the skill set I learned in the ER to be invaluable. Rapid assessment, quick thinking, improvisation, a cool head under fire, being able to roll with the punches, prioritization, decision making are all assets learned in the trenches of the ER. and will serve any CRNA well.

That being said, there is a definite advantage to the icu because the icu is the realm from which most CRNAs were born and therefore can most relate. Common traits among CRNAs are type A personalities and anal retention, two qualities well suited to an icu type environment as well as the OR.

People tend to make a big deal about drips and lines in the icu; however, the pharmacology, physiology, and technical skills learned in anesthesia school take one to an entirely different level so as to negate any advantage of prior knowledge.

Unfortunately, schools are showing less and less inclination to accept ER as acute care experience making icu the preferred route. IMHO, this is folly on the part of acceptance committees as the ER skill set is an asset in the OR. I thank my lucky stars everyday I go to work that I am no longer in the ER, but wouldn't trade those skills for all the icu gtts and lines in the world.[/quote

Joe- All of that makes sense, but from the ICU standpoint...everything you described in the first paragraph happens in the ICU too b/c those patients go from alive to dead really fast sometimes. So there's much hustle and bustle that goes with all of that.

I think if you're coming from a level I trauma center and working in the main core with the trauma pts and ones that are tranferring to the ICU then you're fine. In my experience with getting into school, and applying to a few different places- they all took experience into account on an individual level.

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dfk has 11 years experience as a RN, CRNA and specializes in Critical Care, Emergency.

501 Posts; 6,092 Profile Views

Re: ICU or ER

permalink

I personally came from an ER background and to this day find the skill set I learned in the ER to be invaluable. Rapid assessment, quick thinking, improvisation, a cool head under fire, being able to roll with the punches, prioritization, decision making are all assets learned in the trenches of the ER. and will serve any CRNA well.

That being said, there is a definite advantage to the icu because the icu is the realm from which most CRNAs were born and therefore can most relate. Common traits among CRNAs are type A personalities and anal retention, two qualities well suited to an icu type environment as well as the OR.

People tend to make a big deal about drips and lines in the icu; however, the pharmacology, physiology, and technical skills learned in anesthesia school take one to an entirely different level so as to negate any advantage of prior knowledge.

Unfortunately, schools are showing less and less inclination to accept ER as acute care experience making icu the preferred route. IMHO, this is folly on the part of acceptance committees as the ER skill set is an asset in the OR. I thank my lucky stars everyday I go to work that I am no longer in the ER, but wouldn't trade those skills for all the icu gtts and lines in the world.

hey joe,

i'm assuming you mean "retentive"...

otherwise, OUCH!!! :lol2:

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17 Posts; 1,046 Profile Views

hey joe,

i'm assuming you mean "retentive"...

otherwise, OUCH!!! :lol2:

No, I actually meant retention as a double entendre.

But, thanks for the assumption.

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657 Posts; 7,312 Profile Views

I have to agree having worked both ER and ICU I find my ER/Paramedic skills are what I rely on more than anything. The best thing about ICU for me personally would be lab interpretation and using the ventilator. Rarely will you see swans in Anesthesia patients unless you work doing cardiac anesthesia. Even then we didn't use that many swan-ganz catheters. I personally see the ER background as invaluable for Anesthesia, but that is just my .02 woth.

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