FNP in the Main ED

[matthewandrew]

Are there any family nurse practitioners working in the main emergency department. I know many FNPs working in the urgent care/fast track settings but I wonder if FNPs are allowed to work in the main ED.

[synaptic]

you cut out the part of the paragraph that I was referring to.

[sjalv]

you cut out the part of the paragraph that I was referring to.

I don't think the issue is most doctors don't "want" to work ED; it's that ED residencies are extremely competitive.

[synaptic]

they are getting more competitive but still on lesser difficulty of the spectrum. in rural areas there are very few board certed em docs. They do get burned out quickly i believe, hence why many do not want to work in it, but again it is strange that many midlevels do strive to work the ER.

at my wife medical school everybody who applies to em residency gets matched pretty easily

[PMFB-RN, RN]

Its very surprising to me that so many people who purport to be nurses so easily and willing use a degrading term like "midlevels".

[Chen808]

FNPs here work ED, Hospitalist and anywhere else needed. ACNPs are more limited and harder for them to find positions here.

[AnaLong, BSN, MSN, APRN, NP]

At my critical access hospital, there is 1 FNP and 1 RN and in my opinion 1 big chance for disaster. My MS BON has a position statement allowing FNP's in ERs. However, I look at it this way. In the court of law if G-d forbid one of these FNPs kills somebody or somebody dies, all the plaintiff's attorney has to do is pull out the FNP curriculum and ask the FNP where in his/her education were they taught to deliver babies, intubate, insert chest tubes, thoracentesis, etc. The next Level 1 trauma hospital from us is 1 hour by ambulance or you can WAIT for the helicopter. A life can't always wait in my opinion. I am an FNP, I work in urgent care. To me there is a difference. FNPs belong in primary care. If anything, a dually certified ACNP in both adult and PEDS critical care should be allowed in EDs. No offense to anyone, but I just feel that it the best way to protect the patient #1 , your license #2 , hospital liability #3 , NP profession #4. In our situation anyway where there is 1 FNP and 1 RN.

[PMFB-RN, RN]

At my critical access hospital, there is 1 FNP and 1 RN and in my opinion 1 big chance for disaster. My MS BON has a position statement allowing FNP's in ERs. However, I look at it this way. In the court of law if G-d forbid one of these FNPs kills somebody or somebody dies, all the plaintiff's attorney has to do is pull out the FNP curriculum and ask the FNP where in his/her education were they taught to deliver babies, intubate, insert chest tubes, thoracentesis, etc.

It should be very easy to show where in their education there were trained to deliver babies or intubate or whatever they do. Doctors are not trained to intubate in medical school, or in most residencies, yet those who do are trained. RNs don't learn to intubate in nursing school yet I can and do intubate and can document my training to do so.

Just because the training doesn't take place in the initial preparation for licensure doesn't mean it doesn't exist.

The FNP who works in our rural ER took the Physicians Advance Airway Management course right alongside the family practice docs who also work in our ER and received exactly the same training as the physicians did in airway management, to include intubation.

[TicTok411]

You Must be in Texas. I have heard that sort of thing down there...here they work ED, Hospitalist and in the ICU. Depends on their background and who hires them. Think that is a good thing!!

[PMFB-RN, RN]

You Must be in Texas. I have heard that sort of thing down there...here they work ED, Hospitalist and in the ICU. Depends on their background and who hires them. Think that is a good thing!!

Not sure who you are talking to here. However just the fact that we are well paid and treated as nurses where I work pretty much precludes any chance that we are in Texas.

[blondenurse12, MSN, NP]

When I worked in the ER as a nurse, we had one FNP that worked in both the regular ER and the fast track. However, she had been a nurse in the ER prior to getting her FNP so I think it was kind of a natural transition since she knew the process and such. I guess it would probably be specific to facility as to whether or not they want a FNP in the ER. Some ERs also have stipulations in terms of what the NP/PAs can or cannot do. Like at the aforementioned facility, the PAs and NPs were not allowed in the trauma rooms nor could they intubate.

[WIBound]

The ED where I worked had majority of PAs and a couple of NPs - that was mainly because one old PA did all the midlevel hirings. The midlevels worked fast track and as part of the main ED. The MDs took the more complicated cases and they also signed off on any questionable issues. It seemed to work out for the most part as more that 80% of ED patients are minor (at least where we were).

I did get to hear the PAs drone on and on about how they thought they were better prepared than NPs and overall I did not see it. We had two really great PAs but the rest were (at times) a little scary. The few NPs I worked with were very solid and did not tend to order every lab and scan possible.

Our midlevels didn't intubate but could place central lines - if time and the MD felt comfortable with them.