Frustrating... ED is Not Critical Care

[bgxyrnf]

I've been an ED nurse for 7 years, working at four different hospitals from a tiny, rural, critical-access hospital (as I call it, Level None) through a regional academic medical center (peds and adult Level One). I've also worked in the critical-care float pool at the Level 1. Whether it be from CRNA programs or from ICU nurses in the smaller facilities, I get a bit tired of the offhand presumption that ED nurses are not critical care nurses.

While I will admit that that assessment does hold true in many circumstances, there are EDs where the nurses get substantial experience with some of the most critical patients.

Think about those times when the ICUs are full and you are boarding critical patients for hours. I've boarded critical burn patients, unstable trauma patients, critically ill medical patients on multiple drips, post-ROSC patients, as well as patients deemed too unstable for transport to one of the units or needing to hold in the ED for completion of various diagnostics or procedures.

How 'bout a shout out to and from the ED nurses who would absolutely raise their hands to self-identify as critical care nurses?

[AZRN84, BSN, RN]

There absolutely are schools that accept ED experience. Check out this link: Unique CRNA Programs

I intend to apply to school in May of 2019 with two years of experience in a Level-1 ED, and one year of experience in a rural Indian Health Services hospital. I also have the following advanced certifications / experience: CEN, CCRN, ATCN, ACLS, PALS. I have a good GPA and shadowing experience. I am extremely hopeful that this will count for something. Please feel free to contact me if you want to discuss further.

[PiperLambie, MSN, APRN]

As a new grad nurse resident working in the ED for all of two months (with a prior career and lots of life experience), working at the flagship facility for one of the large organizations in the hospital business, I can say that I am grateful for the way that our residency is organized. We are divided into tracks, one of which is the "Critical Care" track, and this includes ED, ICU, Step Down, and Cardiac/Tele. Naturally we all work on our assigned units, but we all have periodic didactics together, with instruction by a variety of nurses and physicians from different specialty areas.

I feel like this has allowed for all of the new "critical care" nurse residents to form a camaraderie and rapport that allows us to see one another as equals, while working against the established attitudes on the units of "ED nurse vs. ICU nurse" that we all know exist. It is already making a difference from my end in the ED when it comes to calling report to fellow residents in other critical care areas, since we know one another, and get along. I understand the OP is more about recognition for the purposes of CRNA schools, but I thought I'd chip in simply because, as someone in the middle of this attempt at unit culture shifts, it definitely seems like things are moving in the right direction toward recognizing the similarities in the critical care areas, rather than the differences.