Nurse practitioner in EM/ER

Editorial Team / Moderator · Mar 6, 2012

Our Fast Track uses PAs as providers, but we do have an ACNP who works in our core ED. He is FABULOUS. And unfortunately now deployed with his National Guard unit for a year. It will be great when he's back, he rocks!! :)

boyfactory · Mar 6, 2012

In the ED where I used to work, we had 1 PA-C and 4 FNP's. Of the NP's, 3 of them only saw fast track patients. The PA-C and the other FNP saw regular ED patients in addition to the FT patients if things were slow in FT.

Where I am currently working, there are 6 different FNP's and they only work FT. Of the FNP's at both of the ED's I have worked, all but one had worked previously as an RN in the same department. As far as FNP via ACNP, it may depend on location and hospital.

CrashED · Mar 24, 2012

We have 2 NP's who work at our trauma center, and the implementation of them has been a marvelous asset to our hospital. They see the levels 3-5 within their scope. It works great, and makes for faster ER times and Patient Care!

VICEDRN, BSN, RN · Mar 25, 2012

The ER NPs see mostly fast track patients where I work. They have started to use them more with ESI 3s but we really have no need to use them in this capacity because we are a teaching hospital.

It is my general preference to work with PAs over NPs and it is my general opinion that the scope of practice is too narrow for an ER NP.

Oddly, my husband and I were just talking about this. He works in an ICU but will bounce to ER for a shift or two and he commented to me recently that he can see why the idea of ER NP doesn't interest me because the Acute Care NPs seem to do more in his opinion but this is just what we think.

BostonTerrierLover, BSN, RN · Mar 25, 2012

I work in a small critical access hospital, and take patients on a rolling basis of admission, Over the weekends, the doc works a straight 60 hour shift, so I handle everything but Cardiac, Major Trauma, and other No Brainers. Its nothing to not even have to wake him up on a non-eventful weekend. I do get his approval for admitting patients to the hospital, but DO HAVE admitting rights, I do that as a courtesy, and a back-up, amazingly, he's great and does the same. I think its like anything else, after they learn your skills and abilities, or after you get competent in your skills and abilities, automy gets wider with time.

But as of common sense, I get him to sign off on CT scans, MRIs, and other special expensive labs, Triage to larger medical facilities, and I have also done ride-alongs with critical patients w/EMTs.

My background was nearly 2 years Med-Surg, a year of ICU/CCU/CVR, and the rest was completely ED, ED Holding, ED Obs, ED Trauma. Even as a ENP, I still work a floor nurse on travel assignments, per diem, and agency. I do 7 on, 7 off, and actually make more money working agency (per diem and contract) as a staff RN in ED and Trauma, I just like the atmosphere of practicing as an NP and getting all 7 days off if I wanted them. (as the prior post says, there are smaller changes between ACNPs, FNPs, and ENPs. On staff we have 4 MDs, 2 DOs, an ENP, and me an ACNP. We are in the process of hiring a PsychMHNP for our new 30 bed Inpatient MH Care Center as a type of Hospitalist.

Good Luck! Will always answer questions if you have them later.

LG1137 · Mar 25, 2012

good thread, lots of interesting info here, please keep it coming.