NC-RN

ChiaLing, Please don't worry. The ED is by no means the only or best path, I was just staing the reasons I like it. Critical care will also give you very good assessment skills and provide a solid foundation. Good luck.

I am starting my FNP program and I went to the ED as soon as I could for precisely the reasons listed here. I really would not want to work anywhere else in the hospital and think it is very good preparation for being a FNP. On a day-to-day basis the majority of ED patients are ambulatory and at an acuity similar to primary care settings. Of course you will also see much higher acuity patients daily, which is also excellent experience. In the ED you will also do a lot of teaching to both patients and their families. Additionally you will care for patients across the life span. Probably the best thing I can think of about the ED in relation to a future FNP career is that the majority of patients require you to really use your assessment skills to listen to the patient, look, feel, auscultate, etc. Is a stroke or Bell's palsy; too many tacos or a MI, menstrual cramping or an ectopic pregnancy? You get the idea. From my experience, in the ED you also work with the MDs more closely. They are always there which gives you as nurse an advantage to learn and be part of the diagnostic process. Before jumping into the ED as a new grad do some homework. Does the ED have a solid preceptorship program? I would suggest three months under a preceptor as a minimum. Do you multitask well? Is the hospital committed to training and education? The ED where I work has a great bunch of nurses who really work as a team. In contrast, the ED at another hospital in my area has a reputation as "you're on your own" type of place to work. Good luck!

ENPC is a comprehensive class on pediatric emergency care. PALS is more basic, and concentrates on airway and cardiac life support (ACLS for kids). My hospital is now offering ENPC and PALS together as one course. To get the additional PALS certification a couple more hours of class on PALS algorithms is required and you must take both the ENPC and PALS exams. David

Nursing should be considered noble profession and deserves a far more powerful voice in the healthcare industry than it has, but the root of it's problems can only be changed from within the field itself. Many of the problems of the nursing field result two reasons, (1) from nursing lacking a clear path of entry certification at the professional level, and (2) lack of cohesiveness of nurses as a group. While in nursing school I had a long discussion with a professor who I much respected about whether nursing was a considered a "profession" or an "occupation". She maintained that professional nursing did not begin until the master's level. I strongly disagreed, but now after a year and a half as a practicing nurse, my opinion has changed and I agree with her argument. Nursing has set a standard of entry at the diploma or two-year associate degree level, which is not considered a "professional degree" level in almost any profession. I am NOT saying ADN nurses are not qualified excellent practitioners, but their degree does not confer "professional" status in the American system. BSN nurses do have a four year degree which is considered to be a "professional" level degree, however because licensing standards are the same as a ADN prepared nurse the BSN nurse is considered no different to those outside the nursing profession. In a field where 2-4 years beyond undergraduate level is required to attain professional status (i.e. PTs, RpHs, MDs) nursing will never get the respect it is due until has a four year degree entry requirement as a standard of practice. A good start would be a separate licensing path conferring RN-BSN licensure specific to the BSN degree with a "NCLEX-BSN" which would acknowledge and test the additional professional preparation the BSN should require. The second barrier I mentioned is the lack of cohesiveness of nurses as a group. Nurses are one of the largest occupations in this country. There are four nurses to every one physician in the nation (http://www.nursingadvocacy.org/faq/rn_facts.html). However, a small percentage of those nurses belong to their state and nation Nursing Associations. Doctors do not have the power they do solely because of their education; over 97% of them belong to the AMA, which is a powerful state and national lobbying force. Money buys power and influences change.

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