Why are emergency nurses not considered critical care nurses?

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Just an observation but why are emergency nurses not considered critical care nurses? Who deals with more critical patients? We work on the same patients although we take care of more critical patients at one time on many occassions. We do the many of the same procedures (internal pacemakes, arterial lines,burr holes). We give the many of the same drips (dopamine,neosynephrine). We have the same education need the same prerequsites (ACLS PALS, arrythmia interpretation). If you work in an ED that has Pediatrics dept then you need to know more because we are dealing with completly different group of patients with different needs. We monotor many of our patients on telemetry and have no telemetry nurse manning the central monitors. I also can't tell you how many times we have kept patients in the ED because "they were not stable enough to go to the ICU". We are not allowed to sent patients to the ICU with critical low vital signs until we stabalize them. We have to do most of the admission orders before we send them. (put in central lines, start drips,give all IV meds, if we start blood we keep them one hour after we start. We have to address all abnormal blood values).Many times we board ICU patients in the ED many times we recover patients from the OR because there is no PACU nurse afterhours. I love it when an ICU nurse is floated to us. Half the time we give them the most critical person then devide the rest between us because they are totally overwhelmed. I am not saying we are more special then ICU or PACU or NICU nurses but we should at least be considered one of them.

Specializes in Day Surgery/Infusion/ED.

I think it might be because on this board ED nurses are not included in the "Critical Care" section. Just a guess.

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A friend of mine is pursuing her masters degree and is an ER nurse. The masters program requires one year critical care experience and says ER " doesn't count" So she had to change departments to fulfill the requirement. I was told it has something to do with swans and balloon pumps and such. I don't know.

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I understand that for some masters programs such as nurse anesthetist, er is not considered critical care due to not having swans and balloon pumps. I am not saying that some er nurses aren't crtical care nurses but unfortunately have had quite a few that I have gotten report from that could not tell me what rhythm the patient was in and the patient was an acute mi. The same nurse told me that the patient was on a ntg drip at 30 and when the patient arrived he was on at 30cc/hr....100!!!, with unrelieved chest pain 6/10. I have gotten intubated and vented patients and the nurse had no idea what his settings were or where to find them. I think that just because one is an er nurse doew not make them a critical care nurse, it's what they choose to do when they get to the er.

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Specializes in mostly in the basement.

"AACN recognizes that critical care nurses work in several types of areas, including the ED, Radiology, PACU, etc, etc.

To the OP: Who told you we weren't?"

Um, I guess the moderators of this forum?

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"Um, I guess the moderators of this forum?

Why's that? Because we have our own forum rather than being included in the Critical Care forum? We are critical care nurses but the ER is a whole different ballgame than ICU/CCU/tele. If I'm correct, PACU has their own forum too, but they are critical care.

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in our hospital er nurses have same even more value than icu's

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Specializes in CCU/CVU/ICU.

In my opinion, emergency-nursing is a 'type' of specialty...amongst other specialties that consider themselves 'critical-care'. (anyone who monitors telemetry and is acls can be 'considered' critical-care)

I think that perhaps the biggest difference is that in the emergency room, seeing/treating critically sick patients is the exception rather than the rule ...in the vast majority of the nations er's . This, combined with the fact

that you're expected to manage/treat the whole spectrum of patients...whiny kids, freaked parents, drunken idiots...headaches, belly aches, rashes... All this translates into a 'specialty' that is perhaps the nearest thing to a 'jack-of-all-trades' amongst nurses. YOu do critical care..to an extent (you dont do iabp's, monitor hemodynamics, prisma, continuous eeg's...and all the other snobbery-inducing-fancy-icu stuff...and contrary to popular culture's opinion of ER's, you dont do surgery, cath-lab stuff, flirt with ultra-babes,etc.. ).

In ICU,however, all day every day you care for critically sick or potentially critically sick..and commonly the grieving/freaked families...all day every day...AND you're trained on all the snobbery-inducing-fancy-icu stuff.

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Specializes in M/S, Onc, PCU, ER, ICU, Nsg Sup., Neuro.

I fought this question for the 8 yrs that I was doing ER and never received what I felt was an appropriate answer. During my time in the ER I had ICU nurses work in my unit that had total meltdowns by the end of the shift. I have even sent emails to our moderators asking why Emergency Nursing was never included in with the other Critical care specialties and just lumped in with all the rest of Nursing areas but never really got an answer to my liking, was usually it was just an oversight(one that was never corrected yet....GRR)

I left the ER over a year and a half ago. But good ER nurses are every bit as much of a critical care nurse as those who work in ICU, CCU PACU etc and should be recognized as such. I now work 7P-7A in a 15 bed ICU but my mind still functions like that of an experienced ER nurse when things happen to my pt's, or maybe that's just the critical thinking skills that all of us(ER,ICU/CCU,PACU,PICU etc) nurses use on a daily in the delivery of care to our pt's doing everything we can to keep our folks alive and well.

flaerman

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Specializes in Trauma Critical Care.
Last Saturday I got a 73-yr-old man with heat exhaustion. By helicopter. Ended up transferring him out for cardiac involvement. The next day I got two more helicopters with two firefighters with heat exhaustion from fighting a brush fire. One ended up admitted. The second one almost did. The day after that I was off but another helicopter arrived with another heat exhaustion pt. My firsst day back to work I got yet another helicopter with a drowning victim that we transferred out. Don't tell me I'm not a critical care nurse, I'm liable to bop you upside the head!!!

BTW......our pad usually only sees helicopters that are taking our pts out. Only once or twice a year do they bring us something. Five in one week had us walking around dumbfounded.

That was my question. Why are you accepting patients by air that you than have to send out. Perhaps the bird should have stayed inthe air for a couple more minutes and taken them to a hospital that could have fixed all their systems....

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Specializes in Trauma Critical Care.

In my opinion, emergency-nursing is a 'type' of specialty...amongst other specialties that consider themselves 'critical-care'. (anyone who monitors telemetry and is acls can be 'considered' critical-care)

I think that perhaps the biggest difference is that in the emergency room, seeing/treating critically sick patients is the exception rather than the rule ...in the vast majority of the nations er's . This, combined with the fact

that you're expected to manage/treat the whole spectrum of patients...whiny kids, freaked parents, drunken idiots...headaches, belly aches, rashes... All this translates into a 'specialty' that is perhaps the nearest thing to a 'jack-of-all-trades' amongst nurses. YOu do critical care..to an extent (you dont do iabp's, monitor hemodynamics, prisma, continuous eeg's...and all the other snobbery-inducing-fancy-icu stuff...and contrary to popular culture's opinion of ER's, you dont do surgery, cath-lab stuff, flirt with ultra-babes,etc.. ).

In ICU,however, all day every day you care for critically sick or potentially critically sick..and commonly the grieving/freaked families...all day every day...AND you're trained on all the snobbery-inducing-fancy-icu stuff.

BINGO !!!!!!

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ER is defintly a critical speciality, in that they have to assess, diagnose and treat critically ill pts. Said and done.

All you have to argue over is length and breadth of treatment.

ER is typically stabilize and transfer, that is what they do. It is VERY hard for an ER nurse to have to monitor pt.s for long periods of time, it simply is NOT their focus.They are educated in treating an acute MI in the first hours, they don't typically have to deal with reperfusion ectopy.

They diagnose the new onset a-fib, they don't have to set up and monitor corvert therapy.

They don't set up or monitor A-lines or SG caths, that's OUR job.

Expecting them to be able to do such things is likely to result in their expecting me to be able to set up for a pelvic, get a Mom into delivery position, or know how to assess a kidlet for croup.

Thanks, but no thanks.

I'm very glad to take the sickest off thier hands. I KNOW I can do it better, and they know it too. I've got the time, and the equipment. Let those great nurses triage and once the matter is settled, I'll be happy to take over, so they are free to use those diagnostic skills on someone else.

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AACN recognizes that critical care nurses work in several types of areas, including the ED, Radiology, PACU, etc, etc.

To the OP: Who told you we weren't?

Has anyone looked at the forums here? Critical care has its own area and includes PACU NICI ICU the ED is in the Other specialty sections with the med surg nurses,obstetrics etc.... I have worked in facilities where ICU nurses got specialty pay ED nurses did not because they were not considered critical care nurses.

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