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 ICU/ER/TRANSPORT.

Anyway leave it to a bunch of nurses to get pissed off over a issue like this. No wonder the hospital admin. and the medical staff try to push us around so much, if they see us spend so much energy trying to one up each other, they will continue to look at us a little meager helping nurses.

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Specializes in CCU/CVU/ICU.
Anyway leave it to a bunch of nurses to get pissed off over a issue like this. No wonder the hospital admin. and the medical staff try to push us around so much, if they see us spend so much energy trying to one up each other, they will continue to look at us a little meager helping nurses.

Very nicely put bullydawgrn.

However...icu nurses are way cooler than er nurses. so naahh naah nana nahh!

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Iabp in the er..hmmm. interesting. So does the er doc give the initial orders for timing and cycling of the machine?

Nope! We have still had to take them from other hospitals that were transferred to us when no unit bed was available. CTU doc comes to the ED and sees the patient, writes the orders and we wait until a bed is ready before we take them upstairs.

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Specializes in CCU/CVU/ICU.
Nope! We have still had to take them from other hospitals that were transferred to us when no unit bed was available. CTU doc comes to the ED and sees the patient, writes the orders and we wait until a bed is ready before we take them upstairs.

sorry for butting in...but. Why would a hospital transport a patient on IABP to another hospital with no unit beds? to sit in the ER??? Thats stupid...and unlikely. Transport of these patients doesnt happen unless a bed is available...

And...ICU nurses are cooler anyway! Nahna nanana!

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Okay, I have to say it. So as an ER nurse you're taking care of a balloon pump patient, do you actually know how to adjust it and what you're looking at and why you should adjust it? ICU nurses have to take classes and be oriented on the unit for a ocuple of days before taking them on their own. I just find some things that are said here very arrogant. Everyone likes to think they're so smart that they can take anything, it would take someone a very long time to become extremely proficient in all areas and maintain that proficiency by doing it frequently. So how do you manage a balloon pump on a patient fresh out of a mitral valve repair? aortic valve repair? massive MI? the point is that critical care nurses have the title because that's the area they work in, you don't see them wanting to be called emergency nurses just because they have to deal with emergencies also.

Anesthesia more frequently is looking for candidates that deal with critical care nursing daily, because that's what we do in the OR. We put patients to sleep, monitor hemodynamics, keep them alive, and deal with the effects of surgery. Many SICU nurses have to deal with the effects of surgery, do you as an ER nurse know how to take care of a whipple? We all have our specialties, just because you've taken care of a certain type of patient or are forced to do it in non-ideal situations doesn't make it right. Why in the world would i want someone taking care of me in a critical status when you have to take care of seven other patients. it seems that the attention and care wouldn't be ideally what the patient needs. it is great that you can deal with emergencies and stablilize and handle all of those patients, but our purpose is to have the patient stay alive and actually walk out of the hospital. let's not let our pride get in the way of the patient's best interest.

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sorry for butting in...but. Why would a hospital transport a patient on IABP to another hospital with no unit beds? to sit in the ER??? Thats stupid...and unlikely. Transport of these patients doesnt happen unless a bed is available...

And...ICU nurses are cooler anyway! Nahna nanana!

Unit bed was available at time of acceptance. We are the only level 1 trauma center in the state. This particular patient had to be packed up and transported to us which took quite some time. During transport to our facility there was two codes on the floor that took the last two unit beds. Patient had to be boarded in the ED until things could get shuffled around upstairs. Nahna nanana!

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Okay, I have to say it. So as an ER nurse you're taking care of a balloon pump patient, do you actually know how to adjust it and what you're looking at and why you should adjust it? ICU nurses have to take classes and be oriented on the unit for a ocuple of days before taking them on their own. I just find some things that are said here very arrogant. Everyone likes to think they're so smart that they can take anything, it would take someone a very long time to become extremely proficient in all areas and maintain that proficiency by doing it frequently. So how do you manage a balloon pump on a patient fresh out of a mitral valve repair? aortic valve repair? massive MI? the point is that critical care nurses have the title because that's the area they work in, you don't see them wanting to be called emergency nurses just because they have to deal with emergencies also.

I cannot take care of anything and actually said that in my earlier post. Not being arrogant and actually said that ER nurses are not ICU nurses, but they do critical care nursing to an extent. Also said that I was not an ICU nurse, never said that I wanted to be called one. We were given a 2 day advanced hemodynamic monitoring class which included IABP, and had to spend one day in the CCU with an experienced ICU nurse taking care of a patient with IABP. This does not mean that I am proficient in anyway and was on the phone with the CCU charge nurse during the patients care, as well as my charge nurse who was a former CCU nurse of 10 years. All I stated was that I took care of a patient in the ED with a IABP.

Anesthesia more frequently is looking for candidates that deal with critical care nursing daily, because that's what we do in the OR. We put patients to sleep, monitor hemodynamics, keep them alive, and deal with the effects of surgery. Many SICU nurses have to deal with the effects of surgery, do you as an ER nurse know how to take care of a whipple? We all have our specialties, just because you've taken care of a certain type of patient or are forced to do it in non-ideal situations doesn't make it right. Why in the world would i want someone taking care of me in a critical status when you have to take care of seven other patients. it seems that the attention and care wouldn't be ideally what the patient needs. it is great that you can deal with emergencies and stablilize and handle all of those patients, but our purpose is to have the patient stay alive and actually walk out of the hospital. let's not let our pride get in the way of the patient's best interest.

I am glad that anesthesia is looking for nurses who deal with critical care daily. They should be! I personally have no desire to go to anesthesia school, but two nurses I work with, 1 ED and 1 flight nurse did get accepted without ICU experience. Nope, probably couldn't take care of a whipple. Have never had to before. Besides an ER nurse has no clue how to keep a patient alive especially long enough to get them to the OR or ICU.

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Specializes in E.R. Peds, PICU, CCU,.

We as ER nurses do not need to justify ourselves. If your facility doesn't consider you a Critical Care Giver they are misguided.

I don't care how many gadgets are attached or who attached them. Without us up front they don't get a chance to play with the expensive toys.

We save lives on a daily basis, we don't just maintain life.

What more justification is actually needed?

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Specializes in RN CEN.

The facility I work in has a 7 bed ED, a 6 bed ICU, and a 10 bed Tele. our ED sees just over 10,000 patients a year, not a great deal for a level 3 trauma center but we are only 60 miles from 2 level 2 trauma centers and a burn center. All of the nurses in our facility are on the same pay scales per union contract. We have nurses that work only ER and nurses that work only ICU, and then we have those that float to both, our name badges all say critical care. I work only ER, I do not know a damn thing about vents, "I bag the pt" I do not know anything about swans, baloon pumps, art lines or the like. We do not have an IV team or a code team, when some one needs an IV and the nurse tries but fails (including our ICU) we in the ER are the ones called to start them as we do about 80% of them anyway. We have a 5:1 ratio on codes we see many more in the ER than in our ICU. Our ICU/Tele and our ER are considered 1 department, under 1 nurse manager, I feel this is wrong, we are not the same. Our ICU nurses that float down say it is 2 totally seperate ways of nursing, 2 totally diffrent mind sets. Some of our ICU nurses are great in the ER, but there are others who are not, they are terrified of kids, or of psych, or OB, or Trauma, and that tends to put a lot more of a load onto those of us who take care of it all.

When I first joined this forum I was surprised to see that ER was not in the critical care area and a little dissapointed. ER nurses are critical care nurses it's just that our patients are acutely critical and generally unstable, I also noticed that flight nurses are not considered critical care nurses in the forum either HUH? In my area of the country that is all they take care of, every flight, granted only 1 at a time but critical none the less.

Please any ICU nurses or nurses from any other area do not take offense to my words. I work only ER and that is all I want to do.......God bless those of you who take care of the same pt day after day after day... I personally do not have that desire.

Sorry for rambling, it's late

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Specializes in ER.

ER is critical care even if administration and others don't classify us that way, we have so much overtime in our ER, we started having ICU nurses cross train so that they wouldn't have to take mandatory time off, that lasted all of 2 months, the nurses refused saying it was too much work to have more than 1-2 patients per shift. Sad really because I know ICU nurses from other institutions that would love to have the option to do both for prevention of burn out.

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Specializes in Emergency, Trauma.

This shouldn't be an ICU vs. ER debate; both are critical care areas. Both ER and ICU nurses are considered critical care nurses by the AOCN and both are eligible to sit for the CCRN. We all take care of critical patients, though at different stages of the hospital visit. Many of our skills overlap, but there are many aspects an ICU nurse couldn't do without additional training and many an ER nurse couldn't do without additional training. Luckily, we can do critical care nursing in different areas with different focuses.

Why is it such a big deal where we are categorized on a message forum? I couldn't care less-there are way bigger issues to get worked up about.

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Specializes in CCU/CVU/ICU.
. Nahna nanana!

OH ya? Well...Nana nahnahana! times 100! ;)

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