There is probably nothing more frightening than when a loved one's life hangs in the balance after a medical emergency. As the patient is rushed into the hospital, ambulance lights flashing, family members hold their breath and look to the professionals in the hospital for any sign of hope and word that things will be okay. More often than not, these family members look into the eyes of the Critical Care and Emergency Room Nurses.

Choosing to specialize is a personal choice every registered nurse needs to make. From taking care of children to elder care, the different career paths to choose from are almost endless. Why, a nurse doesn't necessarily have to work in a hospital anymore. School nurses, flight nurses, army nurses, clinic nurses, extended care facility nurses, ship or cruise ship nurses…the list goes on. In any of these situations a nurse may run into an emergency case were the patient must be rushed into an emergency room and, in some unfortunate cases, the patients may end up in critical care units of hospitals. This is where the Critical Care and Emergency Room nurses come into action.

The Critical Care Nurse

Critical Care nurses are unique. Registered nurses, the critical care nurses help assess patients medical conditions and needs, create and implement patient care plans, maintain accurate medical charts, administer medication and treatments to those very ill, injured and disabled patients in the hospital. Because these patients are very ill or in possibly unstable medical situations, the nurses closely monitor the patients for even the most slight or subtle change which could mean the need for immediate emergency care. Often the patients are on cardiac or respiratory monitors, need intravenous medications, ventilation and other technologies such as:

• Hemodynamic and cardiac monitors
• Mechanical ventilator therapy
• Intra-aortic balloon pumps (IABP)
• Ventricular assist devices (LVAD and RVAD)
• Continuous replacement equipment (CRRT/CVVHDF)
• And more…

Critical care nurses are trained to notice even the most barely perceptible changes in the patients' conditions.

As family is often visiting the ICU patients, the nurse will often be the one the family looks to for the latest updates on the patients' conditions. Critical care nurses make sure the family and the patient are informed about the treatment plans and medications the patient is receiving so they might make the proper personal decisions necessary for their care. Many times what the family is looking for is hope. Just as passengers on a plane look for the calm and relaxed faces of the flight attendants when there are turbulents, family members will often look to the nurses to see if they are at peace and comfortable with the way their patient is responding to treatment.

Critical Care Nurse Certification

Critical Nurses, as we stated, are registered nurses who have obtained CCRN certification through the American Association of Critical Care Nurses. The CCRN is a certification that the registered nurse is now a critical care nurse for adult, pediatric, and neonatal patients. Different variants of the CCRN certification include:

PPCN – Progressive Care
CMC – Cardiac Medicine
CSC – Cardiac Surgery
CCNS – Adult, Neonatal, Pediatric Acute and Critical Care.
PCCN – Progressive Care
ACNPC – Acute Care Nurse Practitioner
CNML – Certified Nurse Manager and Leader
The AACCN also offers an advanced practice certification test for Acute Care Nurse Practitioners.

In addition to the various specialties in the Critical Care Nursing field, there are numerous sub-specialties, including:

• NICU – Neonatal Intensive Care – includes patients, mostly newborns and premature babies up to a month old.
• PICU – Pediatric Intensive Care – includes patients from one month to 18 years of age.
• ICU – Adult Intensive Care – includes all patients 18 years of age and older.

Emergency Care by Emergency Room Nurses

Certified Emergency Room Nurse's (CEN) are registered nurses trained to work in the hospital's emergency room, where patients are brought with medical conditions needing urgent and immediate treatment and care. The ER nurse is trained to quickly assess the situation and the possible physical problems the patient has, their needs, and immediately begin a patient care and recovery plan. The nurse is not only trained in the care of the patients' physical needs, they are also trained to remain calm, focused, steady, emotionally stable, and caring to the patients and the family or friends that have accompanied the patient into the hospital. Some ER nurses choose to specialize even further to become transport nurses who work with mobile units such as helicopters and airplanes and a paramedic team.

The CEN certification is awarded by the Board of Certification in Emergency Nursing. This governing body also provides training for further specializing, such as the Emergency Nursing Pediatric Course (ENPC), which is focused on emergency nursing knowledge for nurses who want and need to expand their skills in pediatric emergency nursing.

The Future is Bright for Critical Care and ER Nurses!

According to the Bureau of Labor Statistics Occupational Outlook Handbook 2008-2009 registered nurses are "projected to generate abut 587,000 new jobs over the 2006-2016 period." This is one of the biggest projected rate of growth in any occupation. ER nurses and Critical Care Nurse wages vary from state to state and with the hospital and the experience. In 2006 the American Hospital Association stated that hospitals and their emergency rooms had an 8.5% shortage of RNs.

Is there a future for you in emergency care? With the apparent shortage of nursing and the expected growth in the industry, the nursing field is still an attractive and necessary profession. If caring is in your nature, if thinking fast on your feet is your forte, if helping people get well as you heal their bodies and the spirits of their loved ones around their bed, then emergency and critical care nursing may be for you.

Article © My Nursing Uniforms.com / Young Lion Incorporated
Image Courtesy of Eklektikos from Flickr.