Nurse Practitioner in ED's

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takl23

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Hey All,

My lovely wife has been a NP in a family setting for about 5 years previously she was a RN in an acute care setting. Her current practice is very busy and her case load is quite complex. She is feeling a bit bored and my venture into EMS has reignited her interest in emergency medicine. We live in northeastern MA so hospitals are plentiful. We are having a tough time finding any info on NP's in a ER setting.

What I have found is overall experience is necessary and she has that many times over. Any thoughts would be great!

I figured there were enough people here that could help a little :D
 
What type of NP is she? FNP,ANCP,etc

Most trauma centers usually prefer ACNPs over NPs due to the fact that they can perform more advanced procedures. But many ERs use NPs predominantly in the "fast track" or clinic role seeing patients with minor complaints that would usually be seen in an office. Makes sure she does her research and shadows because she may end up doing something very similar to what she is doing now.
 
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What Chase said. A few local ERs use them and they are mostly handling fast track. Sometimes they do get a more complex pt but those get handed off to an ER doc to handle.

Some of the local ICUs are using them as the first line care person before a doc is called. I do the know the pay is great. A medic/RN friend that recently became an NP just got an ER job @ $70hr with 84hrs every 2 weeks.
 
She currently is a FNP working on her doctorate. What really interests her are trauma's, codes and the ever changing ER case load. (I suppose that interests most of us). Before she left her last hospital as an RN she was working on being a part of the code team.

I think what would make her happy is per diem hours at an ER for a change of scenery and pace and keeping her current role in family practice.

shfd about where was this job located?
 
Most of the ER's that I've seen use NP's and PA's strictly in a fast-track role, basically doing the same stuff you'd see in an urgent care. Pretty much all the large, busy ED's use them. Smaller ones tend to be staffed by just one or two ED doctors, or maybe one doctor and one PA or NP.

There are certainly exceptions, though. Where I used to fly in central NYS, there was a specific rural hospital ED that we frequently responded to that was staffed by a PA at night. He was the only practitioner in house at night and handled everything that rolled through the ED door as well as everything that went bad on the floors and in the ICU. And he did a damn good job. Yes was a PA, but PA's and NP's are interchangeable in most midlevel job descriptions.

If she's just looking for "a change", there are lots of things an NP can do outside of family practice or EM. In the southeast, there are excellent opportunities for NP's in critical care, pre-op / post-op clinic, general hospitalist roles, etc. Pain seems to be a rapidly expanding field, too.

Generally the more rural you are willing to go, the more opportunities there are as a midlevel, but there are plenty of jobs in the cities as well.
 
Unfortunately, she may be at a disadvantage. The FNP role is not really suited for traumas, codes, etc. It is not impossible but I am sure it will take some work to find a role like that.
 
She needs to go ask.

PS: maybe DMAT or MERC or other disaster and event crews might help scratch that itch.
PPS: I've met some "kick arse" FNP's who would do well on the cowboy side of the ED. Besides, if so MANY emergency patients aren't emergencies, she will fulfill a very busy and valuable role.
 
Both the local Hospitals I have here that are low level Trauma centers (both level 4) have NP's and PA's in the ED. They are more reserved for a "fast track setting" They have one Physician, and one NP/PA on during the daylight hours but they PA's and NP's both rotate to do 1 day at a urgent care center that is owned by the network and 1 day at the Level 1 Trauma Center to help relieve the Full time PA's down there. the NP and PA's often go into major traumas and codes to help the ED doc.

It may not be impossible to get into a ED as a NP but she may have to be willing to relocate.
 
We use NPs and PAs in my ED (level 1 trauma), but they don't get involved in anything too complex.

We have a fast track portion of the ED that is staffed with a mid-level and an MD. In the more acute section, our mid-levels tend to stick with abd pain, pulmonary issues, and non-cardiac CP... the less acute patients. Our docs handle the low level traumas and the very sick medical patients and codes.

The really bad traumas are covered by our trauma team. And even then, the trauma NPs don't really do anything while they're in the ED.
 
As an ER Paramedic, I handle up to six 'fast track/flow' patients at a time, and my provider is generally a PA or NP. THat's what we use them for at the only trauma center in NM
 
msjellybean said:
We use NPs and PAs in my ED (level 1 trauma), but they don't get involved in anything too complex.

We have a fast track portion of the ED that is staffed with a mid-level and an MD. In the more acute section, our mid-levels tend to stick with abd pain, pulmonary issues, and non-cardiac CP... the less acute patients. Our docs handle the low level traumas and the very sick medical patients and codes.

The really bad traumas are covered by our trauma team. And even then, the trauma NPs don't really do anything while they're in the ED.
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And the Titanic really didn't need those expensive lifeboats.
 
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