Research Blog #3: Career Paths

Career Paths in the ER

There are many jobs to be filled in the Emergency Room as there are a near - infinite number of ways people can get injured or need to come into the emergency room.  As I learned with last week's blog post,  early emergency room staffers soon learned that things tended to go smoother when they had people specialize. Patients were better taken care of as medical professionals were able to focus on less specifics (medicine-wise), allowing for a wider range of conditions and ailments to be detected. And because of specialization, there are now a wide variety of positions in the Emergency Room - or in other words, there are a lot (of different jobs one can do in (and around!) the ER (and they are all extremely important!)

ER Nurse

An ER  nurse is a nurse by many name. The can be known as trauma nurses and critical car nurses. A nurse can have a bachelors degree (at a bare minimum), a medical degree, or a PhD. ER nurses make up about 30% of all total nurses. They make an average of $70,104 a year. An Emergency Room nurse has to be flexible.  Their job can go from fast to slow (or vice versa in a matter of moments. They are responsible fro provide care for whoever needs it regardless of situation. The Emergency Nursing Association lists the following skills as being necessary to be a successful ER nurse:

• Ability to shift gears and accelerate your pace as needed
• Good observation, assessment, and prioritization skills
• Likes complexity and variety
• Multi-tasking ability
• Compassion
• Good interpersonal and customer service skills
• Stamina
• Good personal coping skills
• Efficiency 
• Assertive patient advocate
• Ability to maintain calm amidst chaos
• Good sense of humor
• Ability to think fast and on your feet

While these are not the only things that will make a nurse successful, this list lists some good general principals of what could make a good nurse. As there is currently a shortage of nurses, most - if not all - hospitals are hiring and training nurses frequently Emergency Nurses can work (practice) in a wide variety of places, including the following

• Hospital emergency departments
• Administration
• Schools of nursing/universities/colleges
• Research/research institutes
• Emergent care centers
• EMS/Prehospital transport
• Flight nursing in helicopters/airplanes
• Poison control centers
• Telephone triage
• Military
• Corporations/businesses
• Crisis intervention centers
• Prisons/correctional facilities
• Federal and state governmental agencies

Although there is a shortage of nurses, not all emergency rooms - or hospitals for that matter - will hire nurses fresh out of school. Many fresh out of school graduates are not hired because of the time sensitive nature of emergencies and potential lack of training, but there are several ways someone wanting to have a career as an ER nurse.  Working in another area of nursing for one to two years prior to specializing in emergency nursing can give you invaluable experience to help pave your path to our profession of choice in the ER. If you work in a critical care environment, you will gain invaluable life experiences such as in life and death situations, and resurrection. Working in a medical-surgical environment will hep you prioritize in a medical environment and manage multiple patients all at once. There are many ways a recent student can get this experience. If a student gets lucky and hired immediately into an ER, they should look for one with a training program to be better able to serve in the ER. 

Nursing Specialties

There are many ways one can specialize even further as a nurse in the emergency room. 

Pediatric nurses have specialized to better be able to care for children ad adolescents and their families. On average, they earn $66,640 for RNs and $102,670 for NPs. Some pediatric nurses specialize to study different parts of medicine while focusing on kids, such as cardiology or immunology. In acute settings such as the ER, job duties can include caring for kids who are chronically, critically or acutely ill, performing detailed physical assessments, interpreting the results of medical tests, ordering medications and going through physical therapy among other duties. 

Progressive Care Nurses - sometimes known as step-down nurses - provide care for patients who need close monitoring and frequent assessment, but are well enough not to be in the ICU. They closely monitor vital signs as to better be able to monitor recovery.  This position is in the weird zone between ICU care and general care, so medical organizations have classified it in the field of critical care. PCU nurses tend to need the same type of training as ICU staff, minus certification on invasive technologies. This includes either an associate’s or bachelor’s degree in nursing as well as at least one year of service on a medical-surgical floor. PCU jobs are growing steadily, with over 500,000 new jobs created in 2016. The average salary is around 75,000. 

Nurse Practitioners  are Advanced Practice Registered Nurses (APRNs). Being a nurse practitioner means "a higher salary, more responsibility, and additional education requirements" (Nurse.Org).  They can act very similarly to physicians in the sense that they assign medication, examine patients, diagnose illness and provide treatment.  in 20 states they can practice independently of a doctor, while in the remaining 30 they still have great power,. Their average salary (at least of 2015) is $50.36 an hour and $104,740 a year. But how does one become a nurse practitioner?  One needs a bachelor's degree from an accredited university. One needs to become a RN, and keep their license in good standing, and then one needs a BSN.  Next, one needs to enroll in a MSN program, which will depend on your bachelor's degree. The one needs to pass a test. In an ER setting, nurses can work in a wide variety of positions because they are so incredibly credentialed. 

ER Doctor

Emergency Room doctors - otherwise known as emergency room physicians - generally have autonomy when making medical decisions for patients and leading teams.   According to payscale.com, they earn an average salary of $206,114 per year. According to ACEP, "The physicians must have the ability to do what they believe in good faith is in the patient’s best interest at all time." They assist patients, and order further testing if they deem it to be in the patient's best intrest. 

The first step to becoming a doctor in any setting is to earn a bachelor's degree. One should take science classes - more specifically, one should take - especially if they are doing the pre-medical track offered at some schools - biology classes, cellular biology classes, human anatomy and physiology classes, organic chemistry classes, math classes, english classes, and the occasional physics class. One should also volunteer. While volunteering will provide invaluable experience that might lead to future employment, it also helps spruce up one's resume for med school. But before med school, one has to take the MCAT, otherwise known as the Medical College Admissions Test. It is essentially like the SAT for med school, and the standardized test measures writing, problem solving and critical thinking skills. Once admitted to med school, one should chose to specialize in order to become an emergency room doctor. Finally, after med school, one has to get their license by  taking the USMLE (otherwise known as the United States Medical licensing Examination. Finally, a doctor has to complete either a residency or a fellowship, and then they are good to work in the emergency room by themselves. 

Doctors and nurses and MORE - oh my!

There are many other jobs - and people who fill those jobs - that make the ER run smoothly. There are  Emergency Medical Technicians (EMTs), who transport people form the site of their emergency  to the hospital. There are surgeons, who work to do both routine surgeries and live saving ones.  There are midwives, who help bring life into this world.  There are the specialists, who can help people discover their condition. And then there are the administrators, who help make the hospital run.  Hospitals help save lives, and are (now) staffed by a wide variety of health experts who can help save more lives than ever before.

Sources
- Harrison, Erika. "A Day in the Life of an ER Nurse." Olivet Nazarene University. N.p., 27 Jan. 2015. Web. 22 Mar. 2017. <http://graduate.olivet.edu/news-events/news/day-life-er-nurse>.

- "Emergency Physician Rights and Responsibilities." ACEP. ACEP, n.d. Web. 22 Mar. 2017. <https://www.acep.org/clinical---practice-management/emergency-physician-rights-and-responsibilities/>.
- "Emergency Room Career Options and Education Requirements." Study.com. N.p., n.d. Web. 22 Mar. 2017. <http://study.com/emergency_room_career.html>.
- "How to Become an Emergency Nurse | Training | Education | Salary." EveryNurse.org. N.p., n.d. Web. 22 Mar. 2017. <http://everynurse.org/becoming-an-emergency-nurse/>.
-"How to Become an ER Doctor: Career and Education Roadmap." Study.com. N.p., n.d. Web. 22 Mar. 2017. <http://study.com/articles/How_to_Become_an_ER_Doctor_Career_and_Education_Roadmap.html>.

- "Medical Jobs in the U.S." Jobs in the U.S. | American Mobile Healthcare. AMN Healthcare, n.d. Web. 22 Mar. 2017. <https://www.americanmobile.com/jobs/k-er-l-/?k=er&dfc=&dft=&page=12>.

- "Nurse Practitioner Career Guide." Nurse.org. N.p., n.d. Web. 22 Mar. 2017. <http://nurse.org/resources/nurse-practitioner/>.
- "Pediatric Nurse | About Careers and Education." All Nursing Schools. All Star Directories, Inc, n.d. Web. 22 Mar. 2017. <http://www.allnursingschools.com/articles/pediatric-nursing/>.
- "Progressive Care Unit (PCU) Nurse Jobs & Salary Info." NursingJobs.com. AMN Healthcare, n.d. Web. 22 Mar. 2017. <https://www.nursingjobs.com/nurse-specialties/pcu-nurse-jobs/>.
- "Safe Practice, Safe Care - About Emergency Nursing." About Emergency Nursing. Emergency Nurses Association, n.d. Web. 22 Mar. 2017. <https://www.ena.org/membership/Pages/WhyEmergencyNursing.aspx>.