Deena Brecher, MSN, RN, APRN, ACNS-BC, CEN, CPEN , Wilmington, DE


t’s the end of June. Your manager catches you on the way out the door and says, “Hey, did you know your ACLS (Advanced Cardiac Life Support) expires at the end of July?” There are so many ways to respond to that question. A response out of frustration because the reminder does not give you enough time to get into a recertification course. Perhaps a response of appreciation because you did forget to schedule a renewal. Maybe it’s a response out of anger because it would have been helpful to be reminded about 2 months ago. How many things are required of us to be licensed as registered nurses? For most of us, we need to submit our renewal paperwork on time, and for some, a certain amount and/or type of continuing education must be completed. When we consider the requirements of being an emergency nurse, however, the list grows much longer. In addition to a valid registered nurse license, most of us are required to maintain credentials in ACLS, PALS (Pediatric Advanced Life Support), ENPC (Emergency Nursing Pediatric Course), TNCC (Trauma Nursing Core Course), NRP (Neonatal Resuscitation Program), CPI (Crisis Prevention Institute), or some combination of these courses. There may be requirements for workplace violence education, annual hospital-required education, or state-mandated courses or, in some places, certification as a CEN (Certified Emergency Nurse) or CPEN (Certified Pediatric Emergency Nurse).

So, who is responsible to make sure you have all of the credentials, training, and education you need to practice safely as an emergency nurse? What happens when you do not know how to use a piece of equipment? When was the last time you pushed all of the buttons on the defibrillator? Do you know where the internal paddles are? How about the rapid infuser? Do you know your way around your resuscitation room? Could you put a blindfold on and direct someone else where to find the chest tube drainage system? How fast can you make a norepinephrine drip for a 10-kg pediatric patient in septic shock? It is so easy to point a finger toward your ED leadership team and say, “You did not teach me how to do that.” Now, imagine a critically ill child on a stretcher, hypotensive and bradycardic, with his distraught parents standing by. Is standing there, shrugging your shoulders, and saying, “No one taught me how to do that,” an acceptable response? As emergency nurses, we must realize that each of us individually is responsible to make sure we are practicing safely in the emergency department. We need to be accountable for our practice, which includes completing not only the required education but also continuing to seek out and take advantage of opportunities to learn. TNCC provides the emergency nurse knowledge, skills, and attitudes necessary to safely care for trauma patients. ENPC does the same for our pediatric patients. Ditto for PALS, ACLS, and NRP. The same is true for protocols, pathways, and evidencebased practice guidelines. We need to be well versed in the who, what, where, when, and how of our practice. We need to be able to identify when we need help and not be afraid to ask for help. ENA’s clinical practice guidelines, topic briefs, position statements, and toolkits provide answers to these questions. The accountability for keeping up with everything we need to know about being an emergency nurse belongs to each one of us. It’s time we own our practice and stop waiting for someone else to tell us what we need to do. Our patients are counting on us to care for them safely, each time, every time, no matter what.

Deena Brecher is President of the Emergency Nurses Association. For correspondence, write: Deena Brecher, MSN, RN, APRN, ACNS-BC, CEN, CPEN, Emergency Nurses Association, 915 Lee St, Des Plaines, IL 60016; E-mail: [email protected] J Emerg Nurs 2014;40:413 0099-1767 Copyright © 2014 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

September 2014




Emergency nursing practice… it's time we own it for our patients' safety.

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