They’re referred to as an “extra set of hands,” though they’re anything but extra.
When a child shows signs of decline on a medical unit, or a trauma team races to meet an ambulance in the emergency department, they bridge the gap between routine care and full crisis response.
“We wouldn’t be able to do what we do without our crisis nurses,” said Deborah Haddon, RN, who oversees the crises nurses at Children’s National Hospital in Washington, D.C. “Because of them, everyone else can keep doing their jobs.”
The role launched in 2012 to give bedside teams immediate access to experienced clinical support. Today, crisis nurses are embedded in nearly every emergency pathway in the building.
“They go anywhere they’re needed,” Haddon said. “And wherever they show up, everyone’s very happy to see them.”
Enhancing early intervention
A core function of the crisis nurse is leading rapid response teams. Within one year, about 70% of rapid response calls resulted in patients remaining on acute care units rather than transferring to the ICU.
“That tells us early intervention is working,” Haddon said. “It keeps kids out of the ICU, shortens stays, and reduces stress for families.”
Crisis nurses are also central to the hospital’s code response to medical emergencies involving visitors or staff.
But not every shift revolves around emergencies. They spend much of their time doing proactive rounds, checking in with charge nurses, following up on patients who raised concerns overnight, and offering help before a situation escalates.
“Sometimes it’s as simple as, ‘Can you look at this patient with me and tell me if I should be worried?’” Haddon said.
They also provide hands-on help throughout the day — from medications and transports to supporting sedations and stabilizing patients during imaging.
“What they can do is pretty limitless,” Haddon said.
A crisis nurse is available 24/7, with a second serving an overlap shift from 11 a.m.-11 p.m., which are peak hours.
Not just any nurse
Because crisis nurses move constantly between units and patient populations, the role requires deep experience.
All crisis nurses at Children’s National have critical care backgrounds, emergency training, and advanced life support certifications. Many have worked across multiple areas of the hospital before stepping into the role.
“They have to function autonomously, walk into any situation, and be helpful right away,” Haddon said. “That takes confidence, clinical judgment, and a lot of empathy.”
That empathy is especially important when working with acute care nurses managing multiple patients at once.
“A child may look stable in a critical care lens, but not when you have four other patients,” she said. “Crisis nurses have to understand both worlds.”
Benefits across the hospital
Because the program isn’t tied to a single unit, its impact is widely felt.
By assisting with almost anything, any time, crisis nurses allow inpatient teams to continue caring for their full patient assignments.
For hospitals considering a similar program, Haddon offered one key caution: Avoid viewing crisis nurses as supplementary staff during shortages.
“When you pull them to fill a hole, you’re just creating another one somewhere else,” she said.
From her perspective, the role is indispensable.
“They have their hands in just about everything we do here,” Haddon said. “If you shadowed them for a day, you’d be amazed at what they do.”
