Background: Critical responsibilities for emergency nurses require a diverse set of skills, 
which is called competence. Competence includes the desire to show prospective personality 
traits that can be advantageous in specific situations. Aim: Assess emergency nurses' core 
competencies in the management of critically ill patients in the emergency department. 
Subjects and Method: Design: A descriptive research design was conducted in the 
Emergency Department of General Qena Hospital and Emergency University Hospital, 
Egypt. Subjects: A convenience sampling of 70 emergency nurses was recruited to provide 
direct care for critically ill patients. Tools: three tools used in the study: 1. Core competences 
of clinical skills and knowledge for emergency nurses. 2. Core competences of 
communication and teamwork skills for emergency nurses. 3. Core competences of 
professional development, organization awareness, research, and quality improvement for 
emergency nurses. Results: The emergency nurses' core competencies during respiratory 
care were 75.14% from General Qena Hospital and 80.36% from the emergency University 
Hospital. The emergency nurses' core competencies in cardiovascular care were 71.45% from 
General Qena Hospital and 88.36% from Emergency University Hospital. There were 
statistically significant differences among the studied nurses from both hospitals in the 
majority of items. The levels of core competence criteria for emergency nurses were 45.7% in 
the general Qena hospital but 17.1% in the emergency university hospital. However, the level 
of core competencies for emergency nurses was good at 45.7% in the general Qena hospital 
and 80% in the Emergency University Hospital. Conclusion: Competency can be used as the 
cornerstone for evaluating critical nurses' performance. Core competence should be used as a 
vital tool to evaluate nurses' levels of performance and patient satisfaction.