ER VS ICU NURSING

Specialties Emergency

Published

hi, I'm a second year RN student and I eventually want to be an ICU nurse or an ER nurse, but I want to know which of the two really requires the most experience, highest skill set, and highest knowledge base? and which one pays more and works less??

Im just wondering so I can have an idea when I get out of school, thanks! =)

:coollook:

Specializes in ED.
oh well I just heard from my peers that ER nurses only have to do like half the work of floor nurses and ICU nurses and stuff, so I was just wondering.. any thoughts??

As an ED nurse and a former ED Tech I am very insulted by this comment. Sure we don't handle ADL's on the same patients all day long but we do CPR for hours on end, deal with people at their worst as far as mental status goes and we make split second life or death decisions on a daily basis. I would love for any of the people who feel this way to spend a day with me.

Specializes in ICU.
ICU nurses can work anywhere, even ER, because of our skill level. ER nurses, and med surg nurses do not learn how to care for the type critical patients we get in the ICU. Hemodynamic monitoring, vasoactive drips, read cardiac monitors, etc. I have had to float to the ER to care for a critical patient until we could get an open bed in the ICU.

Ummm....no.

While your run-of-the-mill ICU nurse might think that they walk on water, do multiple codes simultaneously (and at the same time!!!), and deal with those frequent "is the bed ready yet??" calls from ED, I seriously doubt (given my 3 whooooole years experience in ICU:uhoh3:) that an ICU nurse can "work anywhere".

Yes, the ICU RN may be better than the standard med-surg or ED RN at dealing with titrating multiple vasoactive drips.

As a mere ICU dweeb, do I feel ready/willing to handle 5-7 patients (and their families)? NO! Don't wanna go there. Not at all what I've been trained/inclined to handle.

Along the same lines, I don't feel qualified to float to OB/Peds. Yes, we covered that "stuff" in school, and as a parent, I'm probably better than a non-parent at handling routine peds-related issues.

That being said, I don't feel at all capable of working "anywhere" I could probably fake it, but that's not good for my patients.

Given my ~19 years volunteer experience in EMS, I feel pretty confident that most of my coworkers in the ICU have minimal knowledge of the "golden hour" of trauma resuscitation, extrication, "mechanism of injury", or c-spine immobilization. That suggests to me that ICU nurses are not all-knowing (big surprise, eh wot????).

Yes, ICU nurses may be able to titrate vasoactive drips or be able to differentiate DIC from DKA or HIT. That being said, ICU nurses are "just" ICU nurses. If you dump them in the field with EMS providers, they may end up getting themselves killed in the process. Along the same lines, if you take your run-of-the-mill ICU RN (myself included) and dump them in a strange field of medicine like ED, Med-surg, or wound care, the patients may suffer as a result.

There's specialization in many areas of nursing. ICU is not a do-all, know-it-all field (in my semi-not-so-humble opinion).

Ruby,

Second year RN student probably means a student in their second year of nursing school that will produce you with the ability to sit for the RN NCLEX when you are done.

Specializes in NICU.
Of course ICU nurses, with all their knowledge, can't multi-task. So when they float somewhere, they can't handle more than two patients.

Generalization, but before you go generalizing about your specialty's superiority, realize that the rest of us can generalize about your inferiority too.

Hey Wooh,

I am guilty as charged! And not having my pateints on a monitor or being able to stare at them constantly turns my world upside-down.

Ummm....no.

While your run-of-the-mill ICU nurse might think that they walk on water, do multiple codes simultaneously (and at the same time!!!), and deal with those frequent "is the bed ready yet??" calls from ED, I seriously doubt (given my 3 whooooole years experience in ICU:uhoh3:) that an ICU nurse can "work anywhere".

Yes, the ICU RN may be better than the standard med-surg or ED RN at dealing with titrating multiple vasoactive drips.

As a mere ICU dweeb, do I feel ready/willing to handle 5-7 patients (and their families)? NO! Don't wanna go there. Not at all what I've been trained/inclined to handle.

Along the same lines, I don't feel qualified to float to OB/Peds. Yes, we covered that "stuff" in school, and as a parent, I'm probably better than a non-parent at handling routine peds-related issues.

That being said, I don't feel at all capable of working "anywhere" I could probably fake it, but that's not good for my patients.

Given my ~19 years volunteer experience in EMS, I feel pretty confident that most of my coworkers in the ICU have minimal knowledge of the "golden hour" of trauma resuscitation, extrication, "mechanism of injury", or c-spine immobilization. That suggests to me that ICU nurses are not all-knowing (big surprise, eh wot????).

Yes, ICU nurses may be able to titrate vasoactive drips or be able to differentiate DIC from DKA or HIT. That being said, ICU nurses are "just" ICU nurses. If you dump them in the field with EMS providers, they may end up getting themselves killed in the process. Along the same lines, if you take your run-of-the-mill ICU RN (myself included) and dump them in a strange field of medicine like ED, Med-surg, or wound care, the patients may suffer as a result.

There's specialization in many areas of nursing. ICU is not a do-all, know-it-all field (in my semi-not-so-humble opinion).

I had to laugh when I read your second to last paragraph. I once responded to a motor vehicle accident (I was a pedestrian), and though I did things correctly to help the injured driver, I didn't properly check the scene was safe for myself, and I put myself at risk. Very poor judgement. A little knowledge can definitely be a dangerous thing. So I certainly understand how people who are not properly trained in a specialty can be a lethal menace to themselves and others.

Specializes in ER, M/S, transplant, tele.

I do not post a lot but, aside from the hilarious joke of the day post that started this conversation, I can't restrain myself. The endless war of egos between nursing specialties - especially ICU vs ER -drives me nuts! Esme12, I totally appreciate your post describing the objective, unique characteristics of each specialty.

I find it incredibly disrespectful individually and to the profession as a whole for any specialty to claim superiority. Each of our specialties has a particular, interdependent role to play in caring for patients. I have the utmost respect for ICU nurses because of their focused, detail oriented knowledge. I have respect for the med/surg nurses for their ability to juggle 7-8 patients with varying diagnoses plus the mountain of required charting they do. Etc, etc. soapbox rant.

As for Johnny1414...don't start your career with such as narrow, judgmental, and misguided set of priorities. We don't do it for the money or for bragging rights in an ego competition. Learn the real meaning and purpose of nursing then maybe you will find your niche.

Specializes in Hospital medicine; NP precepting; staff education.

Esme, as usual, your comments are quite insightful, fair-minded, and spot on!

I came to this thread because I'm realtively new to critical care (2 years in, both in ER and 1 in CCU; flex nurse here, so I get the best of both worlds, I guess.)

I'm loving it. I want more! I'm hoping to join ENA and/or AACN and become certified within the next year or so. This is an interesting thread because the comments range pretty much as I expected it to. I hear similar from my peers who are either clueless, egotistical, or realistic.

Specializes in Med-Surg, Emergency, CEN.

as far as you last two questions, if you're asking them you probably don't have what it takes to work either in icu or er. but in most hospitals, the pay is the same. if you're worried about who works less, i'm hoping against all hope you don't wind up in my icu!

Well I am hoping they don't end up in the E.R. either!

Specializes in ED.
oh well i just heard from my peers that er nurses only have to do like half the work of floor nurses and icu nurses and stuff, so i was just wondering.. Any thoughts??

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hahahahahahahahahahahahahahahahahahahahaha!!!!!!!

I just switched to a med surg job and most nights I don't take a lunch break....because I have so much downtime it seems silly to leave the floor to sit in the locker room by myself. When I was in the ER I worked much harder!

Specializes in Intensive Care/AG-ACNP Student.

The best way to know where you would like to work is to experience each of the areas your interested. I'm also in nursing school and that is what I am trying to do: have some experiences in many different areas without regard to money. If your doing something you love, the rest will sort itself out. Find out what you enjoy for yourself, don't let the words of anybody influence your opinion. Use their thoughts to gain an idea of what you want to do, then shadow a nurse in that unit. Thats just one piece of advise from one nursing student to another.

Specializes in ER, progressive care.

In the ER, patients generally start out with nothing. You need to place a line (or two), get their labs drawn, get a stat EKG, sometimes place a foley or NG tube, assist the MD with chest tube insertion or central line placement...give the patients a bunch of STAT meds...your goal is to stabilize the patient. Many of these things are happening all at once so the ER can be a very busy place. You will definitely work HARD...but you will also work hard in an ICU setting or on the floor. I worked on an ICU stepdown before transferring to the ER, and I will say this - 90% of the time I do not get a full lunch break because I am just so BUSY. When I worked on the floor, 90% of the time I got my full 30 minutes.

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