ICU VS. the ER? - page 3

:idea: To ICU, and ER Nurses: Hi. I am curious to know the difference between ICU Nursing, and the ER. Do the Er people just treat people immediately, and iCU treat over the long-run ...or how... Read More

  1. by   BlueEyedRN
    Our Cardiac Care Unit is called the CCU. Everybody's got different names for things. Do your local hosptals offer any externships? It's a thought for getting experience in the area you are considering before totally committing to it. CVICU might be open heart?
  2. by   Mommy TeleRN
    hey blueeyed... yea they offer externships. I actually have been working since summer in a cardiac tele unit. We get chest pains, CHF, and CABGs when they get out of ICU. I like it pretty well. But don't have a lot to compare to. In clinical I've only been on L&D/Postpartum, medsurg, and a uro floor.
    I'm trying to set up a shadow in the OR just to "see" what it's like (don't have any particular interest - just would like to check it out)
    I also have an interview for an externship at another large area hospital and I'm going to try to get into an ICU to see how I like it compared to tele.

    I'm also interested in mother baby - yes I know totally different. But seems like great teaching area and could lead to NICU down the road maybe. I have a lot of interests! Guess I'll never get bored huh? lol
  3. by   Christie RN2006
    Quote from Mommy Nurse2b
    I'm pretty nerdy .. maybe I should check out ICU lol. Still trying to decide what kind of nurse I wanna be when I grow up (at least I have til May)

    Unfortunately we get NO ED OR ICU (or OR for that matter) rotations at my school so I have to get all my info through osmosis here at allnurses!

    I always thought ICU and CCU (critical care unit?) were the same thing different names...I am now guessing that is wrong. Can someone tell me the difference? Also the difference between coronary care unit and CVICU. I'm so confused!
    At the hospital I work at CCU= coronary care unit. CVICU is where all of our open heart patients go. We also have a SICU (Surgical Intensive Care Unit) which is also occasionally called the SCU (surgical care unit)
  4. by   miracle1986
    ALL NURSING IS TOUGH, BUT I DO AGREE WITH JOE....E.R. NURSES RUN THEIR BUTTS OFF FOR THE DOCS. AND ARE NOT MAKING DECISIONS........ IN I.C.U. DEPARTMENT, THE NURSES STEER THE WHEEL SORT OF....NO DOC AROUND 24 / 7 LIKE IN THE E.R. ON THEIR OWN MOST OF TIME MAKING DECISIONS. I RESPECT I.C.U. NURSING AND HOPE TO BE ONE OF THEM SOMEDAY.

    sincerely sorry for the all caps. i am not yelling / shouting. tired and a lazy typer.:zzzzz
    Last edit by miracle1986 on Dec 13, '06 : Reason: called on carpet by tweety. not purposely large capping letters.
  5. by   noBS N
    Since there are some people who have experienced both sides er & icu, could you give me your advice?

    If a new grad. only could enter either the E.R or the ICU which one should he or she take?

    And why should the new grad. enter the e.r over the icu first or vice versa?
  6. by   Dinith88
    The difference is that most ER nurses have an inferiority complex and constantly scream that "we're critical-care nurses too!"...(teasing)

    This is like beating a dead horse...but since the horse is apparently a full-code and no-one's called it...

    Think of ER nurses as 'jacks-of-all-trades'...'masters of none'. If an er nurse says she's a 'pediatric nurse' she's not, but to an extent she is because she deals with sick kids. Now..if she say's 'i'm a critical care nurse' she's not...but to an exstent she is because she will deal with critically sick patients. She does both but is not an 'expert' in either. This can be said about all the other things ER nurses do...(psych, OB, office-types (rashes, tummy-aches, diahhrea, etc. ad nauseum).

    Another way to look at it is as one giant 'triage'. ER specializes in triage. They get people who come to them and decide where they need to go...and get them there. If you're critically sick, you need to be in ICU..not ER.

    Some ICU patients get there from ER...but others (most?) dont. They come from the floor, or after a major surgery (bypassing recovery room), or from other hospitals, or...

    ICU nurses deal with more invasive monitoring, more high-tech equipment, and sicker patients...all day every day. In general, are more autonomous ((ie can order labs,x-rays, etc.)) But this is EXPECTED because ICU nursesONLY deal with the sickest of the sick...thus the 1-2 patient ratio...

    And...i've said alot more about this stuff on other threads and should be done ranting (regurgitating)...but...

    "er nurses are jocks and icu nurses are nerds"??? "...icu nurses are lazy.."??? These statements really say it all if you think about it. Like someone who is more concerned about image(and cooler-important-nurse-job-than-you)...these are the types of people who perpetuate this silly banter...and have a juvenile streak to boot.
  7. by   miracle1986
    E.R. nurses are running nonstop for the docs orders. The doctor makes all the decisions in the E.R. ie: should patient be treated a.s.a.p.? be admitted? go to O.R.? go to I.C.U. ? go to an outpatient facility? or go home and take 2 aspirin and dry out? Docs call the shots. :blushkiss
    I.C.U. nurses brains run nonstop. full code / no code? monitors galore going off...calling the shots of the long term (and sometimes very short term) stay of the intensively critically ill patient. A quick call to the Doc or to follow him around for new orders is the extent of the Doc's visit in the I.C.U. (In the E.R.--there may be 3 Docs on in the same shift). I am supporting Dinith's reply.
    I personally, was taken to an E.R. while being resuscitated. Treated in E.R. - not stabalized....but lifeflighted out to a trauma hospital....coded in flight.....after extensive surgery.....landed in i.c.u. for a loooooooong time. With all the 'combined 'efforts of all doctors and nurses.....I lived. Which nurse was more important than anyone? The one that stopped along the road, saw I was dead, took the sheet off of me and started C.P.R. as I was bleeding out from a ruptured spleen. :angel2:No nurse is better than another. We are all equal and should be a team, not rivals. My life was saved by a med-surg floor nurse. (Renee) The E.R. doc (Cataldo) immediatley flew me out stat and the trauma i.c.u. nurses (numerous ) watched me 24 / 7 for months. In my scenario.......
    A 'plain old' nurse saved me. Then the E.R. Doc sent me. The the I.C.U. nurses were my 'family' while I was in a como and on the respirator...until I got on the floor, then rehab nurses helped me walk again.....I don't remeber an E.R. nurse.............this could go on and on. But ego should be let go and give credit to the nurses with compassion and knowledge. I am with Dinith on all her thoughts.....because I am alive because of a plain old R.N. named Renee who stopped on her way to work and uncovered a dead woman-me-a plain old.
    Last edit by miracle1986 on Dec 13, '06
  8. by   miracle1986
    P.S. Praise God !
    Last edit by miracle1986 on Dec 13, '06
  9. by   GoldenFire5
    Awww... that is such a beautiful tribute.
  10. by   Larry77
    Just to clarify what I meant by "Jocks and Nerds"...I think of ER nurses as "Jocks" just because we like to be where the action is and enjoy running are butts off. And ICU nurses as "Nerds" because they are the braniacs who like to study everything and tinker with settings and machines.

    I do not care about "image" at all and would never consider myself better than any other kind of nurse but also would not consider myself less.
  11. by   npingeorgia
    I promise you that there is nothing and I do mean nothing easy about working in the ER. I do also hate the "ER vs ICU" . I agree that it is entirely 2 different worlds but neither nurse is the less for it. I will say that in this crazy time of healthcare that we are in, often times the ER is holding ICU patients for hours and the critical care must go on, the patient does not suddenly become less stable because they are being held in the ER, and believe me no one cares that you are already holding 2 ICU patients and you still have the potential to have 1-2 more patients that are considered urgent if not emergent in their needs. I have had the experience to have to call upon an ICU nurse to clarify protocols not typically used in the ER and ICU nurses have often called the ER to clarify protocols for patients that may require some expertise from the ER nurse. We are all a team and let's keep it professional.
  12. by   Dinith88
    Quote from Larry77
    Just to clarify what I meant by "Jocks and Nerds"...I think of ER nurses as "Jocks" just because we like to be where the action is and enjoy running are butts off. And ICU nurses as "Nerds" because they are the braniacs who like to study everything and tinker with settings and machines.

    I do not care about "image" at all and would never consider myself better than any other kind of nurse but also would not consider myself less.
    OK. should've read your stuff better.

    I think the reason i get so involved in er-vs-icu threads so much is because i've a chip on my shoulder regarding this stuff (inferiority complex?).

    I know you'll probably think this is stupid...but i beleive the root of my problem with this is not er-nurses...but rather popular opinion of what 'er' is. So many people (mostly lay-persons and eager student-types) have such a mis-conception of the health-care system...and especially Er (from all the shows). And i also dislike nurses who (out of ignorance) put their jobs on pedestals(sp?) and talk-down other areas/positions.

    NOthing personal of course...it's just my pet-peeve.

    And you're probably right about the 'nerd' thing
  13. by   Altra
    I agree w/all the reasonable posters who have stated that the 2 units are different types of nursing ... one is not better than the other.

    But this stuff about ICU nurses being more independent & making more independent decisions than ED nurses is killing me ... maybe in your community, non-teaching hospitals where there are no residents, just attendings who breeze in & out once or twice a day. But in my teaching, Level I hospital, the ICUs are just as overrun with hovering residents 24/7 as the ED ... often more so. Where I am, both environments are team environments.

    If I didn't "make the decision" to do an EKG, start a line, draw appropriate labs, call respiratory, call CT or x-ray, administer appropriate meds for a fever, give ASA to the CP patient, have a thoracotomy tray ready, tell the doc the pt. has no gag reflex, etc. etc. ... I'd be looked at like I was stupid ... and rightfully so. Also ... we nurses have (generally) 3-5 patients ... the docs are juggling 8-10. They depend on us to assess a pt. & tell them "yes, the chief complaint entered by registration says chest pain, but what she's really got is bilateral, reproducible upper arm pain & some nausea. I've done an EKG & it's a sinus rhythm. No fall or injury to the extremities, so I did not order any x-rays." Or, "the cough in Room 5 is hypertensive, states he cannot remember when he last saw a doctor, & has a family hx of sudden cardiac death. Here's the EKG, I've sent off labs & put in the order for the CXR."

    Sorry, but anyone who feels ED nurses are not independent do not understand the concept of triage. And also does not understand that triage is not just at the triage desk in the waiting room.

    And the hospital where ICU nurses come down to the ED to run a code? Really?? Oy!

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