working in the ER and ICU

[al3x117, RN, EMT-B]

Are there any nurses who work in the ICU and the ER? Do you like it? What are some of the challenges that you have faced with doing both? Is it possible to do PEDS ER/ICU at the same time? Do you nurses run shifts throughout the whole week or for a couple of days straight? Just wanting to learn more about working in both fields at the same time. Appreciate the advice.

[kataraang, BSN]

I work in neither but I imagine it would have a lot of overlapping skills. However, they have very distinct differences. Wouldn't say one is harder than the other. I had an ICU nurse as my nurse when I was in the ED and she was fantastic. I was very ill. It's up to individual facilities how they staff their units.

[ILUVERNSG, MSN, RN]

In my 28 yrs as an RN, have worked in both areas and here's my opinion:

ICU: You will learn a lot about keeping people alive and the process of dying. You learn a lot about how our organ systems work. You learn a lot about pharmacology, lab interpretation, critical thinking, surgical procedures, physical assessment and lots of life saving medical technologies. You gain a lot more autonomy and work more closely with physicians. You will enjoy the prestige of being known as an ICU nurse by friends and family. You also have a tremendous amount of stress and responsibility. You risk ICU burnout because you see so much whether it be patients dying, or suffering for extended periods on life support when the outcomes are poor, families grieving for their brain dead ventilator dependent loved one, or just dealing with the stress of caring for the highest acuity patients in the hospital every time you work.

ER: The beauty of ER is that there's always something new around the corner that you haven't seen yet. It's exciting, it's challenging, it's fast paced. Time management, critical thinking, decision making, assessment skills need to be razor sharp. You have to love the unpredictable and the crazy, because here is where you'll definitely find it! If you are someone who wants to do a head to toe assessment on every patient and likes to have a predictable and set routine of how your day will go, ER IS NOT FOR YOU!!! You need to be super flexible, ready to change on a dime, able to constantly re-prioritize, and react quickly and appropriately in emergency situations. And you have to love working with people... ALL KINDS OF PEOPLE, LOL.

I was an ICU nurse before I worked ER. My critical care experience was invaluable. It gave me so much confidence in caring for my sickest ER patients whether they are coming to me in septic shock or as a full resuscitation. I can handle any drip, machine, assessment, invasive line or any technical nursing skill you throw at me. The new things I learned as an ER nurse are mostly the people skills. In the ER, you are no longer dealing with an intubated, sedated, paralyzed patient full of invasive lines and high tech equipment. Now you deal with the public, up close and real personal. You are a nurse, a cop, a therapist, a teacher, an advocate, a peacemaker, a counselor, a witness,traffic director, a public relations expert, and so much more. It rounded me out as a nurse in general, I think and I still love it!

P.S. In my experience ICU and ER nurses work three 12 hour shifts per week as a full time employee. Some hospitals require two additional 8 hour shifts per month to make a 40 hour workweek, some don't. All hospitals have some sort of monthly weekend requirement, it may be a set weekend or something flexible. Your manager may allow staff to,self schedule or not. So, it really just depends on the hospital's policy for scheduling and time and attendance.

[al3x117, RN, EMT-B]

Thank you for the detailed answers! Really appreciate it.

[loriaz]

In the hospital I work at we have a resource pool . I float to ICU and ER and med surg. Get the best of all the worlds and it changes daily.