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djaychris 2,580 Views

Joined Apr 30, '09. Posts: 20 (40% Liked) Likes: 29

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  • Jul 1

    In my opinion, ICU to ED is one of the toughest transitions a nurse can make. I speak as a nurse who worked Med-Surg, then ED, then ICU, then ED. I have worked full time in the ED while working casual in the ICU, and vice versa. Before I knew ICU, I knew ED. ICU nurses are trained to be creatures of routine (forgive me for generalizing). Most give their patients their bath at the same time every day. They start their mornings the same way every day. There is a time to review labs, a time to document on care plans, a time to meet with the CCM for rounds, etc.etc.etc. ICU nurses must do a TON of charting, they have to be extremely thorough. They are also strong critical thinkers, and often diagnose and treat the patient themselves based on pre-determined protocols. Most of this goes out the window in the ED. There is no routine. Every day is different. You cannot spend hours diagnosing and attempting to treat all the patient's problems. You deal with the most pressing issue, then get them out of there. You chart just enough to get by, and no more than that. You must deal with emergencies with no warning, and often with aging/broken/missing equipment. That is the problem I see with alot of ICU nurses. They wish they had more time to spend with the patient. They cannot get all the charting done. They are shocked by monitoring a critically ill patient with only a bp cuff and pulse ox (no swan, no art line, etc.) They feel like they really didn't get to "fix" the patient. In my experience, I find that most ICU nurses feel that their job is way tougher than an ED nurse. Most ED nurses feel that their job is way tougher than an ICU nurse. After doing both extensively, I think that neither one if tougher. Each one presents their own challenges and required skill sets. Transitioning from a controlled (but extremely difficult) environment like the the ICU to the madness of a busy ED can be extremely traumatic (no pun intended).

    -Just my humble opinion, I'm not trying to offend anybody.