Advice for ICU Nurse Thinking about a Switch

NurseHeart&Soul, MSN · Dec 28, 2016

I have been a Neuro ICU nurse for a year now. I began my career in the Neuro ICU and am looking to change gears here within the next year or two (I worry I'm not quite ready for the leap into something new just yet.). Any advice for an ICU nurse in the transition to ER?

Be prepared for a transition from fairly tidy patients (though definitely not always the case with neuro) to organized chaos.

Ideal situation would be to make the transition at a facility that has a Transition in Practice program. Essentially the floor/ICU nurse has classes and support throughout the transition.

Do you have PALS, ENPC, or TNCC? You could start by taking those.

I'm guessing you need pediatric experience. Consider refreshing some of that content.

Can you ever shadow someone in the ED at your facility? Might be a good way to start building relationships at the facility you're at. I think that would be a great way for you to recognize what might be most helpful for you to do in considering the leap. Opportunity for self assessment.

The toughest part about an ED transition for many is realizing that you typically do a focused physical assessment.

The ED is awesome. I LOVE not knowing the diagnosis and trying to put the pieces together along with critical thinking to find the answer to the mystery. Good luck with wherever your journey takes you.

canche · Jan 16, 2017

The biggest thing ICU nurses have struggled with when coming down to ED where I work is time management and learning to juggle 5-9 patients at a time (9 is for if we are in subacute). Imagine having an ICU patient who really should have 1:1 nursing but you have to take care of 4 other patients in the meantime. Its challenging and I would definitely see if you could shadow to see how the teamwork is down there, because teamwork is key. Also in ED we do focused assessments, things are not anywheres near as detail oriented as they are in ICU.

Its much more hectic and like PP said, organized chaos.

Tammy Nightingale · Jan 17, 2017

The main difference with the ER is that its fast paced, a revolving door; Always moving patients in and out. You do not have time to address all the issues of each patient like you do in ICU. Basically, you treat and street and admit and move out. Sometimes, this fast-paced, multiple patient a day environment is too much for others to handle. You can always try it. Sometimes, change is

what we needed all along.