Anyone gone from ICU to ED?

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Specializes in ICU/CCU.

Recently our pre-emptive Rapid Response rounding was changed to include the ED, and I am slightly embarassed to say that this was the first night that I ever visited our hospital's ED. As an ICU nurse, I only ever get floated to the CVICU. Of course, the ED didn't need me for anything, but I got a tour of the place and met the nurses. I really liked it! The charge nurse told me that they were looking to hire some per diem RNs and encouraged me to apply.

BUT I'm not sure I could hack it. The ED nurses do EVERYthing, from small wound care to critical care. I am used to a more predictable pace, but this is also what I do not like about the ICU. Sometimes I want to tear my hair out when I get the same patients for weeks at a time because they are now chronic but too sick to go anywhere else. I crave a little variety, and maybe this is why the ED appeals to me.

Has anyone here worked both in the ED and the ICU? Or transitioned from ICU to ED? Are the skills transferable? What are the biggest differences between the two areas?

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Specializes in Emergency Department.

"Sometimes I want to tear my hair out when I get the same patients for weeks at a time because they are now chronic but too sick to go anywhere else. I crave a little variety, and maybe this is why the ED appeals to me."

I was an ER tech while in nursing school. When I graduated I went into a Surgical ICU where I learned a ton but your quote above described me to a T. I missed ER so much and went back to ER just 8 mos after starting in ICU. I've now been an ER RN for 9 mos and I LOVE it. I like the fast paced environment, the team work and I love having the docs right there with us. We pick their brains and they pick ours. I often get so many learning opportunities, the doctors like to ask us our opinions, what we think are diagnosis, what meds we would give.. you know just to keep us on our toes lol. I feel like I am actually helping people as an ER RN. I never felt like I was making a difference as an ICU nurse. (not knocking ICU Rns because I know first hand it is hard work!) but I want to fix people and I feel like I can do that in ER. We have very basic reports, why they are here, what we did and plan on doing, etc... Never stay over my shiftand never get called off or have paid on call. We staff for what might happen not for the census. They are many times when it is crazy busy that I wonder WHAT AM I DOING THIS FOR??? but more often I go home feeling like I made a difference. My last patient the other night thanked me and told me I was a great nurse as I handed him off the the Step Down nurse. Things like that make you feel like there is a reason for you to be there.

Good luck! Sounds like you'd make a great ER nurse.

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I am a new grad who got hired for the ICU. As part of a New Grad Residency program, I am spending a month in the ER. I never had an ER rotation while in nursing school, but I can say I LOVE the ER! I love the pace, the trauma, the variety of patients, all that.

At my hospital, ICU nurses are crossed trained for the ER and vice versa. The ICU nurses can pick up extra shifts in the ER. The ICU nurses can also get hired as PRN in the ER as well. They did warn me that if I wanted to pick up extra shifts, I'd have to be behind the ER full time, part time, and PRN employees, so that will probably leave only 1-2 shifts a month.

They said I had a better chance if I just hired in as PRN for the ER and full time in the ICU.

I'm really thinking about doing in a year or so.

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

Many of our best ED nurses also have many years of ICU experience. :) So yes!

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Specializes in ED.

My friend worked in the ICU for years and then came down to the ED. She made one great ED nurse, but she absolutely hated it. The pace and quick turnover was killing her. The best thing to do is ask if you can do some cross-training shifts in the ED and see if you like it. You're tolerance for BS needs to be exceedingly high.

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I did that years ago, worked CCU and transferred to ED. The ED nurses loved that I was a "cardiac" nurse and I was always placed in the cardiac/trauma room. That is, until I spoke up, as I wanted to learn what was on the other side of the ER. It is fast paced, sometimes you can't count how many patients you see in a day. But it is a "treat em, street em" atmosphere. Less paperwork, shifts go fast when busy. During my time, I believe the ratio was 4:1 , unless working the cardiac/trauma room. AND, everyone is a family! It's a whole different working atmosphere, unlike floor nursing; as you are with the MD 12 hours, not 2 minutes, and your input is greatly appreciated and autonomy ( at least where I was) is recognized and welcomed.

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Add-on: Yes you do get your drug-seekers, street people, BS patients-nonsense stuff...but you get over it. It was tough at first as I had "fear of the unknown", not knowing what was going to come through the door.

But if your experienced in codes, it should be cake from there. I'm not saying working ED is peaches by any means, but a whole different world in hospital nursing. Not the sometimes monotony of floor nursing. Even though you do get "frequent flyers".

Always worth floating to first to see if you like it! Good Luck.

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Specializes in ED.
I did that years ago, worked CCU and transferred to ED. The ED nurses loved that I was a "cardiac" nurse and I was always placed in the cardiac/trauma room. That is, until I spoke up, as I wanted to learn what was on the other side of the ER. It is fast paced, sometimes you can't count how many patients you see in a day. But it is a "treat em, street em" atmosphere. Less paperwork, shifts go fast when busy. During my time, I believe the ratio was 4:1 , unless working the cardiac/trauma room. AND, everyone is a family! It's a whole different working atmosphere, unlike floor nursing; as you are with the MD 12 hours, not 2 minutes, and your input is greatly appreciated and autonomy ( at least where I was) is recognized and welcomed.

You had a 4:1 ratio? Personally I think that should be the standard ED ratio. Ours is generally 6:1.

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It was over 9 years ago, guess you got me thinking now, I could be wrong, but I do believe it was 4:1. Actually, when you think about it, since you have a almost constant influx of patients...and your taking one after the other, do you really have any ratio in the ED??

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You had a 4:1 ratio? Personally I think that should be the standard ED ratio. Ours is generally 6:1.

Actually, here in CA., the ED ratio is 4:1. Other states may vary?

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Specializes in ICU/CCU.

Thanks for all the replies and advice, people. I guess I'll apply for a per diem NOC position in the ED and see what happens.

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