Career question

[cleothekat]

Hi,

I am in a career midpoint. I have been in telemetry for 4 years since graduation. I have been in the military for 3 years. I am moving to Arizona and hope to move into critical care nursing. Floor nursing has taken its toll and I really want a change. I have always had an interest in trauma,er and ICU. What do you think is the smartest beginning move, ICU or ER? Is it easier to move from one to the other at a later point? What provides a good foundation? I am eager to learn something new. On my floor for the past 3 years, I presently have squash rot from lack of new things/experiences. I cant wait to move on. Thanks for your help!!! If anyone is from phoenix, any suggestions for a hospital to work for?

Jodi:)

[MollyJ]

Frankly, I think you can go either way. To me, ICU and ED nurses are just different cats. I've done them both, but prefer the ED.

Each speciality has it's own perspective because you are dealing with different populations.

I call the ED Guest Appearance Nursing because if a patient drives you crazy, you probably won't be with them for more than a couple hours (on that day, anyway). Both specialities require you to notice subtleties. ED nursing, the patients come in "unlabeled". You have to figure out, at times, is this a big problem or a little problem. In the ICU, lots of big problems, you already know the patient's in deep doo-doo.

My opinion--What new skills do you want to grow? Both can give you fast paced, but ICU's have only so many beds and in the ED the patients can just keep coming even when your brain can't hold anymore information. When I wanted to get some technology experience (S-G lines, Vents, mega drips), I went to the ICU. The ED does technology like crash intubations and bag 'em (less vent management), they start drips but don't do the finesse management of them that you see in the ICU's, we put in lines but treat 'em as garden hoses to poor fluids in. In the ICU, lines mean you are balancing fluids, meds (and meds and meds) and blood products.

I'm not saying ED nurses are clods that cannot do these things, but to my mind they do them differently and with a short term goal in mind: obtain and maintain an airway, GET a blood pressure. Let's save their life and then we'll deal with the subtleties of acid-base and fluid and lyte balance later.

And I think with ED's holding patients longer than ever, ED nurses do more and more of the finesse management.

So, to me, the question is which skills do you want to grow next?

[teeituptom, BSN, RN]

Howdy yall

from deep in the heat of texas

Well cleothekat, I like your name by the way. Both Icu and ED are fun. Ive done both in my decades. I prefer a good ER myself. where you go to, maybe you can apply to both and ask for permission to go in and watch a shift in each. A lot of hospitals will do that for you. Make sure to check on their orientation/ preceptor arrangements.

Good luck to you

doo wah ditty

[traumarns]

hey good luck to your "career change".

i have also done both.

i thought having an er background would help me in the icu.

NOPE i was wrong.

Each has pros and cons.

You have to change the way you think and perform in the er, vs the icu.

er is really fast paced. you have to be able to do things quickly, from starting an iv, to discharging a pt ( there is always somebody waiting for that bed)

in the icu, if you do things too quickly mistakes will be made

ie hanging dopamine instead of dobutamine. oops.

i think whatever road you choose you will love!

your telemetry experience will be a total bonus to whichever department you go to.

[cleothekat]

Thankyou for all the great input. I really appreciate it!! Now I just have to make up my mind or see who gives me the best offer!!

[ERNurse752, RN]

I would also recommend shadowing a shift or few in both ER and ICU. I've done both...like ER better, but ICU is very valuable experience to have as well, as someone else said, especially with the increasing number of ICU pts holding in the ER.

I like the short-term goals of the ER...I have a short attention span.