CCU vs ER

[gratefultobeanurse16, BSN, RN]

I received an offer for both and I like both for different reasons. Would you choose cardiac ICU or ER and why? 

 

[FiremedicMike, BSN, RN, EMT-P]

I think I've concluded that I'm too ADD to work the floor and need the constant chaos and churn of the ED.  I get my fill of ICU care when we get critical patients and I can drop to 1:1 stabilize them until we move them up, then I can go back to the rest of my day.

I will admit that I get most of my enjoyment out of managing those super sick unstable patients, titrating and tweaking, interacting with the providers, feeling like my assessments and opinions matter.  If ICU life was like that the majority of the time then I'd give it a harder look, but the ICU nurses I've talked to have said it's mostly charting, care coordination, and ADLs with the added complexity of 3 IV infusions and a vent.

 

please take my post with a grain of salt though, I've ONLY worked ED.  I have zero fist hand ICU experience.

[akulahawkRN, ADN, RN, EMT-P]

I'm pretty much like FiremedicMike. I'm way too ADD for basically any ICU on a long-term basis. I also enjoy stabilizing the really sick patients. They can keep my attention for a while. 😉 Once they're stabilized, I can go off to do other stuff. That's also one reason why I'm a CCT nurse too... I take my ONE patient and move 'em to somewhere else and go on to another patient. New patient, new challenge. Yes, I can take care of seriously sick patients. I'm not an expert in it... but I can do it.

I would say you should take a good look at yourself and figure out what kind of person you are. If you're the kind that likes to have things orderly, you like to know EVERYTHING about your patient, and you really like taking a deep dive into a subject, then Cardiac ICU might be a great place for you. Steep learning curve to be sure, but you should be able to get through that. If you're more of a squirrel personality, and you like more chaotic stuff along with being stupid busy while going from task to task to task all while keeping tabs on all your patients, then an ER is a good place for you. 

[JKL33]

^ These things exactly. I had typed a reply earlier that said the same but accidentally deleted it. 
 

This is a decision based on personality, IMO, and whether a person enjoys the deep dive, fine details and the long haul, versus sorting, stabilizing and shorter intervals of intensity then the joy/relief of being done with that and moving on to something else. 
 

Others cannot tell you which is better because I really think this is a question where ultimately satisfaction will depend on the likes/dislikes and personality/personal features of the individual. 

[gratefultobeanurse16, BSN, RN]

Thank you all for your response. Very true! I have some serious soul searching to do!  Because I feel like I can definitely do both. I like order but I'm also pretty good with chaos. I think I fear burnout more than anything and wonder if I would be able to do either one of these positions long term. Thanks again for the responses.

[Emergent, RN]

ICU equals repetitive tasks on unconscious patients, such as Q2 oral Care on ventilator patients, all the cleanup care (feces) on people who are unconscious and don't know when to poop, plus the exciting task of giving a bed bath and managing all the tubes and lines. Sure, you are a theoretical hotshot, and can intimidate everyone else in the hospital with your details.

ER equals not having to put up with people for too long, but having to deal with the underclass quite a bit, which means putting up with their BS and their milking the system behaviors. You get enough of the action to keep your blood going. You get to do lots of IV starts and other procedures which are fun to do. The only downside is giving report to the obnoxious ICU nurses who think they are the be all and end all.

[offlabel]

Pick the one with better hours, pay and time off. All things being equal, then pick the unit with less drama and more mature and well adjusted co-workers