Critical Care nurse-ICU or ED? Where to start as a new nurse?

Specialties MICU

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I have been blessed to have been hired during a clinical rotation in Surgical ICU stepdown and after nearly 1 year on the unit I have been looking for advancement to ICU or the ED. I have 2 job offers in different hospitals and have already accepted an offer from a Cardio/Surgical ICU position at a level 1 Trauma hospital. However I just recently also heard back from an ED position at a reputable Heart Hospital who is Not a trauma hospital but see's mostly acute cardiac cases in the community. I am torn in deciding what area I would be a better fit for.

I love critical cardiac care and both have these elements, however as a fairly new nurse with only 1 year hospital experience I wonder if it would be better to start out in ICU and gain a solid foundation on systems assessments and hemodynamic stability of drips or would it be better to start in the ED where rapid assessment skills and prioritizing is key. I do love the adrenaline rush of being involved in rapid critical care.

Can anyone give me a an idea of a day in the life of an ICU nurse and an ED nurse?

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Specializes in ED, Cardiac-step down, tele, med surg.

I'd start in ICU if I were you. Your skills as an ICU nurse will be more valued by ED nurses (I have found this true at 2 facilities I've worked at). If you have ICU skills going into ED, you'll get to take care of sicker patients. The majority of ED patients are subacute, so in all likelihood, you'll start taking care of lowest acuity patients first (maybe a year or more) then move your way up to the critical patients depending on the department. The last department I've worked at was very cliquey and they would always give the more interesting assignments to the most experienced nurses with the most seniority on the unit. If you get stuck in one of those types of departments you might be sorely disappointed. Anyway, that's what I'd do if I had to do it all over again.

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Specializes in ED, Cardiac-step down, tele, med surg.

Your ICU offer was at a trauma center, take that one. Your experience will be way better there. Then after a year or 2, you can transfer to the ED as an internal candidate. I would jump on that ICU offer ASAP.

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I would be eternally grateful if I had either offer. Good luck whatever you decide.

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