What is my best course of action: ICU or ED tech?

[frequentFLyER]

I'm currently in an ASN program (have a Bachelors in Health Science for what it's worth) and am ultimately interested in critical care nursing specifically medical ICU. I am currently an ED tech. I have worked with both specialties (ED and ICU) among others and believe ICU is where I would enjoy most. Although it is difficult to gain an ICU position as a new grad, that's my aim. There are positions within the hospital I work for that are for multisystem ICU techs.

I know it seems like an obvious answer but based on my goals, would it be most ideal to leave my position in the ED and switch to ICU or would it not make much of a difference? I've been in ED only since March so I wanted to get opinions before applying to ICU. ED has been great so if it probably won't matter I would stay put but otherwise I want to put myself in the best position possible.

[guest769224]

Apply as an ICU tech. Do it quickly, as you won't be a valuable asset if you graduate with your RN soon.

Make sure you go above and beyond in your work ethic, and prove to the team you are a good worker. I consider my ICU tech experience a very looooooonng interview. The unit educator and manager told me I can be a new grad in ICU.

So try it!

If you don't get it, take the ER RN position and then transition over to ICU. Either way, you are ahead of the game compared to most upcoming new grads. The medical ICU is a fascinating unit. You'll learn a lot.

[AnthonyD]

I agree with ICUMan

[Bluebolt]

Yes, it's very hard to get a job in the ICU as a new grad. One of the very solid ways to get in is to be a tech in the unit while in nursing school, work hard and impress everyone, then get hired when you graduate. In my experience working in different hospitals it's easier to get into the ED as a new grad. It really depends on the manager of the specific ED but in my experience the ED is usually flooded with new grads come May/June. I believe the reasoning is that in the ED you have a vast spectrum of patients. Some are really not sick at all, essentially their doctors office is closed so they came to the ED for a drug refill or a runny nose, stubbed toe, splinter in finger, etc. I worked in the ED during college and this got on my nerves very bad.

Then you'll get these random MVA's with trauma, chest pains decompensating, drowned children, etc. Typically new grads are accepted into the ED because you can be given all the low acuity runny nose patients and the veteran nurses take the cool bloody high acuity cases.

If you want to work in the ED when you get out of school then stay where you're at, if you want to work ICU transition to the ICU now. They are two different mindsets and different specialties so getting experience in one doesn't mean you will be good at the other. ED is like ADHD nursing, jack of all trades, good at peripheral IV's, doesn't care about history of patients (just stabilize the patient), juggling 4 to possibly 5 patients, patch em and ship em, rapid patient turnover, quick "cliff notes" charting, etc. As soon as patients become ICU quality down in the ED you can bet those nurses are on the phone demanding a clean room in the unit to ship them to right away, sometimes they'll even refuse to start certain drips and just wait for us to do it.

ICU is very focused (no ADHD allowed) imagine sharpshooter marksman analyzing a complex problem and attempting to figure out a complex solution. We will freak out if you load us down with more than 2 patients. Typically we'd be better at assisting in putting in a central line than insert a damn peripheral (what use is a simple peripheral anyways), we want tons of assessment data, labs, monitors everywhere, complete control of the environment. Typically the unit is locked down and families and friends are restricted to small scheduled visits (remember we need total control). Lots of autonomy, you will be expected to start drips and titrate meds based off your clinical decision, you won't do this in any other nursing area. Your charting will be intense, very descriptive, constant updates and accurate. You'll be expected to know lots of labs, not simple CBC and CMP data but procalcitonin levels, ScVO2 numbers, Shooting Swann-Ganz numbers etc.

Hopefully this gives you a brief overview of the two areas and possibly you'll know which suits your style better. On occasion I've seen an ED nurse transition to the ICU or an ICU nurse transition to ED. Although from my experience being pulled to the ED a few months back, its two very different areas. I wouldn't recommend investing time into one if you really are wanting to do the other.