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Discussion

Difference between ICU and ER nurses

What is the difference in terms of patient care and assessment, and duties as an RN?

A regular ER nurse- What does s/he do when first receiving a patient?

-V/S

-Health history? "What brought you here today?"

-(Patient says "well I have ...x...and ..x.x"....)

-Nurse further assesses by asking more Q's, or conducting a physical assessment (if it's within her scope-meaning it doesn't require a Doctor's or APN's judgement).

-Nurse reports all this to the DR. Or calls for help (depending on patient complaints).

-Nurse continues to assess to prevent deterioration and/or treats patient to get him back to pre-illness level of functioning.

An ICU nurse

-Receives call from ER. Hangs up with ER, sets up incoming patients chart-usually ICU has both electronic MR and a paper chart to stick rhythm strips in and to have MR on paper, gets other stuff avail-or delegates someone else to-, etc.

-Receives patient, Sets him/her up, Performs initial assessment to get ICU baseline.

-Carries out M.D orders and continues to assess to prevent deterioration and treats (with md orders and rn interventions) patient to get him back to a more stable level of functioning.

The reason I ask this is b/c i'm a new grad nurse (will be in a week), and I like the ICU, and I thought to myself about not liking the ER as much as ICU? I like the excitement of an emergency situation, yet I don't like the "flow" in the ER. So I started looking at the differences in ER and ICU nursing. I believe I like to be able to sit down and critically think and really focus on a few patients at a time, rather than quickly (but effectively) assess...

Anyway, I would love if someone could tell me the differences between ICU and RN nursing...Am I on the right track?

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    "Sit down and critically think..." Ha! I wish! It's more like running like a chicken with its head cut off while doing ten things at once, keeping track of orders, vitals, drips, tests, charting, family, all while wishing you could cut yourself in two to be in both pts rooms at the same time (in the case of ICU, or 4-5+ pts in ER). Sitting down rarely happens in critical care or ER nursing.

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    Yeah you're right... I guess the ICU I spent time in was too boring (rural area). But I do like the idea of being busy in an ICU. I like complicated patients...but I guess the ICU can be busy like an ER...What are the main differences though? Or did I answer my own question in my original post?

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    ER and ICU are busy in different reasons. I say this often but everything depends on the hospital.

    In the ER, you are busy because you don't know what patients you're getting. It could be people who should have gone to urgent care or heart attack patients. Being quick on your feet, thinking who really needs the doctor's attention right away. If you're in a trauma hospital, in an urban area (like Los Angeles), you'll get all the crazies and the complicated ones. You have to stabilize the patient to either transfer to higher level of care (ICU), admit to floor or discharged home.

    In the ICU, you're patients are really sick. You'll have to prioritize and analyze what needs to be addressed right away. Often times, you are titrating medications, replacing electrolytes and drawing labs while analyzing each result. You'll know these patients in and out because you're with them for 12-hours, which is why the doctors trust your judgment when you report something. You always trend numbers in the ICU.

    There are many differences between the two. Again, it depends on how you are as a person and the hospital you're gonna be employed. Everything in nursing is a balancing act you just have to decide on which rodeo you want to be in.

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    Everything in nursing is a balancing act you just have to decide on which rodeo you want to be in.

    Omg. I LOVE this. Applies to all nursing specialties, not just ER and ICU.

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