ED vs ICU for nurse looking for a new challenge!

[koyukuk]

Hello everyone!

I am looking for a little bit of advice about my nursing career. 

 

I’m an American second career RN who has been working on a cardiac stepdown for the last 2.5 years. I am feeling like I am ready for a new challenge. My hospital has openings in our ED as well as our ICUs which are the two areas that I think would most help me build on my skills, learn new things, and include some of the critical care aspects of nursing that I enjoy. 

 

I have no idea what type of nurse I want to be in the future (other than a safe, competent one!). Basically, every path seems like it could be interesting- teaching, NP, CRNA, flight nurse. I know that CRNA and flight nurses need to have ICU experience. But I have no actual direction. 

 

I am strongly considering a transfer to the ED because they have a day shift position open. My current unit is so specific- we care for heart patients. So, the prospect of broadening my nursing knowledge in the ED is very intriguing. 

 

Our ICUs are only offering nights. Each of our ICUs are very specific so I would be able to transfer to a CVICU. 

 

Is there anything else that I should consider? Is ICU vs ED easier to travel with? I have thought about international nursing- are either of the specialties better for working in New Zealand or Canada? 

 

Thanks in advance for any insights!

 

[uniasian]

I would warn you that transferring FROM an ICU to an ED is easier than the other way around (I have been both in the ICU and the ED and have precepted RNS from ED). The ICU point of view is very detail oriented, especially if you do PICU or NICU, whereas the ED is more generalist but still requires your knowledge base be broad (encompassing neonates to elderly). Now, there is a difference here, but the ICUs are more geared to “maintenance” than “stabilize and admit/discharge”. Because of this different focus, the ICUs are more picky about IV/other intake and output by cc’s (or maybe even 0.0 cc’s). While ICUs will train you within their established specialty, EDs will emphasize rapid recognition of conditions/treatment/disposition of their patient population. Each specialty will teach you resuscitation of life threatening conditions but ICUs will focus on the longer term. If you plan on moving on (eventually) to an RN-Nurse Anesthetist, you’ll want to do ICU as most programs are asking for ICU experience. Either way, if you can stand it, I recommend 12 hour night shifts as you get more money in the form of differentials, you tend to have less visitors (families & administrators), and less meals to serve. The money factor is especially good if you are paying off student loans or saving for more education. If you do work nights, I recommend you don’t work more than 2 in a row unless you know you can handle it.