Emergency or Critical Care..Its up in the Air!!??!!

snovbunny25 · May 5, 2006

Hi, I am not a nurse, but a tech. I first started working in the E.R. and was a little intimidated at first, but It was one of the best experience that i have had in my life. I never knew you could get hooked on working in the E.R......but you can. You do learn a lot, everything different each day, and YES you do most of the time in and out patients...not like on the floor. But sometimes that is good too isnt it?

I cant really give you advise from a nurses stand point.........But I have been there, done that, and will keep going back...It's unbelievable. Especially if it's a Trauma I hospital.

Good Luck :rolleyes:

aimeeinorbit · May 5, 2006

I went straight into MICU as a new grad. I lasted 13 weeks and then decided I wanted to work the Frosty machine at Wendy's. I quit and spent the next 5 weeks on my couch. And it wasnt because I "couldnt handle it" or wasnt smart enough, I graduated in the top of my class. I even did my preceptorship before graduation in said MICU. It was INEXPERIENCE. I had a renegade preceptor and an absent manager. Which is fine if you have some experience. How can you feel like a competent nurse if you havent started an IV since 4th semester and every single patient has an A line? How can you learn to organize if you have never had more than 2 patients? How are you not going to totally FREAK OUT when you forget to flush the mediport after drawing blood cultures and it CLOTS OFF:chair:!?!?!How are you going to handle terminal weans if youve never taken care of a dying patient, or better yet, THEIR FAMILIES, ugh!

Anyway, after 5 weeks of festering I went to med/surg (in a different hospital) and Ive been there for 5 months and I feel ready to go back to ICU.

You probably dont want to hear this, but my honest opinion is dont do either until you can handle 5 patients and can cover an LPN and still manage to keep it together when one of your patient codes. Please dont take this offensively, just trying to offer my experience for you to consider when making your decision.

my2sons · May 5, 2006

I have worked both SICU and ED for a long time. My advice is this: Get into a good ICU (read: one with an official internship!) and give it at least a year. (Preferably two or three.) I have seen way to many new grads freak out and quit right after their internships are over. (I think that this is why you see so many experienced RNs opposed to new grads in the ICU.) It is extremely frustrating to put your heart and soul into teaching a new grad only to have them quit. After a year or so, if you still have the ED itch, go for it. It will be a much easier transition for you to go from the ICU to ED rather than the other way around. ICU will give you the time to fine tune your assessment, prioritization, and organizational skills. And with both ED and ICU experience, you'll be a hot commodity!

mandana · May 5, 2006

I can't give you any advice, but I'm in a similar quandry at the moment, so I'll be interested to read your responses.

Good luck to you,

Amanda

TopherSRN · May 5, 2006

Either one will be roughly as 'difficult'. And neither will be that bad. If you have the determination and the want to work there you can make it work. Just be a sponge and soak up everything and learn from everyone. Don;t be afraid to ask questions.

Being in the top of your class has little to do at how well you will do in a unit/er as a new grad. Granted you need to know your patho/pharm and feel confident with your assessments/skills. But book smarts /= common sense.

analee23 · May 5, 2006

I went from new grad into an ER, I have just finished the class portion (about 4 months of classes) and will follow a GREAT preceptor for another month or two. I would highly recommend it, it's a lot of different stuff and you'll find that you do have some time to look up patho and such on slower days and so forth, and when you don't you'll look it up later! It's pretty fun seeing so many different things and if you like that, you'll do fine. I personally get bored with the same patients for a full 12 hours, so it's just my opinion, but if you do have a decent fellowship, GO FOR IT!

Dinith88 · May 6, 2006

taken care of a dying patient, or better yet, THEIR FAMILIES, ugh!
.

So true...and a great point. Thats one of the most difficult parts of ICU work... You're ALWAYS dealing with families in crisis mode. It's something ICU nurses eventually need get used-to (if not, bad things/burn-out happens sooner rather than later). And, unfortunately, even if 'used to it', many nurses never truly do it well...

Katnip, RN · May 6, 2006

If you're heart isn't in ED, then I suggest you don't do it. Why put all that time into it only to find you hate it and leave soon after the internship?

jellybeanmead · May 6, 2006

I just wanted to say thank you to all your help and input. It really gives me a different look at things. Thank all of you dearly for your time. :balloons:

-jellybeanmead

WVUturtle514 · May 6, 2006

I too was in your position when I graduated from nursing school. I had done my senior preceptorship in the ER and I loved it, but I opted to take a job in a CVICU right after graduation because I knew I needed ICU experience in order to go to CRNA school. After I got accepted into CRNA school, I immediately transferred to the ER, because like I said, it was something I had always wanted to do. However, I found that after being an ICU nurse (we can be very anal-retentive about things), I did not enjoy ER as much as a thought I would. I may have enjoyed ER more if I had done it first and then transferred to the ICU, but after getting used to the routine and the organization in the ICU, the ER was terrible for me. I felt so disorganized and I felt as though I ran around like a chicken with my head cut off! On the other hand, had I not had the ICU experience before going to the ER (level 1 trauma center), I probably would not have fared as well as I did because of lack of critical care experience. Either way you choose, make sure you find a program that caters to new grads and make sure the program includes classroom time as well as an extended preceptorship. My ICU experience was great and I learned a ton. I do not think you need to "get your feet wet" with med-surg experience before going to a critical care area, although experience in any unit is never going to hurt you. If you feel you are up to the challenge, I say go for it! Best of luck to you!!!

Tracie :)

aquaphoneRN · May 6, 2006

Well, I'm an RN for two years, I work in ER.

My advice would be . . . . NEITHER! Do yourself and your patients a favor and do a year of med-surg, then go into ICU.

Before you get mad at me, let me say, a lot of the people here suggesting you go straight into ER or ICU are not experienced nurses.

As a new-grad I wanted to go straigh to ICU. I NEVER wanted to do med-surg, and went straight into a CCU stepdown. I soon realized I bit off more than I could chew and was miserable. It was also a terrible teaching environment with inconsistent, undedicated preceptors, and an abusive manager. After about 10 weeks I'd had enough.

I did a year of med-surg, got bored, went into an extremely busy ER in New York City where I've been for about 9 months, and I'm doing great.

Patience . . . .