I am a student nurse who is interested in working in critical care. I need to select a site for my senior preceptorship, and was wondering what the best setting for this would be - working in an ICU unit or in the ER. It seems the ER would give a much broader view of urgent care, yet the ICU is where I would like to work.
Any comments or suggestions are appreciated!
Jul 17, '01
I can't tell you about differences between ICU and ER because I have never worked in an ICU. I have workled Surgical telemetry and ER both of which are considered Critical care, but differ significantly in types of patients seen.
You asked about baackground for a nurse going to ER in our ER nurses coming to ER for the first time have experiences that range from new grad to 15 plus years in nursing with a variety of nursing backgrounds. I think a years experience in ursing is a good idea before going into a critical care area but not necessary. I saw this because in the ER you have to be able to care for patients in all categories of nursing. ER patients run the spectrum for newborn to over 100 years old. From minor problems like colds and sore throats, to dialysis patients and cancer patients experiences complications with their treatments or disease process. You also have to be able to care for all levels of trauma from I hit my finger with a hammer to life threating trauma codes and cardiac codes where you MUST know what to do How to do it and DO it NOW.
This leads me to your next question what makes a good ER nurse. FLEXABILITY. If you like routine then the ER is not for you. If you work well under pressure, can shift from the adrenaline high of a trauma code to the soothing tone needed for a child who needs an IV but isn't about to let you stick them because they know it will hurt. Then when you are about to will this battle another crisis (2nd code) comes in and you must leave this task and return agian later. And now deal with the upset parent as well as an uncooperative child. While the person in the next room is demanding their pain medicaine now. You get the point.
The interesting thing is I've seen new grads handle this type of stress better than some nurses with years of experience. A lot depends or your life experiences and personal nature. Don't let lack of experience keep you from trying. Knowledge and skills can be learned.
We do have nurses from other units that come work PRN in our ER. We have some flight nurses who pick up a few extra hours as well as nurses from ICU, and one Nurse Administrator who works with us on a regular basis. In my opinion He is not only and excellent nurse but a skilled administrator (He also works ICUs often) I think this is what makes him such a good administrator. He stays in touch with what it is like in the units. By the way the med surg nurses also like him .
If you are concerned about lack of experience with skills and knowledge ask around in your facility and see if there are in-house workshops that you can atttend. Also don't be afraid to ask those who are skilled at a certain task to help you improve.
As for ICU I know that the patient we send to ICUs are very sick and definately need highly skilled nursing care as most are tetering on the boarder of life and death and nursing care recieved could make a difference in outcomes.
Best of luck in wwhich ever area of nursing you decide to persue.
Last edit by mikemw on Jul 17, '01