ER to ICU

[mbrason]

I was wondering has anyone started in ER and then went to ICU. It appears that I will not get my dream job and start my career as an ICU RN. However, I have an opportunity to start in the ER at a hospital that I am not really familiar with. I thought that at least I could have ER experience under my belt then try ICU which is where my heart really is. It seems that most people have gone the ICU to ER route but I know floor nursing is not what I want and I know eventually after getting ICU experience I would move to the ER. I have even thought to get ER experience then go to tele or step down and then ICU if I am not accept by ICU coming from ER. I just wanted to know what any of you ICU RN's thought. Is my plan ridiculous? I have even thought about not accepting this position and try to work at the hospital of my choice in a med surg unit and then work my way to ICU then ER or just sit out for 6 months until the next internships but have been told I should just take the ER position and then work my way to where I want to think.

Again takers on this route?

[nurselemmon]

I did it that way I am glad I did. When I went into the ICU (CV-ICU) I had alot of prior cardiac and resp arrest experience and new most of the drips (alot I had never heard of though) Not only that, in the ER you are used to handling alot of very unstable patients that have nothing done yet when they come to you (etc maybe a 20g in the hand being bagged) You you learn very quiclky how to "multi-task" QUICKLY when patients are going down (ex-quickly obtaining better IV access, know the defibrillator inside and out, know the vent etc) I think then since you have that base knowledge already you get to spend more time learning on the actual patho that you get to learn in the ICU, and the "OPEN CHEST TRAY-I had never experienced that one until the ICU!! lol) GO for it...One thing I never learned how to do very good in the ER was how to gica a bed bath...LOL

[oceanfloor]

how long were you in ER prior to getting the CVICU position? i see your deal says you have 4.5 years experience but units aren't specified. did you find it easy or difficult to get a hired into an ICU position given your experience?

[upstateRN]

I did the ER to ICU route. I joined a new grad program which was 1 year in the ER, combination of hands-on and classes. I then transition to the ICU. I think the ER gives you valuable experience with drips, and vents. It helps you to think on your feet and react appropriately based on what you are being presented with. As TLLCRNA said, you learn to handle unstable patients and how to multitask. Many times you really are starting from scratch. A patient might come into the ER in serious distress and needs to buy a tube quick, but there is no access for drugs to be given. I think this environment prepares you later on to react to "emergencies" on the floor and codes etc. Going to the unit will be a substantially different sphere of experience. The focus is completely different. You will appreciate the training in the ER as it will show you how disease progress. Normally we don't get to see what happens long-term in the ER with the patients as we are more concerned with the stabilization and hopefully a quick transfer to the unit that will help the patient best according to their needs.

If you really want to get the ER experience to add that to your belt, then by all means go for it. It is a very marketable asset, especially depending on the hospital/type of ER it is. If all you really want to do ICU though, and that is really where your heart is, you can always just for that and then try to cross-train in the ER to get that experience too.

Hope that helps.

[nurselemmon]

I have been in the CVICU for a year now. Still work in the ED contingent about 4 to 6 shifts a months. I still need my ER fix.