ER to ICU?

[iheartnursing91]

hi guys I'm currently an ED nurse with 2.5 years of experience. I'm moving to another state and looking for opportunities. I've always wanted to work in ICU but ended up in ED since being a new grad and stayed there since. Since I'm moving now and have some experience, I'm looking for ICU level jobs. Now the problem is that every ICU job I apply to, I immediately get a "not qualified" status. One recruiter had called me and tried to get me an interview with an ICU manager, and she wasn't interested in interviewing me. So now my question is, is there a negative stigma about ED nurses? Why are ICU (and sometimes even med surg/tele) managers so reluctant to hire a nurse from the ED? I know we may not have the in depth knowledge that ICU nurses have, and to be honest thats why ak want to go there, to further myself and learn more. I've taken care of ICU patients who spent >24 hrs in the ED due to no available bed, and I really enjoyed the challenge. I've even had some people tell me I'd do very well in the ICU. I'm just curious why I'm having a hard time getting an interview that's not for the ED. ?

[JBMmom, MSN, NP]

Glad to hear your good update. Were you trained to care for vented patients during your time in the ED? Did you start pressors, insulin drips, cardiac drips, sedation medications? If so, you're probably familiar with most of the medications. If not, don't worry, those will definitely be covered in the orientation period.

As for skills or questions, I would ask what their current ratio is? Are they well staffed enough to maintain 2:1? What will the orientation period be? You should expect 8-12 weeks transition orientation. Will you have a chance to shadow nurses on the unit? If so, that's where you get a real feel for the unit, the workload, the morale, etc. Managers aren't always the best source for realistic information about a unit. 

Good luck with your transition, hope you enjoy critical care!

[hellostar11, BSN, RN, EMT-B]

Hey, so this is a little late for this thread. I made the transition from ED (1 year of experience) to an ICU at a level one trauma center. It's very high acuity and I take care of TICU, NICU, MICU, SICU, and sometimes CVICU patients. You can do it! I sold them with my critical care skills from the ED and told the hiring managers I was interested in doing prolonged critical care and focusing on continuity of care. Managers were interested in my critical care skills. What I lacked was long-term care. I wasn't used to tube feeds, oral care, q2 turns, continuously dealing with A-lines, CRRT, vents for my entire shift, rectal tubes, and some meds like precedex, phenylephrine, and bumex. I also wasn't used to dealing with pressors other than levo. Titrating multiple pressors is also something I'm getting used to (I'm 3 months in to the ICU). The hardest part for me was getting used to the charting. ICU nurses chart so much OMG. You'll get it though, honestly, I'm better at dealing with certain things such as Afib w/ RVR, Rapid sequence intubations, TPA'ing my patient, getting IV's, and etc. There are just some things we do more in the ED and those skills come in handy in the ICU! 

 

Good luck on your interview, and your journey into ICU nursing!

It's so different from the ED, but it's a new challenge and I hope you find it as invigorating as I do! 

[iheartnursing91, BSN]

Thanks everyone for your tips and support! I finished my ICU training and started on my own. I was given 12 weeks of unit training, classroom training, and modules. It was really challenging & at times I thought I wouldn't make it but I got through it...I got hired for a Level 1 hopsital Trauma-Surgical ICU and crosstrained in MICU.  After a year I have the option to crosstrain in CVICU. The hospital is just down the street from me & they even offer free benefits & pension.

I learned there are managers out there who will love a nurse with ED experience. It's a very challenging unit to be on but the support is endless in ICU, & I feel great being able to actually critically think about what's happening with my patients. ER taught me some great skills (like putting in IVs and Foleys with my eyes closed ?)....But ICU is a whole different ball game which I'm loving so far. While I waited for an interview I continued reading and took that time to earn a certification too & I think it helped. ??