ER VS ICU NURSING

JustinAllen · Jul 18, 2012

"Which one pays more and works less?"

If this made it to your priority list of questions to ask about which one of these two positions were better perhaps you should step back and rethink what's important to you in nursing.

Johnny1414 · Jul 18, 2012

oh well I just heard from my peers that ER nurses only have to do like half the work of floor nurses and ICU nurses and stuff, so I was just wondering.. any thoughts??

Sun0408, ASN, RN · Jul 18, 2012

Nursing is hard period. ER is just as frustrating as ICU. Both are way underpaid and unappreciated.. Pay is based on experience not what unit you go to. As far as working less, well if you are in LTC, or hospital you will work your butt off. There is never enough time in a day or night. If you want to make good money and not work a lot, go into something other than nursing. Every area of nursing has it's pro's and con's.

ER is to stabilize as much as possible and either send home or to the floor/ ICU. ICU is much more in depth, the sickest of the sick. Lots of time is spent on these pts. That's why the nurse usually only has 2 pts, if bad enough the nurse will have only 1. But trust me, one pt can be as busy as 7 floor pts.

Johnny1414 · Jul 18, 2012

but which of the two requires a hire skill set?

Esme12, ASN, BSN, RN · Jul 18, 2012

I am concerned that you are starting your career want to find the most pay for the least work. Nursing, regardless of what your speciality is not the profession to see these qualities. You will be frustrated and disappointed. I am curious, however, who are your peers.......I would guess that they are not ER nurses. Since I have been both I am particularly qualified to answer this question.

The ER and the ICU are different skills sets. They are both critical care areas but the amount of patients they care for and the length of time they are cared for are completely different.

The ER nurse is an expert in multiple levels of nursing. She/he must care for the mundane and idiotic to the horrific and traumatic nature of critical patients. The ER nurse must care for of ALL ages at all times. The encounters, while brief, are vital to a patients survival. Triage is the most vital section of an emergency department for only the most talked and experienced nurse belongs here to decide who needs to be seen and who can wait. Delays on the wrong patient can end in death and loss of limb.....not to mention lawsuit. The ER nurse must know how to deliver a baby, to coding a 5 year old, resuscitating a teen trauma or coding the acute heart attack.

The flow, or patient movement, in and out of the department is never stopped and most ED nurses need to juggle 6-8 patients, of varying degrees of illness or intoxication, and still accept the multiple trauma 2 min out. The ability to multitask is key here. You will never sit down and be in constant motion on your feet for there is always something that needs to be done. There are brief moments of calmness,that never lasts (in most departments), followed by the ever intake of the sick and injured. Then deal with the drunk/addict that decides that remaining in the department is not what they desire and decide to attack staff.

Emergency departments at the gateway for admissions these days and in fact are the safety net for the uninsured who cannot afford a $300.00 doctor visit or the teen parent who can't quiet the crying newborn and come to the ED to keep from harming their child. It is where people turn to when they have no where else to go.

The ICU nurse case for the sickest and the critical. She is responsible for every aspect of that patients care From meds and their illness but for the emotional and physical well being of those patients. She must pay meticulous attention to detail of those patients keeping track of minute details and changes that may mean significant impacts on the patient survival.

A sick ICU patient can have as many as 10 to 13 IV drips infusing with multiple invasive monitoring devices that require constant attention and monitoring to sustain stability and life. There are tubes made for every orifice and then there are the orifices that are man made by equipment that sustains life....whether that is for the kidneys, lungs, or heart.

The ICU nurse must know how to manage the subtle difference in the titrated meds to that specific cocktail that will elevate B/P, increase cardiac output, correct abnormalities, sustain life without causing harm from the side effects of the meds. Especially in non-academic setting she is the doctors liaison to stabilize and improve the patient's condition and know when to call with those subtle differences that can mean an ominous outcome is near.

Most ICU nurses hate the ED. They prefer their patients in bed on a monitor. The commotion and noise of the ED drives them to distraction. Most ED nurses don't like the ICU. The ADHD tendencies of the ED nurse finds the ICU while difficult and interesting...suffocating by tending to the same patients everyday. There are a few, like me, that loves them both. But even I prefer that sickest of the sick in the ICU for if they are not ....my ADD kicks in.

As critical care nurses we are not paid any more money than anyone else in the facility with the same length of service as a nurse. We MIGHT get a differential for our speciality certification,(CCRN,CEN) that can cost up to $1000.00 per certification, of 50 cents per hour.....and that is a HUGE maybe. There are other special certifications that are required like ACLS, PALS, ENPC, TNCC etc......that are also require but we are not paid to have them. You work the critical areas because you have a passion for it is certainly NOT for any extra money.

Neither is easier that the other. Neither pays more money for the speciality. Both work incredibly hard.

MissERN · Jul 18, 2012

Johnny1414, Your peers are sadly mistaken. You must realize that, generally speaking, in the ED you are starting from scratch. Your patients will arrive with nothing, and often they need many intervetions quickly, and more times than not you get multiple patients at a time. Your SOB patient that just walked through the door needs an iv started, EKG, and a whole workup, while you are trying to stabilize and get your other patient with an acute MI to cath lab...I'll stop there, but could go on and on about this. There is no "which is better" in the ED and ICU...they are just very DIFFERENT. Half the work? Not on your life!

Esme12, ASN, BSN, RN · Jul 18, 2012

but which of the two requires a hire skill set?

Do you mead a higher skill set? Neither...they are both difficult and require specialty skill sets.

One1, BSN, RN · Jul 18, 2012

which one pays more and works less??

wooh, BSN, RN · Jul 18, 2012

The ADHD tendencies of the ED nurse finds the ICU while difficult and interesting...suffocating by tending to the same patients everyday.

Hehe! I often whine that I should just go work ICU since my floor gets patients that would be in ICU at our sister hospital (and I've got a 5 to 1 ratio where their floors have a 4 to 1.) But I absolutely HATE only having 2 patients. I don't care how much work they are, how interesting they are, how critical they are. BORING. I actually like running from room to room AND TO ROOM TO ROOM TO ROOM. :)

brainkandy87 · Jul 18, 2012

I'm starting to think "Johnny1414" is really someone else from these forums that got drunk and thought it would be funny to say absurd things.

wooh, BSN, RN · Jul 18, 2012

I'm starting to think "Johnny1414" is really someone else from these forums that got drunk and thought it would be funny to say absurd things.

LUV; don't play the stupid game! ER and ICU both work hard!

If you want to make max money, get an MBA and become a hospital CEO.