ER vs ICU

johnnrachel · Jan 15, 2008

I am an ER nurse and I know this discussion can get to be an ugly discussion on ER vs ICU. I can just say this little advice, I personally would make a terrible ICU nurse, but I think I rock ER. This is because ICU is more of a long term type of nursing care, and ER is more like treat em and street em attitude. Just different type of nursing, one is no better, or harder or anything like that. Also you have to be very adaptable and able to change gears in an instant in the ER. However, I think in the ICU you have to get closer to the patient and worse yet the families because most patients are in the ICU long.

I will be following this thread because I am curious what people will say!!!!!! Good Luck with your decision. I personally think if you are a new grad you should go for ICU, I worked telemetry before ER and I adapted well!!!!! Good Luck with your decision. :innerconf

cheripa · Jan 16, 2008

I started out in the ER and now am in ICU. I like ER better. In ER you will do a lot of walking/running around. ICU you tend to sit a lot unless your patients have tests that you have to take them to. Both units are type "A" personalities so make sure you can handle that. Good luck to you what ever you chose. You can always change units!!:cheers:

ronsrn · Mar 5, 2008

I am a new grad - 9 months and am in an ICU and as far as sitting id have to disagree we dont sit much - both have pros and cons both are difficult

skittlesmom · Mar 5, 2008

I was an ER nurse for 18 years and although burnout comes quicker working in the ER, I had great experiences. You have to think quick, move quick, be energetic and love the exciting, fast paced environment. You also have to be able to adapt to different areas in the ER such as peds, cardiac, surgical, etc. and to be able to work with all different people such as police, social workers, x-ray, and doctors. Some people feel you never develop relationships with patients and families but that is not true. You have your regulars you get to know over the years, some who are probably still around and some who have passed on. There is also a certain bond that develops between ER nurses that I will never forget. Even though I do not work in the ER anymore, I wouldn't have traded those experiences for anything. Hope this helps.:nuke:

MissDoodaw · Mar 13, 2008

I am a new grad working in ED. I have a friend from nursing school working as a new grad in ICU. We have a critical care class together once a week. Keep in mind my perspective is still as a new nurse and very limited.

He gets the more throrough approach to pt care, I get more info on immediate stabilization and recognizing when a new pt w/ no diagnosis etc is about to go bad. I get orders for my ICU admit pts, but don't get to see many of them recover - only seen 1 pt extubated in 3 mos-he gets to see more of the recovery process - and more of the diagnostic stuff and complications that develop for the tricky ones.... The part I hate most about my job is not knowing what happened next.... I get to see a whole lot more patients than he does I might get about 8-20 pts a day depending on severity he only has 2-4 I think.

aeauooo · Mar 13, 2008

I used to think I'd like to work ED, but the times I have floated to ED I have really not enjoyed the experience.

Depending on where you work, working ICU can be an adrenalin rush. I used to work in a neuro/trauma ICU in Philadelphia and found myself addicted to the high of busting my butt trying to keep someone alive.

Then there's the other side of working ICU; keeping people alive for weeks or months without seeing much, if any change - and again, busting my butt to do it.

It really depends on what you want. The great thing about nursing is that if you don't like where you are working or want to make a change, it's (almost) always out there.

That's my 2c.

lis102me · May 7, 2008

I'm glad I found this discssion thread. I'm a new grad, my degree hasn't even posted yet for me to take the NCLEX...that's how new Iam:nuke:

I also have the opportunity to start in the ICU or the ER. I've done over 300 clinical hours between a SICU and MICU. I've worked as an EMT in the ER for 2 years! Both appeal to me and both are definately two different creatures and I have adapted well in both settings. As a new grad the ICU appeals to me because it's learning systems and there I've seen a lot more autonomy in ICU nurses. ER appeals because of the rush and learning to prioritize 5 patients at once instead of 2 like in an ICU. In your opinion, would ICU or ER lay a better foundation for a new nurse? I know MedSurg is the IDEAL foundation, but no thank you, I don't want 8+ patients at once and lose the nurse-patient relationsihp.

On another note, I would like to start taking travel assgnments after 1yr experience. Does anyone know if there are more ER or ICU assignments out there? Or are they about the same?

ronsrn · May 7, 2008

My wife was a travel ER RN and found that most places that need travellers need Both er and icu nurses. I am now an ICU nurse and and have the 1 year experience but im not sure i would feel comfortable with travelling as of yet. I wish our hospital permitted cross training in the ER as I would like to see that side of nursing as well

mkey333 · Jan 16, 2009

I also have been wondering the same thing. I have two interviews, one with ER and one with ICU this month and I don't know which one to pursue more!!!! :banghead:

I am a med-surg/telemetry/oncology nurse for about 1 year and a new (second career) nurse. Med-surg has been a great experience, I love the team I work with but the patient to nurse ratio is very, very demanding and challenging. On average I have 7 patients a night, and they are very sick, or confused, or in a lot of pain. It's rougher than I thought in regards to getting everything done that the patient needs and then getting everything documented as the hospital wants. The documentation demands grow every month...it's insane!

In addition, I am in a MSN program to become a Family Nurse Practitioner in about 2-1/2 years and I wonder what nursing experience would help me the most...ER or ICU??? Any ideas or suggestions from experienced nurses or NPs out there??? I sure could use the insight.

oceanfloor · Apr 14, 2009

I started out in the ER and now am in ICU. I like ER better. In ER you will do a lot of walking/running around. ICU you tend to sit a lot unless your patients have tests that you have to take them to. Both units are type "A" personalities so make sure you can handle that. Good luck to you what ever you chose. You can always change units!!:cheers:

did you find it difficult or easy get to get hired into an ICU position given your previous experience/credentials? (and what particularly was your experience...length of time in ER etc.)

emt2rn2fnp · May 29, 2012

I worked 8 years as an ER Tech in ER's and my number one nursing job choice was always ER. However, a lot of the great ER nurses I worked with often told me they started out first in the ICU before going to the ED. They said it gave them a great foundation to build from.

In nursing school I had extensive time in the ED and loved it, felt right at home and knew it was someplace I could jump right into after I got my license. I also spent my last semester alternating one week in ICU and one week in ER during my last clinical. I love the pace of the ED and way things are always moving and changing. The ICU was challenging and had a very different focus. Personally I am not a huge fan of having only two patients or less for 12 hours. But there was also so much more I needed to learn, based on my previous experience, than in the ED, so that may have made a difference in my enjoyment level during that time.

When I got my license the ED's around me and in the hospital I worked at were either not hiring or not hiring new grads. I ended up getting a position in my hospital's ICU. I am now seeing that a lot of the focus of ICU, such as really taking accountability for the hemodynamic situation of my patient and independently making decisions, such as starting or titrating drips, will be much more practiced in the ICU. Yes, ED nurses hang drips and focus on hemodynamics, but often they also treat clinic type patients and other less critical patients as well as critical patients. I now see what those previous ICU to ED nurses are talking about. Yes, I can jump into ED right now and feel comfortable. But if I put in my time in the ICU I gain expertise in hemodynamic monitoring and interventions. So when I do eventually go to the ED I will not only be at home, I will be very secure in how I manage the critical patients I come in contact with, at least to a greater extent than if I started in the ED and worked the same amount of time as I'll put into the ED.

On another note, the ED is fast paced and you think on your feet, but there are Doctors and PA's or NP's besides other nurses around all the time. The ICU keeps you very busy with your one or two patients, but usually there are no doctors, so you either must be confident in making those decisions withouth the doctor and consulting your co-workers before you are able to get a hold of the doctor. Of course this is all based on where you work. My sister was admitted into and ICU where there was always a doctor around, so that point wouldn't apply.

I hope that helps a bit.