Experience before entering the ER?

Boomer MS, RN · Dec 27, 2016

Hello! I am an ICU nurse considering making a switch to the ER within the next few years. I have been an ICU nurse for a year and want a little more experience under my belt before I plunge into something new. How long would one recommend spending at their first job or in the ICU before beginning an endeavor in a busy ER at a Level 1 Trauma Center?

You did not say if you started your career in an ICU or had other experience, such as med-surg, before ICU. For what you are asking and considering, I feel you are fine for transitioning to an ED with your one year of ICU experience under your belt. It is a very different environment, however. In the ICU, you are limited to two patients, at least in CA. The ICU is able to have control over who is admitted to its unit, which is not true in the ED. I loved working with ICU nurses who floated to the ED, but some of them hated the unpredictability and not knowing who/what might walk through or be transported through the doors. Some felt out of their league seeing such a different kind of patient population than only in an ICU. The ED nurse has to be a generalist and a specialist, and not everyone is very sick, as in ICU terms. I have worked with many ICU/ED nurses who loved both areas and some who went back and forth between the Level I units to keep their interest and skills up. I've heard ICU nurses say they liked that many of all their patients are on vents, which is not true in the ED. (And an aspect I didn't like about the ICU.) I think ICU nurses have the best assessment skills, BUT much of what an experienced and knowledgeable ED nurse does covers a huge spectrum of information. I say, "Go for it." Like any other specialty, just be aware that you might like it. "No guts, no glory." "Nothing ventured, nothing gained." Good luck.

Nurse3242 · Dec 27, 2016

Thank you so much for your advice! To clarify, I did begin my career in an ICU. What worries me most is that we are very specialized. I am at a large hospital and work in the Neuro ICU. I would be interested in switching to our ER within the same facility, but am not sure if I am ready with my level of experience. I do appreciate all advice and I agree: Nothing ventured, nothing gained.

Boomer MS, RN · Dec 27, 2016

Thank you so much for your advice! To clarify, I did begin my career in an ICU. What worries me most is that we are very specialized. I am at a large hospital and work in the Neuro ICU. I would be interested in switching to our ER within the same facility, but am not sure if I am ready with my level of experience. I do appreciate all advice and I agree: Nothing ventured, nothing gained.

I think you will be fine. Being in a specialized ICU, in your case neuro, is not a drawback; it's a plus. The ED nurses may ask you some questions about neuro; I know I did. Any new environment is challenging and an adjustment with a steep learning curve. And, in my opinion, I loved the Level I EDs I worked in. Others' mileage may vary, but I say give it a go. It always depends on the needs of the department, but you will never know until you try. Put out some feelers and maybe try to chat with the ED manager. She/he might be thrilled to see your interest.