Going to ICU after working ER

[nursingnugent]

I have been working in a very large "non-trauma" hospital in orlando for about a year and a half now and have about 8 months left on my contract. At some point, I need ICU experience as I want to do critical care transport nursing. Even after searching, I can't seem to find another thread answering my question. What experiences have other nurses have transferring from the ER to ICU? I'm currently regarded as a resource person when other nurses have questions regarding their ICU or trauma patients and feel relatively comfortable with the drips and protocols that we use frequently in the ER. Any feedback you guys could give me would be really helpful.

[irishicugal]

I worked ED for several years before transferring to ICU, as did several of my colleagues. ICU is like the Resus bay of ED, only a lot more organised lol (think organised chaos rather than chaos). I love ICU, and feel I've found my niche. However, regardless of how much experience you have and how comfortable you are with drips, protocols and handling vents etc., it's important to remember that you are essentially starting over. Yes, you will grasp many of the concepts much quicker, such as analysing ABG's and titrating pressors but you will still be seen as a newbie iykwim. You will fly through orientation and it may even be shorter for someone with your background. Is there an ICU in your hospital? Could you ask to pick up a few extra shifts there to see if you like it? Is your contract with the hospital itself or with the ED?

[RNperdiem, RN]

I did work with some nurses who made the transfer from ED to ICU. They managed just fine.

I found gaps in their knowledge that I hadn't anticipated until I thought about it. One guy was excellent at IV placement, but had never changed a wound vac. His orientation was targeted at the skills less used in ED like wound vac, complex wound management.

ICU has more "administrative" sort of things like knowing when the last BM was and how to prevent constipation, Q2 hour turns, daily fall risk scores, Braden scores for risk of skin breakdown, and CIWA protocols for alcohol withdrawl.