Help RN Split Personality! Bouncing between ED and ICU looking for home.

[SaltySeasRN]

I've been a nurse for 7 years and have always worked either ICU (SICU or N/S-ICU) or ED, many times together one specialty as full time and the other specialty as agency to make extra money. My biggest dilemma is I love/dislike them both and after 7 years still can't decided where to make my home but I'm tired of the bouncing back and forth. The variety, chaos and "treat em and street em" bustle of the ED is just as fulfilling and as the super sick 8 drip vented patient on CRRT with bilateral EVDs. The nursing personalities are the same, bold type A, "can run a code with eyes shut" type which I get along with fine. But how does one choose? Working in the ED changes you in ways I never thought possible. I've been back in the ICU strictly for over a year and went back to it to make sure I didn't lose my skills regarding multiple drips and treatments exclusive to ICUs, but I oddly find it mundane lately. Is this a sign that I'm a displaced ED nurse? Has anyone been in my shoes and can share some light as to how they chose? The first time I went exclusively ED I had the same feelings about missing ICU. Most of my peers are typically strictly ED or ICU nurses so they can't relate. Any suggestions for those of us who love both worlds?

[guest769224]

At my previous level 1 facility I had many coworkers that worked both. They did 2/3 ICU, 1/3 ER, at the same facility. Both managers approved this and thought it was beneficial. I think it would be an awesome position, maybe see If you could obtain something like that. If not, just pick up per diem at a local ER.

By the way, I've done ICU for 4 years now and have never heard of bilateral EVD's. That's interesting.

[NuGuyNurse2b]

even in my ED it's mundane, most of our patients are elderlies from the nearby nursing homes who fell or just need a blood transfusion and same day is closed.

[SaltySeasRN]

Thanks for the suggestion, I have in the past worked per diem in either ICU or ED while maintaining my primary which I'd like not to do for awhile. But I will definitely talk with the managers regarding splitting my 3 shifts between the depts, I hadn't thought of that.

And I currently am working in a NeuroSurgical ICU and with our patients that have massive bleeds they put bilateral EVD (external ventricular devices) in because sometimes one drain just can't keep up. It's very interesting.

[SaltySeasRN]

Yes that happens too depending on the ED, my most recent one had a high level of acuity thankfully but on those days when its just routine with junkies or slip/fall its not challenging enough. Those were the days I missed ICU the most.

[Wuzzie]

I think it's time for you to look at CCT. Best of both worlds!

[Buyer beware, BSN]

You have reached the trained monkey stage of your nursing career. You know most of the stuff inside out and you're sick and tired of chasing K+.

So what's left?

You could take the easy way out and become a nurse practitioner.

That way you'll get the respect and love you crave from your supervising physician and adoring patient load.

This method of career advancement (NP) and replenishment is far from the same job different day banality of the treat and turf and turn and water mentality of either the ED or ICU.

And you would have to admit full of glamor and ultra intellectually stimulating also.

Life I love you. All is groovy !

[NurseGirl525, ASN, RN]

At my previous level 1 facility I had many coworkers that worked both. They did 2/3 ICU, 1/3 ER, at the same facility. Both managers approved this and thought it was beneficial. I think it would be an awesome position, maybe see If you could obtain something like that. If not, just pick up per diem at a local ER.

By the way, I've done ICU for 4 years now and have never heard of bilateral EVD's. That's interesting.

I've seen that a couple of times. It's interesting. It happened actually to one of my patients who ended up with a huge decline in neuro status with the first evd in. The pt's bleed had just started spreading.