I don't know if I want ER or ICU

[tarotale]

Hello, I am having hard time whether my heart is in the ER or ICU. As you all know, there seems to be a bit of competitiveness (or even enmity) between these two units, and I don't care what other people say, I have highest respect for the nurses of these two units. I graduated with big heart for ER, because of its unpredictability, versatility, adrenaline rush, demand for prioritization and problem solving skills, critical thinking, excitement, etc. But now I am also interested in ICU because of the depth they go into, how critical these pts are, also the rush (since I love urgency and code situations).

As I am searching for new positions in other hospitals right now, I am split between going into ER or ICU at this point. The reason that made me rethink ER is probably b/c of the liability of unpredictable situations that keeps pouring in, that I may not be able to handle (which probably doesn't happen everyday, but sure will). If one of the my pt codes in ER, then 3 or 4 other pts of mine will be left without attended, and then what if another codes? what if couple others get too delayed for CT or critical meds that I get my butt handed to the docs? Well list is endless....

Compared to that, from what I see in ICU at my hospital, seems like it's not as unpredictable and crazy (although there ARE times), plus they got 1 to 2 pts, on top of that if all hell breaks loose (like a code), then the team is so effective that I can treat the coding pt while other nurse will cover for the pt if I have 2.

Don't get me wrong, I still want to do ER really bad, and NOT saying ICU is easier or anything, but just two different animals with different structure. As I said, I love love love code situations where I am there for the most urgent pt and I want to know what to do; I am sure ER and ICU nurses know what to do in codes. I know lot of people worked in both ER and ICU, so I heed your advice and experience. Thank you!

[NurseOnAMotorcycle, ASN, RN]

The thing you should do is to talk to the nurse manager and shadow for a shift to see if you like it or not.

[ChristineN, BSN, RN]

In my ER when I have a code or a critical pt that requires 1:1 care my coworkers are great about jumping in and helping out with my other pts, or taking over care on my noncritical pts completely. We typically have a float nurse during the afternoons and evenings, and this nurse does not have a pt assignment so they are able to help out.

I know not all ER's are like this, but I definitely feel like pt safety is a priority where I work.

[Medic2RN, BSN, RN, EMT-P]

There is teamwork in the ER the same way you described it in the ICU. You can't be 1:1 in a critical situation and physically be in 3 other places at the same time. The doctors, other nurses and the charge nurse realize this and help out. At least this has been my experience in the ERs that I have worked in. And yes, there are times when 2 codes occur at the same time. This is where prioritization skills come into play and everyone adjusts accordingly. The ER and the ICU are very different animals with different mindsets. Shadow a nurse in both areas and see where you would feel more comfortable or challenged.

Good luck!

[Larry77, RN]

I think the best thing about the ED is the variety of patients. We can be taking care of an infant one moment then a 90 yr old the next. I also like the teamwork with the MD's as they are right there discussing plan of care with you. And don't forget if you have a difficult patient you only have them for hours instead of sometimes months in the ICU.

There are also benefits to ICU, you get to know your patients better than any other nurse. You get to know drips and lab values better than any other nurse and you can plan your day instead of never knowing what will come in the door.

If you aren't sure, just get whatever job you can in either and transfer if you don't like it. It's not like you will be stuck forever if you choose one.

[tarotale]

thats what i like about ER too. even with nasty pts, you send them up and never see them again, but i like icu in that you are expert in drips, labs, and other gadgets

[ChristineN, BSN, RN]

thats what i like about ER too. even with nasty pts you send them up and never see them again, but i like icu in that you are expert in drips, labs, and other gadgets[/quote']

Depending on how critical your ER is you can also get skilled with those things. My ER is not a trauma center, and the majority of the pts are fairly stable. However other ER nurses who have worked in rural area or Level 1 trauma centers may be coding/starting gtts on a daily basis. Whereas I have taken care of 2 intubated pts in the last year

[NursExec]

ICU will give you critical care training that will help you in the future. I was in EMS for years before nursing and was convinced the ER was my calling..I was wrong..after a few years in ICU the OR became my home. Keep trying them all..that's the beauty of nursing.

[Guest219794]

Shadow a few shifts in both.

Very different from each other.

thats what i like about ER too. even with nasty pts, you send them up and never see them again, but i like icu in that you are expert in drips, labs, and other gadgets

The short-term nature of our relationships is one HUGE benefit to the ED. I do not want long-term relationships with my patients or their families; I prefer to cycle them in and out.

We end up taking care of patients on multiple drips, vents, a-lines/central lines, etc, though not nearly as often as the ICU folks do... though a lot of their patients are soft ICUs, too.

A large number of my ED colleagues have come out of the ICUs specifically because they prefer the pace and turnover of the ED.

One major benefit of the ED, in my opinion, is that you form very close relationships with docs because they are there continuously and you interact with them routinely throughout the shift.