ICU to ED

RNperdiem, RN · Sep 18, 2020

I work ICU and like it for the structure.

ICU has an underlying structure that ED does not have.

In ICU you know you will get 1 or 2 adult patients with a diagnosis specific to your unit. You begin with report, assessment, meds, turns Q2 hrs, rounds etc. Of course the unexpected will happen, but ICU has an underlying structure and a level of predictability that I like; it makes it easier to plan and manage time.

ED is for all ages, all diagnoses, a lot of unknown factors, variable number of patients assigned. You have to reshuffle priorities and change direction quickly. You do a lot of mental triage. If the routine of ICU was getting to you, ED should be a refreshing change. And, the patients turn over. Difficult patients and families will be gone after your shift and you begin a shift with new patients.

speedynurse, ADN, BSN, RN, EMT-P · Sep 19, 2020

8 hours ago, Kbelle said:

Hey everyone, I wasn’t sure where the best place was to ask this question, so please move if it’s in the wrong place.

I’ve been a nurse for a little over 2.5 years, spending 1.5 years in acute oncology, and most recently a year in a SICU/CVICU. I thought ICU was what I wanted, however I’m finding it’s not what I expected and I’m not enjoying it that much.

There are some ED positions open, and ED was always my dream throughout nursing school so I plan on applying.

Does anyone have any tips for an ICU nurse transferring to the ED? I know it’s a completely different world and would love any tips anyone has to offer.

ICU and ED are very different thought processes. ICU is very detail-oriented, everything is very precise and exact, and organized. ER can be mass chaos and you have to be comfortable with leaving things undone sometimes - it may mean leaving charting unfinished, leaving your ICU level patient with a complete mess of tangled lines and bed linens because you were so frantic with getting him or her stabilized, it may mean dropping everything with a lower level acuity patient to take care of a higher acuity at a moment’s notice. In other words, ICU and ER are as different as night and day. Both forms of critical care nursing but VERY different thought processes and nursing care.

Alyssa Queen · Nov 4, 2020

Newish ER nurse here, with a few years previous floor experience. Funny enough, I’m interested in going ER to ICU. I Agree with what was said before. It’s a very different flow of nursing. Also it depends on the facility. I actually like the chaos, but I also work at a teaching hospital (and level I trauma county hospital) and that’s the part I don’t like- Normal Er chaos + lots of students/residents is really a struggle for me as I am still learning so much myself and the POC is always changing from all the different providers involved and the hierarchy of them. Also I am having difficulty being “less thorough” in some ways, if that makes sense? Like I’m having trouble not treating them like floor patients and making sure every thing is done 100%. I mean, sure that’s the goal in a perfect world. The floor nurses love getting pts/report from me, but it’s killing me to do it all (also we never have aids or techs). Especially when your turning over pts and then suddenly 1-2 of them turn ICU acuity and you’ve still got 2 other pts to worry about or admits/discharges to manage. For me, I enjoy the higher acuity pts I sometimes get in the ER but want more structure like an ICU. I know a bit opposite of your situation, but maybe that will help give you more ideas on what you might like/dislike ?