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ICU to ED

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by Kbelle Kbelle, ASN (New) New Nurse

Specializes in Oncology, Critical Care. Has 3 years experience.

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. 

RNperdiem, RN

Has 14 years experience.

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, RN, EMT-P

Specializes in ER, Pre-Op, PACU.

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

Specializes in ER, Women’s Health, Med/Surg, Tele. Has 8 years experience.

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 😄