ICU or ER?...Dec 2012 Grad

Specialties Critical


Hello everyone! I will be graduating in December of 2012 and am itching to get into Trauma nursing.

I know this is a very competitive field and most Trauma centers require some sort of experience prior to working in this department. However, I have been given a great opportunity from the hospital that I have worked at all through college and nursing school. I have been given the option to work in their ICU or ER upon graduation provided I pass my boards, in order to get a year or two of experience.

However, this would just be a temporary job because I want to work that a Trauma 1 hospital and we are just a tertiary care hospital in the middle of nowhere. My question is, what would be more beneficial to me...accepting the ICU position or the ER position. Both are very interesting to me so I would enjoy either but I was just wanting the opinion of some seasoned nurses that understand the profession better than I.

Thank you for your time!

Specializes in ED, Flight.

I recently had an interesting conversation with my Chief Flight Nurse regarding who we ought to hire, and why.

The CFN is an NP who works in Neuro ICU. She has worked rotor wing and fixed wing flight jobs, and in house critical care nursing. She contended, and pretty well convinced me, that nowadays an ICU nurse is going to develop a lot more medical understanding and critical thinking than the average ER nurse. Especially if the ICU nurse works nights.

Today's ERs are full of patients who aren't all that sick, and don't have emergencies. We spend a lot of time just rushing to keep up with the amount of patients. As a result, the new ER nurse will have to look more for opportunities to learn and understand complicated patho-phys and how to make decisions and implement treatments. My shift today was a good example of that. Within a four hour block I had two drunks with rule-outs, a bug bite, two simple fractures, a cardiac rule-out who was stable before I got him, and new onset CHF. That last one could be an interesting and mildly challenging patient - but I didn't have that much time for him after the initial assessment. The busy ER environment doesn't allow much for taking advantage of the chance to get really involved in the patho-phys, differential Dx, and Tx decisions and modalities.

An ICU nurse is going to be seeing genuinely sick patients. There will be much more opportunity to hone knowledge and thinking skills. The nurse spends a lot more time with each patient. The ICU will confront you with educational and cognitive challenge; the ER might not give you the time to pursue similar learning.

Specializes in Flight RN, Trauma1 CVICU STICU MICU CCU.


level 1 trauma is more likely to hire a newer, but with experience ICU nurse (because they are trained to do ICU nursing) than a ER nurse with the same amount of experience.

Because that ER nurse still has to be trained as an ICU nurse.

Specializes in Ambulatory Surgery, PACU,SICU.

ICU - I work at a level 1 trauma center SICU. Any new people that get hired for days have prior ICU experience, at smaller hospitals usually.

Thank you very much, this helped me out significantly.

Specializes in Cardiothoracic ICU.

I am a pretty new nurse working in ICU but i am able to pick up shifts in the ER. I dont think my facility would allow new ER nurses to work in the ICU. Working in ICU allows you to get comfortable with sick patients the fastest.

If you're interested in trauma then ICU is where you should be. A lot of people say that its unlikely to get a job in an ICU as a new grad but several of my nursing school friends have gotten hired in an ICU unit because the unit can train them how they want them, good luck!

Its hard to choose... ICU is more with critical pts and ER is both..

Thank you to everyone for responding. I interviewed yesterday for a job in an ICU and was offered the job after the interview. Now I have to pass boards and begin me career! Thanks again

Thank you to everyone for responding. I interviewed yesterday for a job in an ICU and was offered the job after the interview. Now I have to pass boards and begin me career! Thanks again

I have been in the emergency field for 10 years and it is the best decision that I ever made! Seeing different things everyday, witnessing people defy the odds of death despite what you've learned and bringing people back from the brink of death is exhilarating!

Specializes in Critical Care at Level 1 trauma center.

It is possible to work level one trauma right out of school... I got into an internship with guaranteed hire in a level one trauma SICU... It is just competitive 250+ people applied for 20 positions broken up between BICU CICU AND SICU

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