ICU-->ED

[kwisatz_haderach]

The burnout is setting in and Im looking to move from Critical Care to something entirely different. I have Medical/Neuro/Cardiac Intensive Care background and I'm looking to kick the tires in the ED. I originally wanted to work ED fresh out of school but went ICU instead and Ive put in 5 years in Critical Care. The logical transition seems to be ED to me. Am I wrong?

Any suggestions/cautions?

Thanks.

-Z

[PeakRN]

The ED is great. The biggest difference is that 80-90% of your patients are not sick, and you have to tease out which is which. This also means that you have to be very fast with the patients who are not so that you have enough time with those who are. You'll have to be able to multitask getting a history, performing an exam, starting interventions, and planning when to document all at the same time.

Do you have any opportunity to shadow down in the ED for a few shifts? I feel like when our unit nurses come down they either love it or hate it, and decide pretty quick if the ED is for them.

[Lunah, MSN, RN]

Can you shadow in the ED to see what you're getting into? I worked with a lot of former ICU nurses in various EDs, most were awesome!

There are a ton of threads on this topic for now this forum, the search function will probably yield more threads. :)

[Guest374845]

I can echo that it's definitely not as mentally stimulating as a heavy ICU, but it's freedom from the tedium. You can still put your skills to good use when the time comes and you may even be a cut above the rest when you're boarding patients on nimbex drips, floating pacing wires or even zeroing the rare EVD. The flip side is that it can get a bit tiring maintaining constant vigilance for the secret-sick patients and the needle-in-the-haystack diagnoses.

All that being said... from coding someone on the floor with volcanic ruptured varisces to delivering babies in triage, there's no place else where you'll have that kind of variety. And then you send them upstairs!

[Shanimal]

I started off in the ED as a new grad and stayed for several years (loved it, but was starting to feel the burn out too) before switching to ICU. I've always likened the ICU environment to controlled chaos and the ED environment to the Wild West. Like others have suggested, it's a good idea to shadow in the ED a bit before taking the plunge, because just like any other specialty, there's the good and the bad--you just have to decide for yourself which is which. Certainly ICU critical thinking skills will serve you well in the ED. I would also suggest reflecting on what specifically in the ICU is burning you out, because depending on what it is, you may or may not be escaping that by going to the ED (where it could be even worse). Sometimes it's not being in the ICU that's the problem, just the need for a change in patient population (going from a trauma ICU to a CVICU, for example) or workplace environment.