ICU thinking about ED

I find myself getting burned out on the chronic and often futile care in the ICU. Any thoughts?

Well, for the most part - I'm sorry to say that when it comes to critical patients - the ED and ICU aren't ALL that different. We BOTH experience 'chronic and often futile care.'

The BIG difference being - unless the hospital is FULL; the ED sends all their 'train wrecks' to the ICU. Because we need the room for the next 'train wreck'...

Guess it can't hurt to shadow.

Nope! :-D

Absolutely not!

Given your story and your life/professional experience - I honestly think you need an investigative reporter....

cheers,

I think it'll be a refreshing change. I'm moving there from an Observation Unit (6-7 pt ratio). I am coming up on my first year of nursing I did my transitions in an ICU and I loved it but couldn't get a job there. When I shadowed ED they threw me right into an intubation and I felt like I was back in the ICU until I moved onto the next patient. So much variety. You have that critical care experience to draw from and that will be so helpful. Good luck!

Many less train wrecks in the ED. The difference is they often have crashed before they arrive. No lines, no tube, knife in their pocket, restrained by EMS, blood and commit everywhere. Or whatever "unsanitized situation" is happening. We usually get them stable and send them up.

Then you have the other 3-4 rooms with frequent flyer abd pain work up, vag bleed, chest pain, and HA.

I would say lower acuity in general, but when they crash the environment can be very different than an ICU. You might like it. Never know till you try

I agree with your shadow idea. You will bring some valuable skills with you from the ICU if it is a fit. Then you will need a paradigm shift to manage in the ED. I did both and I liked both but I ended up the in ED for personal reasons. I still remember trying to put heart tones (you know, all those gallops and murmurs) into a cardiac charting form I was developing when I was early in the ED. It did not fly.:)

Do it! The couple times I have worked upstairs in the ICU I always find myself falling asleep. You get different patients everyday rather than getting stuck with the same 2 GOMER pts for 3 days in a row.

Most people that go from ER to ICU or vice versa either love it or hate it. From what I've experienced with my friends that have gone from the ED to the ICU is that they hate the ICU. They thrive on the constant chaos of an ER.

Not sure how your ED is but some ERs have high and low acuity areas of the ED. I prefer to work those sick and stink patients while others are content with the HAs, coughs and colds - lower acuity patients.

I do like that I never know what's going to roll into my room and that every single day is different. I don't think I would like the ICU right now. I still enjoy the "crazy" days and it is what I clock in for.

m

Try day surgery or PACU it is light and fluffy and you don't get mired down in all the drama. The ED can make you nuts and it is a much faster pace than the ICU. The ED you will see drug seekers all the time and amazingly they are allergic to everything but dilaudid. People coming in for stubbed toes and so many more families that are just as crazy as the patients.

You'll never know until you go! It all depends on your personality. As an ICU nurse you'll likely be very organised and well able to prioritise care. You'll need those same skills in the ED along with the ability to cope with the (highly organised) chaos. Not everyone can cope but some of the best ED nurses I know came from ICU. Conversely, some came down and couldn't cope.