ICU v. ER

[nyforlove]

ICU v. ER

I think this will be a very short-lived thread, because I think the answer may be simple...to put it briefly (for once ;-) ..... Is the ER just as bad as a med-surg floor?--i.e., so many patients dying that you can't focus?...I'm in ICU and LOVE it after having seen the numerous patient in med-surg floors that don't allow you to focus on care...ICU is great with two patients and their need for close nursing/monitoring, e.g., titrating drips, following lab values, counseling families, etc.....The reason I'm wondering: I'm interested in the different perspective of an ER nurse: You sometimes have NO IDEA what ails a patient, as the patient may be unconscious or not speak English, whereas in ICU, you know all that the ER has figured out for you before sending you the patient....I'm just eager for a DAY shift and would transfer to the ER to get it.....but is that precisely why ER is easier to get as a day shift, because it is NOT as desirable as med-surg?? Thanks so much!

[ERNurse03]

I don't blame you for not liking ignorant remarks because I don't like them either, but I didn't throw out any remarks about floor nursing and I did not say that ER nursing was any harder than any other floor or ICU.

[MAISY, RN-ER, BSN, RN]

Hey, think what you will. ER nursing is like any other type of nursing, you work hard. However to say ER is harder than the floor or ICU, come on.

The concept of ER is still simple. Stabilize, move out, or move somewhere. I see floor nurses struggle with 8 or sometimes more patients all day long. Sick, demanding patients. Then, to deal with out of control paperwork all day long ontop of admits and discharges. It really burns me when people throw around ignorant remarks about floor nursing.

I work ER and have handled up to 7 very sick patients due to short staffing or an influx of a ton of patients. My very sick or stabilized and sick patients don't move anywhere unless there is a bed....in addition, the ambulances and dying people just keep coming.

Again, I'll say ITS HARD IN THE ER...OUR DAY IS DIFFERENT....TOTALLY NOT COMPARABLE!

Maisy

PS I can't refuse bad vitals, drips, unfinished orders, no orders, no admission forms and whatever else we have to do prior to moving someone to the floor!

[GilaRRT]

If you are forced to deal with seven critical patients, run away. You should not work in that environment.

[ERNurse03]

You're right Maisy, it would be nice once in awhile to just be able to say, sorry, we're full we can't take any more admissions. It's a good thing our ER patients aren't sick and demanding...it's a good thing ER patients don't require out of control paper work.

[MAISY, RN-ER, BSN, RN]

If you are forced to deal with seven critical patients, run away. You should not work in that environment.

Welcome to NJ...hospitals closing...where is everyone to go?

Maisy

[GilaRRT]

East coast, sorry. Allow me to say this again, if an ER forces you to take dangerous patient loads, run away, it's not worth it. You see, you should be able to say, "sorry have critical patients, no mas!"

[Toquay]

I am sure you have all heard the "If you build it, he will come" well the ER is of the philosophy... If you come, we will see you. It would be nice to close the doors when the ER is full or when staff has reached its limit but there are no limits in the ER. You work as hard and as safely as you can, let people know when you are stretched to the max and hope to see a light at the end of the tunnel. We used to be able to divert ambulances when we were at breaking point but even that is now a "no no" per the hospital system policy that I work for. We are in the business of healthcare 24/7 and as such we see, treat, and admit based on each pt needs... not to pick on the nurses.

I still stand by the fact that every department is different and can vary from hospital to hospital. Every department will have its good days/nights and also bad days/nights, its simply the nature of the beast. The best way to get a feel of the work atmosphere is to talk with the people that actually work in that department or shadow someone.

Toq

For GilaRN: ER patients are not categorized quite as "simply" as you may think, and some patients can be very complicated and time consuming while we find out what is going on. They do not come to us with diagnosis and orders to follow, we often have to scramble to have all that so "simple" information to pass on.