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More critical thinking & knowledge: ER vs ICU?

Specializes in the Emergency Department.

So do you think ER or ICU nurses use more critical thinking? Who do you think uses more knowledge of patho, pharm, disease processes, etc? Especially if you’ve worked both, I’d love your insight.

speedynurse, ADN, RN, EMT-P

Specializes in ER, Pre-Op, PACU.

ER and ICU nursing are simply different. I don't think either necessarily uses more critical thinking, but different types of thinking and processing through patient care. ER nurses are sort of the "jack of all trades" and can drop everything at a moment's notice when a patient crashes. ER nursing is about quick, rapid assessments to ensure a patient is not going to crash and die....it is about understanding priorities and triaging patients appropriately (ex. a level 2 gets roomed before a level 4). ICU nurses are much more detail oriented in their assessments, processes, etc.

I have never worked strictly in the ICU - only in the ER and have taken care of ICU holds. Both forms of nursing are critical care nursing - simply two very different branches of nursing and require some different skill sets.

Undercat, BSN, MSN, CRNA

Specializes in Retired. Has 41 years experience.

ICU will expose you to much more physiology - that's why they require it for CRNA school. You spend days or weeks with patients rather than hours. You get more time to appreciate the processes of disease.. ER requires as much critical thinking but a different kind.

Serhilda, ADN, RN

Specializes in Cardiac Telemetry, ICU.

I've worked both (though my time in the ER was significantly less than ICU) and I'd have to go with ICU. There are so many patients that just don't need to be in the ER that half the time, I wasn't learning much. I've gotten to use much more of my knowledge of pharm and patho because ICU patients have a lot more going on than some 22 year old with chest pain or a 1 year old with a runny nose.

lexotaNIL, BSN

Specializes in intensive care unit. Has 10 years experience.

it depends upon your interest...

critical thinking won't base on your area..so many ICU and ER nurses re not very interested in critical thinking. first you need to assess yourself what kind of interest you have. 

Edited by lexotaNIL

Hoosier_RN, MSN

Specializes in dialysis. Has 27 years experience.

On 8/13/2020 at 12:45 PM, speedynurse said:

ER and ICU nursing are simply different. I don't think either necessarily uses more critical thinking, but different types of thinking and processing through patient care. ER nurses are sort of the "jack of all trades" and can drop everything at a moment's notice when a patient crashes. ER nursing is about quick, rapid assessments to ensure a patient is not going to crash and die....it is about understanding priorities and triaging patients appropriately (ex. a level 2 gets roomed before a level 4). ICU nurses are much more detail oriented in their assessments, processes, etc.

I have never worked strictly in the ICU - only in the ER and have taken care of ICU holds. Both forms of nursing are critical care nursing - simply two very different branches of nursing and require some different skill sets.

I've done both, and this answers it perfectly!  I've also done med surg, which requires heavy critical thinking. LTC to me is heaviest on critical thinking. In acute care, you have  Dr in house (usually present in the ER) for rapid needs, whereas in LTC, you'd better be a quick thinker. Usually no docs in house, a nurse or 2 (RN or LPN) and QMAs to decide on the off kilter symptom. All areas of nursing offer a critical thinking component 

 

 

Edited by Hoosier_RN

mfdteacher, BSN

Specializes in ICU/ER. Has 39 years experience.

After many years working both ER and ICU, I feel that (at least in my day, no on site intensivists), ICU nurses had much more autonomy and had to be pretty quick on their feet.  We made critical decisions and acted on them on a daily if not hourly basis.  I agree that in some ER situations, if the docs trusted you, you could initiate care at a level that required action now and not wait for the doc.  But the doc is also always there.  Bit of a difference.

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