Need Advice- OR to ED or ICU?

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Hi Everyone!

After a year and a half in the OR, I want to move up the ladder and go back to school. I love the OR, but theres not much room for growth except management which I do not want to do.

I like both the CRNA profession and NP professions, so maybe ICU or ED.

ED- super fast pace, unpredictable patients (behavior and status), stat orders,fast pt turnovers. I admire ED nurses for their on the spot critical thinking, its such a great skill to have in the hospital and out. I could definitely learn a lot and want this skill set.

ICU- multiple lines, high acuity, ventilators, more time with patients/family, multiple meds. I have tremendous respect for the CRNAs, they are so smart, very knowledgable about everything and I want that. Plus I'm comfortable with surgical population and had exposure to surgical procedures/vents/lines.

In the end, I am coming from the OR so where ever I go, I will be starting from ground zero (barely any IV skills, no floor experience, minimal medication knowledge, basic nursing assessment) :no:

Any advice for me on which to choose or what I can do to strengthen my nursing skills? I am gonna try to do ACLS, but anything else? I would gladly appreciate it!

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Is there a way to spend some time on each unit to see where your heart takes you?

I think one of the main differences between ED and ICU-- and come here without ever having worked ED, and only ICU-- is that you can get to know the patients and families and watch them over the course of an illness. I would imagine that in the ED the patients move through quickly so you don't know what happens to them after they get admitted.

The ICU has many sub-specialties. Do you have one in mind you'd like to start with? Neuro, cardiac, trauma, general ICU and so on?

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Thank You? Anon456 for your advice.

I am a new RN that transitioned from the scrub role to the circulating role. I enjoy the atmosphere of the OR but enjoyed the pt care of other specialties. Especially after my preceptorship which made me hungry for new experiences. I too would like to transition to ICU or ED r/t experiences I've had in school and where I believe my strengths lie.

Although, I fear that what little clinical experience I have with assessments and procedures/task management will diminish to a point where I am not a viable candidate for such specialties due to how vastly different RN responsibilities are in the OR.

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ER hands down. I can't explain the magnitude of knowledge and experience I am getting working at ER compared to god-forsaken floors. Personally I would never work at ICU; different pace, gotta hold on to 2 patients for ages, etc, but at ED, we just tackle the most important thing and move on. I had to drop lots of floor nurse behaviors working at ED. But if you want to be CRNA, you know you have to do ICU, so pick your poison lol.

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Thanks anon456!

I was thinking SICU because surgery is all I know at this point. How hard is it to get into the ICU? I have heard many scary interviews that ask alot of med and drug calculations.

Tarotale- What happens if you catch something from a pt (bed bugs, lice, TB, flu, etc.). The fact that you dont know a pts baseline is kinda interesting, yet scary. How many times have you caught something from a pt and whats the hospital protocol for it?

Whatever choice I make, its gonna be a huge leap. I just don't know what I can do to help me make that leap easier

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Specializes in Critical Care, Education.

It all depends upon your own comfort zone. Coming from OR, you've been functioning in a highly structured environment. A full-fledged (knife & gun club) ED is completely at the other end of the spectrum & most ICU's are sort of in the middle zone. But if you're in a community hospital ED setting rather than a trauma-receiving environment, the transition wouldn't be that extreme. ED care is episodic by nature, and ICU patients may stay a bit longer, but some - like CVICU - may just function as extended recovery area with patients transferred to a different area as soon as the are a bit more stable.

RE: getting in to ICU... talk to your manager & investigate opportunities in your own facility because there may be avenues you aren't aware of. Your manager deserves a 'heads-up' for investing in your training and giving you a chance in the OR. I would also urge you to engage in some self-directed learning by taking courses in dysrhythmia management, hemodynamics, advanced patho, etc. because you'll need to increase your depth of knowledge in order to function in ICU.

Here's an out-of-the-box suggestion. See if you can become trained on IAPB. Based on my own experience, "pump jockeys" often cross the line between ICU & OR so this may pave the way.

Best of luck to you on your career transition.

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I'm a fairly new grad, I'm curious what is "IAPB"?

This is great advice and insight.

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