ER vs ICU

[HollyRN1212]

I am an ER Charge nurse. I briefly worked in ICU but enjoyed ER more. I REALLY love what I do but would like to move more into management. I have thouroughly enjoyed being a charge nurse and work with an excellent administrative team at my hospital. The nurse manager position in the ER won't be avail for a LONG time however, the ICU nurse manager position is open. I am not so much concerned about my ability to manage as much as I am about the differences in departments. ICU nurses have different toys/equip, different meds, different lots of things .... I know the 2 day shift Charge nurses in ICU but they started in ICU when they had just graduated and haven't worked anywhere else. Also, the Director over this ICU is experienced but new to the job. I hear she's really pretty good.

Anyone reading worked both and have an opinoin. Any Managers have an opinion about switching departments?

[mydesygn]

I think the important thing is to gain the management experience. Having worked in ICU, you have a "feel" for the flow and needs of the unit but the fact that you have ER experieince is a "plus" because you can bring perspective and new ideas regarding processes. Unfortunately, the reality of nursing behaivior would lend the staff toward considering that your background in ER means that "you don't really know ICU". I would suspect that you might have an uphill battle with the nursing staff who will decide not to give you chance. I would interview for the position but really question your potential director about what qualities she expects. Ultimately, you need to know that she will support you in the learning process.

[HollyRN1212]

Thanks for the add-vice. I hear what your saying. I spoke with the director of ICU today. I expressed my interest but explained my reservations due to the "learning curve". We did talk about what positive things an outsider could bring to the table as well.

The manager position is coupled with education. I don't have any big shoes to fill here because unfortunately there hasn't been any ongoing type education requirements implemented as of this date. I guess that is another factor...there are some ICU skills that I am no way going to be able to teach without first re-learning. Is it premature for me to acceept the position , learn, then teach?? The way we set up skill review in the ED is by team work approach. The nurses man the skills stations they are the strongest at and teach each other what they know.

[mydesygn]

I'm a firm beleiver it nursing staff taking reponsibility for the education within the unit (as opposed to merely complaining to you about it). I might suggest "shadowing" a nurse for several shifts. This would give you a feel for the unit and a chance to get to know the staff. Actually, assuminig a assignment would be better but I say that with caution. I took a position managing in a hospital that I had never worked at before. I had done pediatrics for several years however I had not done pediatrics at that specific institution. During my orientation, I would ask questions about policies or get clarification on how they perform procedures there. The staff took my questioning to mean that "I didn't know how to do my job". So I would say be cautious about displaying any lack of knowledge, unfortunately, you will always have a contingent of staff who do not want to accept you and are looking for a reason to criticize. It's the "nurses eating their young" scenario. The sad part is they will never confront you with their "concerns" but will report them to your immediate supervisor. I would ensure that your director is willing to bring those type of complaints to your attention and allow you to discuss those complaints directly with those indiviuals. That's the only way to stop that behaivior but your director needs to recognize it for what it is and be willing to work with you and support you thru your initial orientation period.

[HollyRN1212]

Well, I backed out. I have decided not to interview formally. I just keep thinking about nurses and their behavior and I KNOW that they will pick me apart over what little I don't know and never credit me for what I do know and what I can bring.

Oh well. I will just keep hanging out in the ER until something else comes along. Maybe Med/Surg manager will open? My Director has me working as a system administrator for a new computer charting system we're insatlling in the spring after flu season. Maybe that will develop. We'll see.

Thanks for listening and you advice. It really did help to talk to someone who knows where I'm coming from.

[canoehead, BSN, RN]

Just the interview process can be a learning experience, and nothing says you need to take the job. Go for it.

[mydesygn]

It certainly can't hurt to interview but although it may be difficult, I think having the experience (good or bad) is important. I never had an apprecition for how difficult management can be until I worked as one. Only you know what your tolerence level is but I can say the experience has certainly narrowed what I want in my next job. Personally, I would love to work in informatics and hoping that my current position will be a spring board. I think nursing management is perhaps best for those who have strong nurturing and emotional IQ. I think nurses wil naturally gravitiate toward that sort of person. If that is your personality, you have a fair chance of success. The unfortunate thing is that those same qualities usually mean a unit never moves forward because the staff supports the indiviual who makes them "feel better and supported" and not the one who challenges them toward excellence and accountability. Pity.