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I worked 8 years as an ER Tech in ER's and my number one nursing job choice was always ER. However, a lot of the great ER nurses I worked with often told me they started out first in the ICU before going to the ED. They said it gave them a great foundation to build from. In nursing school I had extensive time in the ED and loved it, felt right at home and knew it was someplace I could jump right into after I got my license. I also spent my last semester alternating one week in ICU and one week in ER during my last clinical. I love the pace of the ED and way things are always moving and changing. The ICU was challenging and had a very different focus. Personally I am not a huge fan of having only two patients or less for 12 hours. But there was also so much more I needed to learn, based on my previous experience, than in the ED, so that may have made a difference in my enjoyment level during that time. When I got my license the ED's around me and in the hospital I worked at were either not hiring or not hiring new grads. I ended up getting a position in my hospital's ICU. I am now seeing that a lot of the focus of ICU, such as really taking accountability for the hemodynamic situation of my patient and independently making decisions, such as starting or titrating drips, will be much more practiced in the ICU. Yes, ED nurses hang drips and focus on hemodynamics, but often they also treat clinic type patients and other less critical patients as well as critical patients. I now see what those previous ICU to ED nurses are talking about. Yes, I can jump into ED right now and feel comfortable. But if I put in my time in the ICU I gain expertise in hemodynamic monitoring and interventions. So when I do eventually go to the ED I will not only be at home, I will be very secure in how I manage the critical patients I come in contact with, at least to a greater extent than if I started in the ED and worked the same amount of time as I'll put into the ED. On another note, the ED is fast paced and you think on your feet, but there are Doctors and PA's or NP's besides other nurses around all the time. The ICU keeps you very busy with your one or two patients, but usually there are no doctors, so you either must be confident in making those decisions withouth the doctor and consulting your co-workers before you are able to get a hold of the doctor. Of course this is all based on where you work. My sister was admitted into and ICU where there was always a doctor around, so that point wouldn't apply. I hope that helps a bit.