Transition from ICU to ER

hartab · Oct 7, 2016

I personally can not speak on account of this, but I can share with you my moms history as a nurse. She spent the first 9 years of her career as an ICU nurse. From what I know, she did enjoy it a lot and it was a huge learning curve for her. When she moved from Canada down to the United States, she switched from ICU to ER. She stayed with the ER ever since and is now the supervisor of an ER. I asked her which she preferred and she said the ER because you are always seeing/experiencing something new and the hours are more predictable. She also mentioned having more patients in ER as a positive; as you mentioned above, having 1-2 patients can be less exhilarating (compared to the ER).

With that being said, I think you should go for it! You'll never know if you don't give it a shot and you know what they say; "variety is the spice of life" :)

supakimchee · Oct 7, 2016

Since I haven't worked in an ICU, I'll just fill you in on some pros and cons of working in the ED (level 1 Trauma, level 2 Ped)! Remember guys, this is my list. Some of my pros might be cons for others and vice versa.

Pros:

-Fast-paced

-Less documentation

-You will become an IV padawan (vascular access nurses are the Jedis)

-You become a more well-rounded nurse (you can take care of any patient - not like you got a choice!)

-Job satisfaction

-Exhausting - You sleep like a baby

-Exciting - TFAs, TTAs, TCs

-Assessment skills become lightning quick

-Patients that are thankful for you

-Scumbag patients that warm up to you because you're actually nice (actually my favorite patients as you build better rapport)

-If you empty your pockets when you get home after a shift, you can probably open your own hospital.

Cons:

-Fast-paced - Make sure you take your breaks

-Resident physicians that think orders should mimic a leaky faucet

-Homeless drunks who want to take a bed all night

-Not-homeless drunks who want to take a bed all night (worse than the homeless)

-Interchange drunks with IV drug users above

-Patients who claim to be allergic to every pain med except dilaudid

-Exhausting - you can literally sleep for 2 days after 4 straight shifts

-The month of July

-You're literally overflow for every damn area of the hospital

-Scumbag patients that treat you like crap no matter how nice you are.

-Patients that show up to the ED because they have "too many boogers" (I'm dead serious)

-If you didn't test positive on a PPD you probably will working in the ED

The Worst Part of ED: Watching family react to a family member's unexpected/tragic death.

Oh, also...you're going to get a lot of psych patients. I would also list management as a con, but I cleverly work the night shift so I should diplomatically disclose that management is not a con.

DayDreamin ER CRNP · Oct 8, 2016

We have seen few of our ER nurses go to ICUs and either come right back or they wait a year to come back. We have a few former ICU nurses that have come to the ER and love it.

I think people love the ER for very different reasons but overwhelmingly is the love for a "fast paced" environment and the high turn over of patients.

I love having the trauma or sick-as-stink patient on a daily basis and those quick STEMIs that go up to the cath lab as quickly as we can get them there. I also enjoy the intubated patient that I'm titrating drips and giving blood, and keeping sedated. I don't care for the fast-track area of the ER but an occasional day there IS a nice break from that pressure but that level 1 trauma or the critical patient is what I clock in for every day. I love it.

For my friends that have tried an ICU after the ER, they don't like that monotony and come right back for the high energy of the ER. Either you love it or you hate it.

njedexpat · Oct 8, 2016

I worked for over 6 years in a busy ICU before moving to the ED of a level 1 trauma center, and even after over 20 years I have a hard time contemplating working anywhere else. I still have vivid memories of my first few days of orientation in the ED....... "what do you mean that I have to care for patients who are not on a monitor"..... getting used to patients not staying in one place, (going off to radiology unescorted, changing rooms), patients who actually can have a conversation with you.....and learning never to remove the shoes off our homeless alcoholics ......unless you have lost your sense of smell. I loved the ICU for many years - until I realized that so many patients were futile cases where families just could not let go and where even the best nursing could never restore the patient to health. But I was worried that I would miss the long term relationships that developed with some patients and their families - and the chance to watch patients improve after our cutting edge nursing care. There was no need to worry......

I would thoroughly recommend a move to the ED, as your critical care and assessment skills will be invaluable, and you will also learn the art of dealing with less critically ill patients, of recognizing a sick patient who has not already been screened by others, and you will learn practical information about a myriad of different medical and surgical conditions that will expand your knowledge exponentially. The bottom line is that working in the ED will be the most rewarding, frustrating, humiliating, inspiring, tiring, unpredictable and unforgettable experience you can ever have as a nurse......and you will not regret it!

bgxyrnf, MSN, RN · Oct 12, 2016

-Resident physicians that think orders should mimic a leaky faucet

OMG, I've never thought about it this way but that describes it perfectly.