1 year ICU...ready for ER?

Emergency RN · Jun 18, 2010

Completely different gears; ICU's fine tune, while the ED is more concerned with keeping them breathing and getting them up to the ICU where definitive care is performed.

Each clinical setting has arena specific foci, from pre-hospital to rehab care; it's all along a continuum. Most ICU RN's going to the ED for the first time generally wind up focusing too much on the finer aspects of care, like trying to figure out things like Glomerular Filtration Rate. The ED RN only cares that the pt's making urine. The toughest thing for an ICU RN to remember once getting into the ED setting, is to remind one's self that it's like the difference between fine dining and McDonald's.

The ED's main job is to stabilize and move them along quickly, making room for the next patient. While in the ICU, you may see two patients the whole night, I see about 20 or more a shift in the ED. So you can do the math.

Anyways, good luck to you

jmblair1 · Jun 18, 2010

I understand they're different gears, but I was just wondering if my year of ICU experience would help me in the ER. The only way to get experience in ER is to actually work in the ER, but I was more wondering if a year in ICU is enough? I don't feel like my way of thinking is too engrained from just a year to be able to switch gears into ER, but maybe I'm too optimistic? :rolleyes:

Emergency RN · Jun 18, 2010

I understand they're different gears, but I was just wondering if my year of ICU experience would help me in the ER. The only way to get experience in ER is to actually work in the ER, but I was more wondering if a year in ICU is enough? I don't feel like my way of thinking is too engrained from just a year to be able to switch gears into ER, but maybe I'm too optimistic?

Your year in the ICU will DEFINITELY help you out because you're now a thinking, hands on, seasoned and clinically articulate nurse. It will just be a matter of adjusting work priorities and learning specific protocols (like eg. stroke codes). Some of us started in the ED straight from school. I had street time, but many others that I know certainly didn't. As far as I'm concerned, a year in any of the units? LOL... You're already swimming in a gravy of excellent experience. I guarantee that you won't have any problems. If anything, your expertise would become a considerable asset to the ED.

Again, Good Luck!

Editorial Team / Moderator · Jun 18, 2010

Many of my favorite ED coworkers are former ICU nurses (and even ICU nurse managers). They're fabulous! :) How long would your orientation be?

JoMcShane · Jun 18, 2010

I love it when ICU nurses become ED nurses! (from an Australian perspective) firstly because they unsderstand ventilation. Its hard for a ED nurse to get good ventilation trianing because once we tube them we get them out ASAP. The only thing some ICU nurses stuggle with is managing many patients at once, and the hectic pace- BUT you get used to it. Good luck...once you become a ED you never look back!

Sarah010101 · Jun 19, 2010

remind one's self that it's like the difference between fine dining and McDonald's.

hahah this is awesome :)

an2on, BSN, RN · Jun 19, 2010

Would handling multiple patients in the ED be the same as med surg ? hence med surg nurse handle many many patients at once...

JStyles1 · Jun 19, 2010

As said above, it is totally different. I'd say a new nurse would be in a bit better position b/c they do not have the icu knowledge set already. Don't get me wrong, your assessment skills and fundamentals should be better than a new grad, but it really is totally different than icu.

All4Seasons · Jun 21, 2010

"it's like the difference between fine dining and McDonald's" :lol2:we use the same analogy here in PACU as compared to the floor (where we send a good number of our cases) - where they have the pt the entire shift to "fluff and buff " (not that any nurse has much time to do that these days!)

Dinith88 · Jun 21, 2010

If you are competent, you would do better than any new nurse. Period. You'll have experience with critically-sick patients and what goes along with all of that...so you should be comfortable when dealing when caring for these patients. You should have ACLS (perhaps even PALS) by now... Cardiac/tele/rhythm stuff should be old-hat for you. You already can run a code. You already deal with critically sick patients regularly and more often than ER nurses do.

A new grad has to learn all of that...there's no way around that and a new ER nurse simply doesnt have the time to devote to soley caring for critically sick patients...as it's only a fraction of what ER does.

BUT that doesnt, by itself, translate into a successful transition to ER. The ER has it's own pace and speed that you're likely not used to. You'll have to do well with large volumes of patients, (Dr's office-type patients, drug-seeking ER abusers, kids, etc,). And you'll have to get used to doing more moving/running than you're used to.

You may not like that.

But...if you are already a good and/or competent ICU nurse, you'll be light-years beyond a new grad. It's simple common sense. The idea that the ICU has spoiled your nursing-mind-set is garbage. BUT....you will have to learn to change your style for sure. Treat-and-street can have it's merits...and you may well learn to love it. If not, you have a incorrect impression of the ER and maybe shouldn't go.