I'm a Murse as well! I just finished my first year of nursing school and I can't decide between the ICU and the ER. I've seen a few of your posts about it that you've said but what are more in depth thoughts one vs the other? What you do, or learn compared to one another? Or why you enjoy the ED vs why you enjoy the ICU? If you've already posted this just tag your previous post! Or copy/paste!
There are pros and cons of working in both units. Again, I could write a whole chapter in my book about working in both the ICU and ED, but I’ll keep my answer to your question relatively short. (lol, yeah right)
ICU - Generally speaking, you keep the same 1-3 patients for an entire shift, which can be good or bad depending on how sick they are and how well-behaved they are (or aren’t). And if you work several shifts in a row, you could have the same patients for multiple days, which, again, could be good or bad depending.
ED - You constantly have new patients. Depending on how busy your ED is, you could easily have double digits by then end of a 12-hour shift. Again, if you have bad patients, it’s good to get them out quickly, but it just means that you’ll get another unknown coming in. Unlike the ICU, you’ll have new patients every shift… well, generally speaking. You’ll also get those frequent ED fliers who come in for the same shit every time and you’ll roll your eyes and be like…
OK, so, when I told my mentor that I was leaving the ICU to go work in the ED, she was genuinely disappointed. She told me that I would be wasting my critical thinking skills and my talents. I tend to disagree, but I do see some validity in her argument. Allow me to expound…
ICU - In the ICU you are hanging multiple critical drips and are constantly titrating those drips to keep patients alive. Some nights you’re riding the pumps and constantly re-assessing the patient; listening to their lungs for signs of fluid overload, or doing repeat EKGs looking for signs of an MI. You’re starting IVs on seriously ill patients, suctioning vents, and countless other focused assessments that require non-stop critical thinking.
ED - Contrary to what my mentor believes, nurses most certainly use critical thinking in the ED. A nurse triages the patients and a nurse is the first to see a patient, so we have to be thorough in our assessments to look for the subtle signs of something more severe. The doctors and nurse practitioners rely on the nurses to guide them in the right direction. ED nurses are looking for different things than ICU nurses. ICU nurses know what the patient’s diagnosis is because and ED nurse and the team they work with helped to find the diagnosis.
I think the main difference between skills in the ICU and ED is that ED nurses start a shit-ton more IVs and drop a shit-ton more NG tubes. ED nurses don’t usually have to deal with patient’s on multiple drips, but it doesn’t mean they’re not capable. And while ICU nurses are certainly adept at starting IVs, most ED nurses could probably find a vein in their sleep.
If you like something new every day and a fast-paced, always changing environment, then the ED sounds like a good fit. If you’re more meticulous and like your IV lines neat and organized, then you’d fit right in with the ICU crew. The ED can be stressful because of the trauma you see and for the sheer volume of pain and suffering that comes through the door. The ICU can be stressful, too, but for other reasons.
There is not a cut-and-dry answer to your question. I like my lines and cords neat and tidy and I’m very thorough in my assessments, but as a former firefighter and EMT, I’m used to the chaos and fit right in with that group as well.
There’s nothing stopping you from trying both! Work in one for a year or so and then try the other.
I hope this “short” answer helps. Thanks for taking the time to ask a question! As always, I open the floor to other nurblrs to share their thoughts!