If you’re looking into becoming an ER (emergency room) or ICU (intensive care unit) nurse, there’s only one question you need to answer:
Would you rather jump out of an airplane or fly it?
Both types of nursing are caring for the most critical patients that come into a hospital. Both require high-level thinking, problem solving skills and a special type of personality that can handle high-stress working environments.
However, an ER nurse and an ICU nurse are at opposite ends of the nursing spectrum, although they’re both caring for patients that are at highest risk.
We’re going to look at this unlikely pair – what they do, how they do it and how much they get paid to do what they do so well.
So let’s take a closer look at two nursing superheroes – ER nurses and ICU nurses.
What Does An ER Nurse Do?
If you answered the above question: “Hand me a parachute – I’m jumping!!” Then you’re a perfect candidate for the pulse-pulse pounding, adrenaline-soaked high-stakes environment of the Emergency Room.
It can be chaotic and disorganized – you don’t know who is about to walk through or be carried through the door. You could be treating a kid for anaphylactic shock from a bee sting or a guy who just took three 9mm rounds to the chest.
What you’re doing is handling patients with life-threatening injuries and medical conditions.
However, thanks to the popularity of medical TV dramas (like ER) most people have the misconception that all ER nurses exist in a whirlwind of constant emergencies.
While life in the ER can be very chaotic at times, real life in the ER isn’t always dramatic. There can be for long quiet periods of calm and some of the things they treat are more mundane like broken bones, abdominal pain, difficulty breathing, chest pains and heart attacks.
So what does an ER nurse do?
An ER nurse has three basic duties:
- Triage & Prioritize
ER nurses have to make quick decisions on what’s the best way to save the patient’s life in the moment. Often they’re making these decisions while simultaneously working on the patient.
Whether it’s clearing an airway, giving an epinephrine shot or starting a blood transfusion the most important thing is to get their patient stabilized so a physician can decide what needs to be done next.
- Assign & Move On
Once the patient is stabilized, the ER nurse sends them on their way and moves on to the next patient, starting the process all over again.
If you like excitement and adrenaline you should look into ER nursing. Some skills and personality traits you’ll need: calm under pressure, ability to think quickly and good prioritization skills.
What Do ICU Nurses Do?
If you want to be the pilot of the plane – with meticulous attention to detail, the ability to handle several complex tasks simultaneously and calm, steady nerves, then you could be an ICU nurse.
Where the ER nurse stabilizes their patients to keep them from dying, the ICU nurse is the one who keeps them alive until they’re out of the woods. And to do this, the ICU nurse’s working environment is the exact opposite of the ER room’s chaotic disorganization.
The ICU nurse provides round-the-clock acute care for their patients. They monitor vitals, run IV drips, coordinate care with doctors and other nurses — sometimes they’re even handling emergencies of their own, like a crashing patient.
They tend to be calm and focused with great attention to detail. They’re capable of multitasking several difficult things at once and known for their color-coded medication charts and checklists.
Critical thinking skills, being able to work as part of a team and planning are necessary qualities as well.
They run a tight ship with everything planned, timed and noted down to the finest detail.
Trauma Nurse Vs ER Nurse
Trauma nursing is a different part of the ER wing. Both trauma nurses and ER nursing are working on the most critical patients in the hospital.
And both require the same ability to handle pressure, love of chaos, adrenaline addiction and the superhuman ability to triage, diagnose and treat at the same time.
There is a difference between the two however and it has to do with caring for the worst cases:
- A trauma nurse is seeing the patients that are in the worst shape. Whereas a patient in the ER may be conscious and talking, a patient in trauma is likely barely clinging to life.
- After a patient has been stabilized in trauma, they may go to the ER where they can get further critical care.
So a trauma nurse and an ER nurse are two team members playing the same game, each playing a specific role.
ICU Nurses And ER Nurses: What Is The Distinction?
Above we gave you a good overview on the differences between ICU nurses and ER nurses. But if you want a bit info, here’s a few more details about these two very challenging and rewarding nursing jobs:
Chaotic, disorganized, fast-paced, high energy, team player, like a soldier in battle
controlled, organized, calmer but still high stakes, detailed, uses charts and lists, multitasks
The ER Nurse is the person with the office that looks like the desk exploded on itself – except they know exactly where everything is in each messy pile.
Everything on their desk is in its place, exactly two inches away from everything else, papers are in file folders, pens in a holder and a detailed, color-coded calendar on the desk mapped out two months in advance.
Their care goals are to prioritize initial treatment, stabilize the patient and get them out to the wing for further care.
The ICU Nurse is making sure that the patient makes it out of the woods. They’re making sure the patient doesn’t deteriorate and stays stable. They also interact with family members and provide health education.
Action-loving adrenaline junkie, calm under pressure, can work in chaos, intuitive, handles stress well, can work quickly and efficiently, good critical thinking skills, nothing fazes them
Meticulous and detailed, calm and collected, critical thinker, planner, ordered, able to see the big picture
Characteristics ER And ICU Nurses Share
We’ve talked a lot about the differences between ER nurses and ICU nurses. Although they work in different environments with a different approach to care, they actually share some very necessary qualities:
In the ER, you may not exactly know what’s going on and you’ll have to use some critical thinking to know whether your patient is having an allergic reaction to medication or a heart attack.
ICU nurses have to know everything that’s going on with their patient – how the medications are interacting, what could possibly go wrong and have plans prepared for every eventuality.
The decisions ER and ICU nurses make every time they intubate a patient or inject them with insulin can mean the difference between life and death. They need sound judgement to know they’re making the right decision every time.
Mastery Of Their Field
Both need the experience paired with a deep knowledge of their field to be able to make the right diagnosis and care decision when there may be only seconds to do so.
Both nurses work as parts of an extended team of doctors, nurses and specialists. Being able to work in harmony using intuition and quick understanding is necessary when you’re in a fast-paced environment such as the ER.
Critical Care And Emergency Nursing – Is It The Same?
As ER rooms across the country have become more and more crowded, the critical care that was traditionally part of the ICU began being practiced in the ER.
Patients are spending more time in the ER and providing this critical care in the ER has become necessary.
So a critical care nurse is like an ICU nurse working in the ER.
Frequently Asked Questions
Do ICU Or ER Nurses Make More Money?
So do ICU nurses or ER nurses make more money – actually, they’re really close.
ER Nurse: AVG: $74,000 ($51,000 to 97,000)
ICU Nurse: AVG: $75,500 ($51,000 – 100,000)
Is ICU Better Than ER?
For the patient it definitely is, but for the nurse, it really depends on your personality style.
Is ICU Worse Than ER?
Worse is a subjective term. If you love a fast-paced, demanding, chaotic work environment where you’re always facing a new challenge, then the ER is better for you.
Are ER Nurses Considered Critical Care?
Usually, ER isn’t considered critical care – although some hospitals and schools recognize it as so.
When you’re an ER Nurse, you’re on the front line. You’re in the trenches of the battle to save people’s lives. You’re there at the critical moment when an injection at the right time or proper diagnosis can mean the difference between living and dying.
ICU nurses are the ones who continue the care, taking these most critical patients and seeing that they keep healing and getting better. And if an emergency happens, they’re right there to put things right again.
They watch their patients like a hawk, monitoring every breath and every beep on every machine.
Although it may seem that these two nursing specialties are very different, they’re just two critical parts to a life-saving machine.
And if you think that this is the right place for you, then get ready to grab your parachute or get behind the wheel because whichever you choose, it’s going to be one heck of a ride.