Two of the most exciting nursing careers are intensive care unit and emergency room nursing.
Nurses in these departments are frequently called on to address confusing or life-threatening situations.
Read on to discover the similarities and differences in these areas and to uncover which option might be best for you.
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ICU Nursing vs ER Nursing
The first part of comparing critical care nursing and emergency room nursing is honing in and define what each one is.
What is Intensive Care Unit Nursing?
Intensive care unit nursing (ICU) also called critical care nursing is one of the nursing specialties that focuses on patients who are suffering from critical illnesses.
What is Emergency Room/Emergency Department Nursing?
ER nursing is a nursing specialty that deals with patients who are undergoing immediate acute illness or injury, or patients who are having severe exacerbation of a chronic illness.
Pro-Tip
While both of these jobs make our list of some of the best nursing jobs for new grad nurses, it’s important to note that both of these specialties can be hard for new nurses to get into right out of school.
Similarities in ICU and ER Nursing
In some respects, ICU nurses and ER nurses have similar jobs. They’re both in fast-paced environments that require expert critical thinking skills.
Both see patients with all types of diagnoses, and both care for patients with life-threatening diseases.
Apply to ICU or ER/ED Nursing Jobs
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Most nurses in either unit work 12-hour shifts. (➜ Related Article: Pros and Cons of 12 Hour Shifts)
There are a few other ways that ICU and ER nurses are similar.
- Both must be able to communicate quickly with doctors and patients’ family members.
- Both must be able to provide good patient education.
- Both must provide thorough documentation of patient care.
- Both provide an array of patient care treatments, including oral and intravenous medications and radiologic examinations.
- Both must stay on top of changes in the medical community through continuing education.
- Both often transfer patients to other areas of the hospital for further care.
Despite these similarities, there are even more differences between ICU and ER nursing.
Understanding the differences in a typical shift, in the type of patients seen and in the typical patient load and pace of work can help you decide which option is best for you at this point in your career.
Differences in Environment
| ICU Nurse | ER Nurse |
|---|---|
| Main Entry Point of a Hospital | Separate Hospital Floor |
| Less Organized “Organized Chaos” | More Organized Environment |
First, ER nurses work in the main entry point of a hospital or major health care facility while ICU nurses work on a separate floor that is generally far quieter and calmer than the bustling emergency room is.
The emergency room is generally a busy, noisy place where acute injuries are treated and patients are moved on to another location for further care.
Patients may come in with anything from minor injuries, such as sprains and influenza symptoms, to life-threatening injuries from automobile accidents.
The ER nurse may work in one of several areas of the ER during a shift and frequently moves between locations throughout the shift.
The triage nurse takes in new patients, assessing their degree of injury or illness to determine how quickly they need to be seen.
Nurses work in many other areas of the department, caring for patients in major trauma areas, medical areas, observation units, procedure rooms, resuscitation bays and much more.
Depending on the size of the hospital, the ER may be sectioned off into several different areas depending on the type of injury or illness sustained and the extent of care needed.
While the intensive care unit is also often fast-paced, it is a much more organized environment.
Patients are usually transferred to the ICU from a medical floor, the operating room or the ER. Therefore, nurses usually have time to prepare for incoming patients.
The ICU is usually situated around one or more centrally located nurses’ stations, allowing nurses to view their patient rooms easily.
Patient rooms often have large windows or glass doors for easy visibility as well. Private rooms are large enough to hold plenty of equipment.
Some ICUs are highly specialized with nurses only caring for certain types of patients, such as those with heart disease, trauma, burns or general medical or surgical issues.
This keeps infectious patients separated from non-infectious individuals.
Differences in Job Duties
| ICU Nurse | ER/ED Nurse |
|---|---|
| Treat Patient Condition (however long it takes) Transfer to Med-Surg or Step-Down | Stabilize and Transfer Patient to Med-Surg or ICU ASAP |
| Generally Cares for One Population Group | Care for Patients of All Ages |
Second, ICU and ER nurses have far different job duties on their typical shifts.
ER nurses solely care for acute symptoms and injuries, helping to stabilize patients so that they can either be discharged home or can be safely admitted to another floor of the hospital.
They must also be able to care for patients of all ages.
Their general responsibilities include the following:
- Triage patients to determine care need
- Take vital signs and perform quick assessments that are generally focused on a single body system
- Provide life-saving care, including cardiopulmonary resuscitation
- Monitor patients in observation rooms
- Educate patients and their family members
- Discharge or transfer patients
The ICU nurse generally only cares for one population, such as the elderly, children, or infants, depending on the department.
Or a specific patient condition. For example:
- Trauma ICU
- Neuro ICU
- Transplant ICU
- Neonatal ICU
- Cardiac ICU
The list goes on. What you will notice is most times those ICUs are getting their patients from the ER.
These nurses perform initial assessments when the patient arrives in the department, but these assessments usually cover every body system in great detail.
Other typical job duties include the following:
- Monitor patient condition and make changes to the care plan as needed
- Communicate with the doctor about changes in patient condition
- Use cutting-edge equipment for evidence-based treatments
- Provide thorough documentation of everything done for the patient during each shift
- Inform and support patient family members
- Discharge patients home or to a different floor
The main difference between ICU and ER nurse job duties is that the ICU nurse provides ongoing patient care typically over several days or even weeks while the ER nurse provides initial care that usually lasts for only a few hours.
Related: MICU vs SICU
Differences in Work Flow
| ICU | ER/ED |
|---|---|
| Slower Pace than the ER (sometimes) | Fast-Paced |
| Treatment of Patient Condition; Transfer to Step-Down or Med-Surg | Discharge or Transfer Patient ASAP |
Work flow in the ER is incredibly fast-paced. Patients move in and out of the department quickly to make room for new patients all the time.
Nurses have to work quickly while providing care only for the primary problem of which the patient is complaining.
Apply to ICU or ER/ED Nursing Jobs
If you know which nursing job you want, you can start applying to those jobs in your area on our nursing job board.
The nurse in the ER must provide quick assessments and must be able to use high-tech equipment when necessary.
The goal is always to get the patient out of the ER as quickly yet as safely as possible whether that means that he or she is sent home or is transferred to a hospital floor.
While the work flow of the ICU is occasionally fast-paced, such as if a patient is coding or if a new critically ill patient is arriving on the unit, tasks usually seem a bit more controlled in this environment than they do in the ER.
Despite this, nurses here must usually deal with plenty of sights and sounds as they’re constantly alerted to changing patient conditions via monitors, beeping IV pumps, and plenty of other equipment.
While ER nurses are usually running around the entire unit caring for multiple patients, ICU nurses often stay glued to their patients’ rooms, charting outside the doors and paying close attention to only one or two patients at a time.
Differences in Goals
As you can now understand, the foremost goal of any ER nurse is to address any life-threatening issues quickly and to move patients through the department to make way for incoming patients.
Because of this, the ER nurse is not usually focused on the nitty-gritty of patient care but instead looks at the overall picture of health.
ER nurses never know who their next patients are going to be.
Instead, they care for whoever comes through the door to the best of their abilities.
They prioritize patient care and stabilize patient health before moving on to the next patient.
ER nurses never know who their next patients are going to be.
On the other hand, the ICU nurse is focused on the entire patient, seeking to solve all issues to return the patient to a prime level of health and vitality.
The goal here is not to work quickly but instead to work accurately and critically, focusing on how all systems of the body work together as a whole.
The ICU nurse has more time than the ER nurse to think proactively, examining possible causes for current health issues and considering what could happen next without additional help.
Because of this, these nurses are often highly involved with physicians as well as family members.
Differences in Patient Loads
ER nurses may see 10, 20 or more patients in a single day.
Most of the time, they’re caring for four to six patients at once unless they’re working in the resuscitation area.
However, if numerous patients come in simultaneously, they could see the patient ratio increase dramatically.
Because ICU nurses are more focused on each patient in the unit, they will only have one to two patients at a time when working in this area.
In some of the most high-acuity instances, two or three nurses may work together to care for a single patient.
This does not mean that the day will be slow. Nurses will constantly be busy in either unit.
Differences in Salary
| Average RN Salary | ICU Nurse | ER/ED Nurse |
|---|---|---|
| $73,300 | $75,250 | $75,787 |
Depending on the health care facility, you may not see much of a difference in salary when comparing ER and ICU positions.
The average annual salary for any type of registered nurse in the United States is $73,300 as of 2019, and you will probably see something similar to this for most mid-level positions in your facility.
However, when looking at the average for ER nurses versus ICU nurses across the country, you can sometimes note a slight difference.
Emergency department nurses make an average of $75,787 per year with the top 10% making over $91,000. ICU nurses make an average of $75,250 with the top 10% making over $87,000.
Differences in Nurse Personality and Skills
ER nurses generally love adventure and spontaneity, which helps them adapt to any type of patient who comes through the department’s doors.
They can be calm even in harrowing circumstances, know how to work quickly, and generally see the big pictures of what is happening to the patient.
These nurses are also highly skilled at working in teams, knowing that extra hands may be needed to care for some high-acuity patients. The mantra of the ER is “organized chaos.”
The mantra of the ER is “organized chaos.”
On the other hand, the ICU nurse is just plain organized and highly meticulous.
These nurses are also incredibly attuned to details.
Instead of looking solely at the big picture, they can also see the little problems that could be causing major symptoms.
They have enough time to iron out the problems that the ER nurse could not address.
In addition, ICU nurses are calm heroes who are able to deal with multiple pieces of high-level equipment simultaneously.
They have incredible critical-thinking skills, are usually assertive and competitive and are great at working independently.
Final Thoughts
You may find that deciding between ICU and ER nursing is a difficult decision because nurses in both areas find their careers to be incredibly rewarding.
Hopefully, you’ve found our ED/ER Nurse vs ICU Nurse comparison helpful in making this decision.
Comment below with your thoughts on these career choices, and check out our job board to find current job openings in either area.
Frequently Asked Questions
-
Is ER nurse critical care?
ER nurses do provide care to patients in critical condition. As far as critical care nursing, it’s a separate nursing specialty.
-
Is ICU better than the ER?
Neither one is better than the other. It’s just about finding which area fits your personality and goals.
