ICU vs ER/ED Nurse – What’s the Difference?

Both ICU (Intensive Care Unit) nurses and ER/ED (Emergency Room/Emergency Department) nurses work very fast-paced jobs that require them to think quickly and experience patients that have very serious diagnosis’.

Differences Between ICU and ER Nursing

While there are a few similarities between the two, there are a lot more differences. Before you read a bit more about each job, let’s look at the most obvious differences between them.

• Different Goals – The goal of the ER nurse is to stabilize and treat the patient and get them where they need to go. This can mean treating them so they go home or stabilizing to admit them to another unit. The goal of the ICU nurse is to give detailed continuous care to critically ill patients.
• Patient Load – An ER nurse might see anywhere from 8 – 40 people on a single shift. However, an ICU nurse will typically only oversee 1-3 patients per shift (if they don’t have any transfers/admissions).
• Protocols – ER Nurses have lots of standard algorithms and protocols they must follow for patients who walk through the door. These include things like chest pain, abdominal pain, stroke, etc. And while an ICU nurse does have protocols to follow, they are different and not as frequent.
• Critical Patients – While critically injured or sick people do arrive at the ER, that isn’t all that come in. ER/ED nurses experience a wide variety of acuity levels – from minor injuries to life-threatening ones. An ICU nurse only manages critical patients.

These are the major differences between ICU nurses and ER nurses. Now that you understand how they are different, how do you decide where you want to work?

Let’s look at each one individually and discover what they do and what their regular responsibilities are.

What does an ICU Nurse do?

An ICU nurse has specific roles and responsibilities during each shift. I explained this job in detail in my post “What do ICU Nurses Do?” It’s a really in-depth look at what a normal shift is like for this job, from beginning to end.

To sum it up, a critical care nurse works in the Intensive Care Unit (also referred to as the Critical Care Unit). This nurse provides nursing care to critically ill patients. They are responsible for direct bedside care, monitoring, and responding to changes in condition.

In addition to that, this nurse is also responsible for communicating with providers and other healthcare team members, as well as families about their loved one and the patient themselves.

In fact, communication with everyone can be trying and difficult. An ICU nurse explains complex medical conditions to laypeople, many of whom have little experience or previous understanding of healthcare.

ICU Nurse Responsibilities

There are some responsibilities that are specific to ICU nurses.

The responsibilities of an ICU nurse include:

• Monitor the patient’s condition, which becomes very complex as patients become more unstable
• Oversee and provide care to the patient
• Communicate with the patient and family and provide support them
• Assess the patient’s and their response to treatment, suggesting changes as necessary
• Use high-tech equipment to provide quality care for the patient
• Stay educated on the latest evidence
• Document appropriately

Also, ICU nurses are typically specifically caring for one patient population. This could mean all adults (a general ICU), or neuro patients (neuro ICU), patients recovering from organ transplants (transplant ICU), cardiac issues (cardiac ICU or coronary care unit), pediatrics (pediatric intensive care or PICU), and more.

What Does an ER Nurse Do?

If you have ever wondered what a typical shift looks like for an ER Nurse, take a look at what does an ER nurse do. It shows you what a typical shift is like.

It all starts with assessments. They have to assess patients quickly and accurately. During this process, they have to make some tough decisions, such as which patients need to be seen sooner than others.

This job is all about focused assessments, stabilizing the patients, and sending them where they need to be. Also, effective communication with providers while working elbow-to-elbow with them is paramount. Quickly identifying an issue and rapidly implementing a plan of care requires effective teamwork.

ER Nurse Responsibilities

ER Nurses have a long list of responsibilities. As varied as this job is, these are the main responsibilities:

• Triage – assess and decide which patients will be seen first and in which order
• Take vital signs and complete focused assessments
• Administer medications
• Emergent life-saving measures like assisting with rapid sequence intubations, cardiopulmonary resuscitation, and more
• Provide medical treatment
• Monitor patients
• Charting – take full histories of patients so the physicians can diagnose them easier and accurately.
• Educate patients and family members – help them understand the importance of the doctor’s orders and repercussions of not following them.
• Discharge – send patients on their way after they are treated
• Communicate with providers, colleagues, and patients
• Transfer – getting patients safely admitted to a nursing unit for further care and evaluation

One of the biggest differences between ER and ICU is the patient population. Unless the hospital you work at has a specific emergency department for kids, most ER nurses must be able to care for patients of all ages (from birth to geriatrics), while ICU nurses have a more specific patient population under their care.

Fast-Paced and Critical Nursing

Both ER nurses and ICU nurses work in stressful environments that will tax them and require quick-thinking and problem-solving skills.

Deciding which to be is a tough decision. Think about how many patients you’d like to see on a given shift. Also, consider your comfort level with medical technology and communicating with physicians and family members.

The best place to go for information about these jobs is directly from the nurse. Find a  mentor who can give you real-life advice and tips for how to prepare for a job in this field.

More resources for those interested in ICU or the ER:

• How to Become an ICU Nurse – Essential Interview Tips for New Nurses
• What Do Emergency Nurses Do?
• The Real ICU Nurse Job Description