What Are the Differences Between an ICU Nurse and an ER Nurse?

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Nursing is an important part of the healthcare system. It entails the prevention of illness, promotion of health as well as taking care of ill people, regardless of their age or background. Apart from its renowned reputation for commitment and compassion, nursing is a highly specialized and diverse field. If you’ve finished your nursing course and acquired the necessary certifications, you will have the option of working as an ICU nurse or an ER nurse. However, it’s important to understand the duties, responsibilities, required skills and the differences of each field, before you make up your mind.

Duties of an ICU Nurse

Just like their name suggests, intensive care unit nurses or ICU nurses are nurses who attend to patients who have been admitted in the intensive care units of healthcare facilities. In a small healthcare facility, an ICU nurse is likely to provide nursing care to all age groups. On the other hand, if it’s a large medical center, the critical care nurses are usually separated into pediatric and adult units. The intensive care units of large medical facilities are usually divided into several specialized care units. Therefore, if you are an ICU nurse, you might find yourself working in the burn, surgical, medical, neurological, medical or other units. Intensive care unit nurses are trained to use their experienced and skills to attend to patients who are suffering from life-threatening health conditions or those who are critically ill. Some of the responsibilities of ICU nurses include:

  • Assessing patients’ condition and reporting to the medical team
  • Treating wounds of patients admitted in the ICU
  • Providing advanced life support
  • Recording patients’ vital signs
  • Ensuring that all the medical equipment that the patient is using are functioning properly
  • Assisting the doctor in performing various procedures
  • Ordering diagnostic tests
  • Administering medications
  • Maintaining an accurate record of the patient’s stay in the hospital
  • Completing discharge or transfer paperwork

As an ICU nurse, you will be working with patients that require critical medical care. Therefore, you need to possess extensive knowledge of various diseases. You will also need specialized nursing skills so that you can provide the right medical care to your patients. Working as an intensive care unit nurse will also require quick thinking as well as fast reflexes, considering that you will be attending to fragile and critical patients whose life is hanging by a thread. Most of the patients admitted in intensive care units are usually ventilated, intubated or placed under various life support machines. Therefore, ICU nurses should learn how to operate different equipment and ensure they are always working properly. Also, you need to learn how to recognize signs of distress in a patient and act swiftly.

Duties of an ER Nurse

Emergency room or ER nurses play a vital role when it comes to the provision of healthcare services. They attend to patients who are suffering from injury, trauma or other severe medical conditions, which require urgent treatment. Since they usually spend most of their time in emergency rooms, they must be quick thinkers. Emergency room nurses also need to have a strong gut, owing to the various challenges they will encounter when working. They are usually the first line of defense for accident victims or other patients that require urgent medical care. Some of the duties of ER nurses include:

  • Triage: As an emergency room nurse, you will be helping the hospital staff to prioritize medical care, based on the severity and critical nature of a patient’s condition. Your quick thinking, medical knowledge and attention to detail will come in handy when it comes to assessing a patient’s medical needs. Triage is normally used when there are more patients that require urgent medical attention than the available resources to attend to them. For instance, the casualties might be a result of an accident, a natural disaster or a terrorist incident. In such a situation, the emergency room nurse will assess the patients coming in, and then determine who will get care first.
  • Monitoring patients: Once a patient has been administered in the emergency room, it’s the work of the ER nurse to ensure that the doctor’s orders are followed. The ER nurse has to make sure that the patient is taking the prescribed medications, undergo any diagnostic tests, and notifying the doctor in case the patient’s condition worsens. Also, the emergency room nurse should field requests that the patient’s family might have, regarding their patient.
  • Administering medicine: ER nurses also administer medicine to patients, after prescription by a physician. The medicine might be administered intravenously or orally, depending on the condition of the patient or the medicine that is being administered. Some patients might also be taking medications for other pre-existing conditions. Therefore, it’s the role of the ER nurse to confirm with the patient or their families, to prevent incompatibilities or other issues that might arise.
  • Recording vital signs: Taking vital signs is also the responsibility of ER nurses. It includes recording patients’ blood pressure, measuring respiration, pulse rate as well as temperature during their stay in the emergency room. Logging these signs will provide a clear view of the patients’ state. This information will then be used to determine which patients require urgent doctor’s attention.
  • Providing treatment: Apart from administering medications and recording vital signs, ER nurses might also assist with treatment. They can assist with basic or minor medical procedures as part of their work. For instance, they can help doctors to stabilize patients, suture wounds or intubate critical patients.
  • Charting: As an ER nurse, it’s also your job to chart a patient’s medical history, current condition, contact information as well as their medications and treatments. You also need to maintain an updated record of their stay in the emergency room. Ensuring a patient’s documentation is accurate during their stay in the emergency room, will provide correct information to other members of the medical team attending to that patient. Also, vigilant and accurate charting will also help to shield the healthcare facility and its staff from legal liability that might arise in the future.
  • Discharge: If a patient has been treated successfully and the medical team has ascertained that they are ready to leave the emergency room, the ER nurse will handle their discharge and process the required paperwork. The nurse will also answer any questions that the patient or their family might have. Also, the ER nurse has to confirm transportation for the patient, especially if they are being transferred to an assisted living facility or a rehab.

Apart from being proficient in nursing and healthcare, ER nurses will also require other skills, which will help them to deliver their duties effectively. As an ER nurse, you are basically the liaison between the patient and the doctor, therefore, you will need to be compassionate, set aside personal feelings, and learn how to be assertive. You will also encounter a wide range of emergency situations, which means you need to teach yourself how to remain calm. Also, ER nurses should have great time management skills.

As an ER nurse, you might also encounter emergency situations, where you might be forced to rush to call the doctor or fetch some medical supplies for the patient. How fast you respond to such situations can determine whether the patient lives or dies. And that’s why you should always be wearing proper nursing shoes. A good pair of nursing sneakers or nursing clogs will keep you light on your feet and prevent slipping or sliding hazards, thus helping you to respond to emergency situations fast and effortlessly.

Differences Between ICU Nurses and ER Nurses

Both ER nurses and ICU nurses are tasked with attending to patients who are suffering from various medical conditions. However, as much as an ICU nurse and an ER nurse might be working in the same healthcare facility, their duties, responsibilities, and response to situations are a bit different.

  • Personalities: Emergency room nurses thrive during chaos. As a result, they have developed proper intuition. They already know what they should do when an accident victim is wheeled into the emergency room. ICU nurses, on the other hand, are used to an organized work environment. Therefore, they value a structured or a well-organized workplace, where they can work comfortably without any chaos or distractions.
  • Goals and priorities: When a patient is wheeled into the emergency room, ER nurses must assess them immediately, identify the major issue, treat it, stabilize the patient and then transfer them to the right unit or department where they can continue with their recovery. Their goals are short term. As for intensive care unit nurses, their goals are mainly long-term. Apart from just focusing on the main issue, they will also check other body systems to determine whether they might have been affected by the main issue. You should also note that patients spend continue a lengthy period in the ICU before they are discharged or moved to another unit. Therefore, ICU nurses also have to establish a closer connection with the patient’s family and continuously update them on how their patient is doing.
  • Workload: An emergency room nurse might attend to approximately 10 to 40 patients on a typical day. Sometimes the patients might be more than that if there has been an accident or an incident that has resulted in multiple casualties. On the other hand, ICU nurses will only attend 1 to 4 patients per shift.

Closing Remarks

Both ICU and ER nurses receive adequate medical training and skills needed to take care of patients in a healthcare facility. However, some distinctive personal traits separate the two cadres of nurses. The emergency room is quite hectic, with each shift presenting a unique set of challenges and surprises. If you can remain calm in a high-pressure and noisy work environment, then you can thrive as an ER nurse. On the other hand, if you are a social, a well-organized and a detail-oriented person, then you might have what it takes to work in the ICU.

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About the author


Hi, I’m Brian Bradshaw. I’m a super duper mega hiking enthusiast, with a love for everything that has to do with outdoors, hiking, gear, footwear and more.

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