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ER VS. ICU Nurses: A Timeless, (Mostly) Friendly Rivalry
By Joleen Sams, MSN, APRN, FNP-C
HUMANS LOVE TO CATEGORIZE, and nurses are no exception. We stereotype the heck out of each other based on specialty and length of time you’ve been a nurse. Memes and TikTok videos are all over the place, poking good fun at these differences. ER vs. ICU nurse personalities provide endless opportunities for comparison, but what is it really like to work in these departments?
You can find all sorts of dry information about education, salary, and work environment, but none of that really captures the essence of what it’s like to be a nurse in one of these departments. So, we turned to social media to get the real deal: Ashley Garner is an ER nurse from Pennsylvania, and Laramie Werner is an ICU nurse in Nebraska. They were eager to tell us what they love about their departments and the nursing profession.
ER AND ICU: HIGH STRESS, HIGH REWARD NURSING SPECIALTIES
Both ER and ICU nurses care for patients with critical illnesses. These specialties require strong assessment and critical thinking skills. They work with high-risk medications, and patient conditions can change minute by minute. Both require excellent communication skills and the ability to work well with interdisciplinary teams. It really comes down to whether you thrive in absolute or controlled chaotic environments.
Both require excellent communication skills and the ability to work well with interdisciplinary teams. It really comes down to whether you thrive in absolute or controlled chaotic environments.
EMERGENCY DEPARTMENT
ER nursing requires a love for the unknown — you never know who will walk in the door. ER Nurses thrive in this chaos. Ashley said, “I was personally drawn to the ER for the excitement of seeing something new every day; you could have two STEMIs [ST elevation myocardial infarction], one GI bleed, one psychiatric patient who’s combative, and another with shortness of breath. I enjoy getting to use different skills.”
ER nursing requires a love for the unknown — you never know who will walk in the door.
To all the ICU nurses detangling masses of tele cords and IV lines while listening to an incessant stream of beeps and alarms all day/night long. Y’all are all amazing, fast-thinking, calm in the “OS” moments, bada** nurses who I’m proud of every single day. Thankful for all you do!! LARAMIE WERNER
To my ER nurses serving up turkey sandwiches and ginger ales. You are all very wellrounded nurses who deal with a lot of shit. Thanks for throwing the IV in the AC and continuing to do your best. ASHLEY GARNER
The focus is triage and stabilization of patients who present with a wide array of injuries and medical conditions. They send labs, administer medications, put in IVs, and get patients to CT or x-ray safely and efficiently. Then, they coordinate discharge or transfer to the inpatient units.
SHOUT OUTS!
CRITICAL CARE UNITS
ICU nurses care for the hospital’s most critically ill and injured patients and are usually only assigned 1-2 patients at a time. Laramie said, “ICU is a very organized dance of knowing what needs to be done, what has to be charted, and who to call. I have the opportunity to use critical thinking and make fast decisions on how to best care for my patients.”
ICU is a very organized dance of knowing what needs to be done, what has to be charted, and who to call.
ICU nurses meticulously monitor vital signs, titrate and manage multiple high-risk medications and respiratory ventilation, and assist with procedures. Patients may require ICU-level care for weeks, so ICU nurses develop therapeutic relationships with patients and their families in a way that ER nurses don’t.
Both nurses speak to the teamwork required to thrive in highstress, complicated situations. Ashley summed it up nicely: “For the most part, I think ER and ICU work well together. We (ER) may not label our lines, but we do know it’s running somewhere.” At the end of the day, it’s all about patient care. You can’t do it alone, so everyone might as well work together.
JOLEEN SAMS is a family nurse practitioner in the Kansas City metro area. She spent the first 10 years of her career in the NICU and inpatient pediatric world before graduating in 2019 with an MSN-FNP from Maryville University. Now, she’s a primary care provider working with underserved populations but often misses neatly labeling and titrating IV lines. Her side gig is writing healthcare articles; you can connect on IG @joleensamsNP or her website ad-astra-services.com.
