What is an ICU nurse?

An intensive care unit (ICU) nurse is a registered nurse who works with critically ill and medically fragile patients who need ICU support. Their patients require close monitoring in a controlled setting. They may be on life support and need ventilators, tube feeding or artificial nutrition and critical medications. The treatments and interventions ICU nurses provide keep patients alive and help them stabilize or recover. 

ICU nurses typically handle these duties:

• Administering medications and treatments often through IVs or central lines
• Caring for wounds
• Monitoring life-saving treatments, including life support equipment
• Monitoring continuous vital signs
• Notifying ICU doctors when patients’ conditions change
• Responding to emergencies within the unit
• Educating patients and family members

What is an ER nurse?

An emergency room (ER) nurse is a registered nurse who works in a hospital’s emergency department. They treat a wide range of patients who come into the ER for treatment. Some may be experiencing life-threatening emergencies, such as a serious car accident or heart attack, while others may require urgent medical assistance when regular medical offices or urgent care centers are closed.

ER nurses typically perform these tasks:

• Triaging patients when they arrive
• Assessing symptoms and injuries quickly to help determine severity
• Assisting ER doctors in treating and stabilizing patients
• Performing CPR and other life-saving measures
• Placing IVs and administering medications and other treatments
• Caring for wounds
• Educating patients and families on follow-up care

Similarities between ICU nurses and ER nurses

To become an ICU or ER nurse, candidates are expected to meet all registered nurse licensure requirements in their state. Both types of nurses commonly earn additional nursing certifications, though the specific credentials vary.

Both ICU and ER nurses rely on the ability to stay calm in emergencies and make quick decisions in life-threatening situations. Working in either the ICU or ER requires knowledge of a variety of illnesses, injuries and medical conditions. 

Nurses in these hospital departments work in rapidly changing environments. They care for people, provide updates to families, understand how body systems interact, and manage a wide range of treatments.

Differences between ICU nurse vs. ER nurse roles

These are some key differences between ER nurses and ICU nurses:

Salary

There is a slight difference in average salaries between ICU and ER nurses across the US. ER nurses average $93,536 per year plus $12,500 in overtime pay, while the average pay for an ICU nurse is $93,445 per year plus $12,375 in overtime pay.

Although the average salaries differ slightly, ER and ICU nurses within the same healthcare facility are often paid similarly, as hospitals typically use standardized pay scales based on experience.

Working environment

ER nurses work in the emergency department, while ICU nurses work in the intensive care unit. Working conditions vary significantly because these roles operate in completely different hospital departments.

ER environments change constantly and remain highly active. ER nurses must respond to a wide range of medical events, work in different exam rooms, and triage arriving patients.

ICU nurses work in highly structured, controlled environments and prepare for sudden changes in patient conditions. The care they provide requires a high level of organization and attention to detail.

Interactions with patients

The length and type of interactions with patients vary for ER and ICU nurses. ER nurses care for people for a short period until their conditions stabilize enough for discharge or transfer to another department. Typically, ER nurses focus on providing immediate, short-term stabilization before transferring care to other hospital teams.

ICU nurses may take over for ER nurses when patients are admitted to the ICU. Because people typically stay in the ICU for longer periods, ICU nurses often care for the same individuals for many consecutive days or weeks, building relationships with families.

Assessing your facility’s needs

If your healthcare facility is planning to hire nurses soon, it’s a good idea to begin by assessing your current staffing and department needs. These factors can help you assess the needs of your ER and ICU departments:

• Current staffing: Evaluate your current staffing by reviewing your ER and ICU. Determine which department has staffing shortages and would benefit from an extra employee.
• Statistics: Reviewing departmental metrics helps identify where adding new staff will improve your facility’s performance. For example, check patient wait times and total hours spent in the ER. ICU metrics to consider include mortality rates, lengths of stay, incident reports and patient satisfaction. Evaluating these departmental metrics helps identify clear opportunities to strengthen your patient care with a skilled nurse.

When to hire an ICU nurse

Consider hiring an ICU nurse under these circumstances:

• An ICU nurse recently left or is planning to leave.
• Your ICU nurse-to-patient ratios are consistently high compared to patient acuity.
• The ICU metrics show room for improvement.

When to hire an ER nurse

Hiring an ER nurse may be an ideal choice when one or more of these conditions exist:

• One or more ER nurses have left.
• The ER has a long wait time.
• You want to serve more patients in the ER.
• Your ER doctors need more technical assistance.