ICU Nurse vs ER Nurse: Where do you Belong?

Choosing between ICU Nurse vs ER Nurse may be an extremely big decision for you to take especially in our ever-changing healthcare delivery system. Both positions come with big responsibility and ability when it comes to nursing skills and knowledge. To help you better understand both sides, let us dig deeper into it and see where you truly belong.

Emergency Department

Emergency Room Nurse

What is an ER (Emergency Room) or ED (Emergency Department) Nurse?

An emergency room nurse or ER nurse is a registered nurse that works in the emergency department. By the name itself, emergency department is the part of the hospital where people go to when they are experiencing emergency life-threatening situations or conditions that warrant an urgent medical attention. 

The ER Department is one of the most crazy and unpredictable department in the hospital. You will never know, a patient that came in with an abdominal pain can have a life-threatening heart attack after a few seconds.

ER Nurses and what they do

An emergency room nurse is one of the first responders of patients of any age and of any medical emergency. The ER nurse sees it all, from a simple fever to a life-threatening heart attack.

With that being said, the characteristics of an ER nurse should possess an outstanding assessment skills and excellent critical thinking ability to be able to address the emergency appropriately and quickly. 

TRIAGE in the ER department is composed of a team that will categorize patients accordingly and make sure that those patients that need immediate medical attention will be attended first and this is where the ER nurse’s assessment skills play a very important role.

ICU (Intensive Care Unit) Nurse

Intensive Care Unit

What is an ICU Nurse?

ICU nurses are registered nurses that work in an ICU or Intensive Care Unit setting. ICU is a unit in the hospital where critical care patients who need utmost care and monitoring are located.

Lives of ICU patients are hanging by a thread and can deteriorate anytime. Because of the critical care that patients need, ICU is made up of multi-disciplinary team members that are highly skilled when it comes to patient care and responding to their immediate needs. 

One member of this multi-disciplinary team is an ICU registered nurse. ICU nurse is responsible for taking care of highly vulnerable patients with life-threatening disease conditions or injuries. Most patients in the ICU are attached to an artificial airway connected to a mechanical ventilator to sustain their life. 

Aside from that, different kinds of potent mediation and drips that require constant monitoring are administered. In this case, ICU nurses should be knowledgeable about different pathophysiology and disease process so that they can work with the team and give utmost care and treatment for the patients towards recovery. 

ER Nurses and what they do

If you want to know what is ICU nursing, then you are about to find out. ICU nurse work closely with other members of the team to be able to come up with a plan to sustain patient’s life. ICU nurses should be equipped with enhanced skills, broad knowledge and specialized critical thinking and assessment skills that is much needed when taking care of a critically ill patient. 

ICU is a structured unit and patients stay for a longer period until they have achieved recovery or does not recover at all and reach palliative or hospice care or die eventually if all means are impossible. Nurses are patients advocate and they are responsible for promoting patient’s way of life. 

ICU nurses are expected to respond to any changes in patient’s condition especially any change that necessitate immediate care and treatment. 

Some of the different types of ICU nurses are trauma ICU nurse, pediatric ICU nurse, surgical ICU nurse, medical ICU nurse and neonatal ICU nurse.

How do ICU Nurse and ER Nurse differ?

ICU Nurse vs ER Nurse

Work Situation

When it comes to the work environment, it is a totally contradicting world for the two types of nurses. Emergency room nurses survive in an unpredictable, fast-paced, and chaotic environment.  Patients arrive in the ER with different signs and symptoms and different disease conditions. 

It is unpredictable in a way that ER nurses will not have a single idea about the patient’s disease condition as soon as they enter the emergency room. Patients can come with different signs and symptoms and it will take a while for them to be diagnosed. The ER nurses will always have this anticipation on not knowing the surprise at the ER door.   

ER nurses only have a short-term care for their patients as these patients will soon depart ER either stable enough to be discharged home or be admitted anywhere else in the hospital.

Is the ER considered critical care? Yes, for the simple fact that they also cater for critically ill patients but for short-term. 

In contrast, a CICU nurse work in a coordinated and structured environment. ICU nurses are the witnesses for patients progress from being critically ill towards recovery. Unlike the ER nurses, ICU nurses usually spend long-term care for their patients as the duration of patients stay in the ICU is usually longer. 

ICU nurses will get to know their patients more because the care that they will provide to their patients will be longer as their critical disease condition permits. Nurses in the ICU are also knowledgeable and trained to handle different disease conditions and their pathophysiology. Because of the patient’s longer stay, nurses will be able to anticipate and recognize some signs and symptoms associated with the disease condition and be able to know how to treat them. 

Patient Load

This is one of the areas where a big difference occurs in every shift. When it comes to patient load, ER nurses will have unpredictable load depending on the number of patients that will present in the ER. It is a case to case basis. An ER nurse may handle as much as 30 patients in one shift depending on their needs and disease conditions. 

On the other hand, ICU nurses can oversee as many as 3 patients only per shift as these are critically ill patients that needs more attention and monitoring. Despite this few patient load, ICU nurses are still always on their feet as these patients’ condition requires so much of nurse’s care and monitoring. 

Goals of Care

ED RN attend to the immediate needs of the patients and determine what illness they have so they can be transferred to their appropriate floor or unit. As mentioned earlier, ER nurses have short-term care for their patients since the goal will always focus on determining the problem, treating, and stabilizing the patient and eventually be transported to their designated unit. Recognize, stabilize and transport is the main goal of ER nurses. 

On the contrary, ICU nurses long-term care for their patients necessitates thorough and continuous plan of care. The goal of ICU nurses is to become the critically ill patient’s advocate and to provide nursing care towards recovery or death. 


When it comes to their pay, it really depends upon the institution. But, according to some research and most common among companies, ICU nurses are paid higher that ER nurses. So, with the question do ICU nurses paid more or do ICU nurses make more than the ER nurses, it usually depends on the state and the institution.  


To sum it all up, ER nurses are first responders that provide short-term care to sick people no matter the severity is, it may be a minor injury or a life-threatening situation, ER nurses are always on the go. On the opposite, ICU nurses only provides long-term care to critically ill patients. 

ICU nurse vs ER nurse, both nurses work in an incredibly challenging unit that requires vast knowledge, skills, and critical thinking. Their shift may be tough, but they always see it as an opportunity to enhance their skills and to learn something new. Critical care vs emergency medicine is very opposite. Working as an ER nurse or working in ICU as a nurse may be different but with them, adrenaline rush is a common thing.