ER Nurse Vs. ICU Nurse: What's The Difference? | (2023)

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(Video) ER vs ICU

Published May 15, 2023 · 5 Min Read

Discover the differences and similarities between ER nurses vs. ICU nurses, including the educational requirements, duties, and salaries.

ER Nurse Vs. ICU Nurse: What's The Difference? | (13)Credit: SDI Productions / E+ / Getty Images

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Nurses help save lives in the emergency room (ER) and intensive care unit (ICU), but the environment and responsibilities differ.

While ER nurses stabilize patients, ICU nurses work to treat and transfer critically ill patients to step-down units. ICU patients often require more specialized care than ER patients.

Find out the differences and similarities between ER nurses vs. ICU nurses. Learn about average salaries, day-to-day responsibilities, settings, and educational requirements in this guide.

(Video) ER VS. ICU NURSE - They Are DRAMATICALLY Different! If You Are Interested in Nursing, Check This Out

ER Nurse and ICU Nurse Key Similarities and Differences

What is an ER Nurse?

As an ER nurse, you are a licensed registered nurse with your associate in nursing degree (ADN) or bachelor's in nursing degree (BSN). You can specialize in pediatrics, trauma, or disaster response. No matter the specialty, you are skilled in handling medical emergencies and stabilizing patients to potentially release them or transfer them to ICU.

The Board of Certification For Emergency Nurses offers certifications to become a certified flight registered nurse, pediatric emergency nurse, transport registered nurse, trauma certified registered nurse, or burn unit nurse.

What is an ICU Nurse?

If you work in the structured environment of an ICU, you care for high acuity patients with complex life-threatening conditions that require round-the-clock monitoring. Medically fragile patients on ventilators and other life support rely on you as an ICU nurse.

You can get certified in critical care after getting experience in ICU units, cardiac care units, or in critical care transport. The American Association of Critical Care Nurses certifies RNs in the specialty areas of adult gerontology, neonatal, and pediatrics.

ICU and ER nurses both work on medical teams to save lives in settings that require critical thinking skills and sound judgment. You need solid teamwork skills to function in ER departments and ICU units — two settings that function at different speeds.

An ER department is often fast-paced and occasionally slow. ICU nurses have organized shifts in environments where patients are critically ill and need a high-level of constant care.

Comparison of ER Nurses and ICU Nurses
ER NurseICU Nurse
Degree RequiredADN or BSNADN or BSN
Certification OptionsCertified Emergency Nurse, Certified Flight Registered Nurses, Certified Pediatric Emergency Nurse, Certified Transport Registered Nurse, Trauma Certified Registered Nurse, and Certified Burn Registered NurseAcute/Critical Care Nursing (Adult, (Pediatric, or Neonatal), Acute/Critical Care Knowledge Professional (Adult, Pediatric, or Neonatal), TelelCU Acute/Critical Care Nursing (Adult), Progressive Care Nursing (Adult), Progressive Care Knowledge professional (Adult), Cardiac Medicine (Adult), cardiac Surgery (Adult), Acute Care NP (Adult-Gerontology), CNS Wellness through Acute Care (Adult, Pediatric, or Neonatal)
Duties and ResponsibilitiesTriage patients as they arrive in the emergency room. ER nurses prioritize treatment of patients based on life-threatening conditions.Cares for critically ill, high-acuity patients. ICU nurses monitor a patient's condition and respond immediately to any changes. The goal in an ICU unit is to improve a patient's condition and transfer them to a down unit.
Average Annual Salary (March 2023)$74,905$74,920

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Duties and Responsibilities

While ER and ICU nurses work in different units of a hospital, many of their responsibilities overlap. For example, both ER and ICU nurses educate patients, families, and caregivers and treat patients with serious conditions.

What Does an ER Nurse Do?

There is no ordinary day in the ER. As an ER nurse, you assist doctors with medical emergencies that can be life threatening. ER nurses work in critical access hospitals, urban hospitals, and teaching hospitals. They sometimes provide care to certain populations or specific medical issues, such as burn, cardiac, trauma, and pediatric units.

  • ER nurses evaluate and monitor various injuries and illnesses, some of which may be life threatening.
  • ER nurses must quickly triage patients and administer treatments.
  • ER nurses need empathy, physical and emotional endurance, and the ability to thrive in a fast-paced setting and make quick decisions in stressful situations.

What Does an ICU Nurse Do?

Once stabilized, some patients are admitted into the ICU, a highly-structured and closely monitored environment. ICU nurses work in ICU units, step-down units, and TeleICU.

(Video) ER vs ICU | A CNA's Perspective

ICU nurses help patients with critical illnesses who require specialized care. They help maintain a healing and calm environment for patients and their families. Patients in the ICU may have advanced respiratory and organ impairment that requires invasive treatment to stay alive. ICU nurses monitor and provide direct care to patients who are intubated, on ventilator support, and have intravenous drips.

  • ICU nurses monitor and evaluate patients.
  • ICU nurses administer treatments and identify any changes to a patient's condition. When a patient has improved, they handle the paperwork to make a transfer to a step-down unit.
  • ICU nurses must be highly organized, compassionate, and have an acute attention to detail.

Education and Certification

You need an RN license and the clinical experience to become an ER or ICU nurse. ER and ICU nurses begin their nursing careers by earning either an ADN or a BSN. In order to take the NCLEX-RN — which qualifies you for licensure in your state —you need to graduate from an accredited program.

How to Become an ER Nurse

You need to complete an accredited ADN or BSN to become an ER nurse. ER nurses can work with a two-year degree. Some employers may prefer ER nurses to have bachelor's degrees.

Both ADN and BSN degrees meet the requirements to take the NCLEX-RN exam and receive RN licensure. Beyond earning your degree, it may be beneficial to gain clinical nursing experience before pursuing an ER nursing role. One of the best ways to gain experience is through a residency program.

Once licensed, you can advance as an ER nurse by obtaining certification. Numerous certifications are available through the Board of Certification For Emergency Nursing, but perhaps the most popular is the certified emergency nurse credential. You can also become a certified pediatric emergency nurse, trauma certified registered nurse, certified flight registered nurse, and certified transport registered nurse.

How to Become an ICU Nurse

ICU nurses, also called critical care nurses, have RN licenses in their respective states. They obtain licensure by either completing an accredited ADN or BSN degree. Hospital employers may prefer BSN degrees, which also allows RNs to more easily advance in their careers and earn an MSN.

Education is not the only way to advance in nursing. Nurses can progress professionally and pursue salary increases after receiving certifications. Experienced ICU nurses can get certified by the American Association of Critical Care Nurses (AACN).

The AACN's certified acute or critical-care nurse adult certification recognizes ICU nurses with 1,750 hours of experience helping critically ill adult patients.

You can also get certified in teleICU acute and critical care nursing or become an acute critical care knowledge professional if you're not working in direct patient care.

Salary and Career Outlook

On average, ICU nurses and ER nurses earn comparative salaries of about $75,000 a year or $34 an hour. The highest earning ICU and ER nurses earn more than $100,000 a year.

ER Nurse Salary and Career Outlook

Average Annual ER Nurse Salary

(Video) ICU nurse vs. ER nurse

Source: Payscale, April 2023

ER nurses earn an average of $74,910 a year. Nurses can increase their salaries with higher degrees, certifications, or work experience. For example, the top 90% of ER nurses earn about $106,000 a year, according to Payscale.

ICU Nurse Salary and Career Outlook

Average Annual ICU Nurse Salary

Source: Payscale, April 2023

ICU nurses start out at an average annual salary of $60,000. ICU nurses can increase their earnings as they take on more responsibilities, continue their education, and get certified for their specialized skills. For example, the top 90% of ICU nurses earn an average of $112,000 a year, according to Payscale.

ER Nurse vs. ICU Nurse: Which Career is Right For Me?

If you compare ER nurses vs. ICU nurses, you'll find many similarities. Both work in direct patient care in a high-pressure environment. If you hold an ADN or a BSN degree, you can choose from either career. ICU nurses with specialized nursing knowledge earn more than ER nurses since ICU patients. However, salary differences are nominal.

.In an emergency department, you need to provide immediate care to patients and keep your composure. ICU nurses provide a higher level of care to critically ill patients in a structured environment. Evaluate your preferences and career goals when deciding which nursing speciality is right for you.

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(Video) ER vs ICU NURSE! // What's the difference? & What should YOU do?!

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ER Nurse Vs. ICU Nurse: What's The Difference? | ›

The emergency department provides immediate medical care to patients arriving at the hospital. That means ED nurses triage and stabilize patients who will then be transferred to the ICU. ICU nurses primarily take care of patients who require a higher level of care than what an emergency nurse typically provides.

What is the difference between ICU nurse and ER nurse? ›

Emergency nurses can see up to 10 patients per shift, while ICU nurses may focus on just 2 patients over multiple shifts. As for variances in the skills that you'll need for success in either job: ER nursing—Requires the ability to remain calm under pressure: a lot of pressure!

What is the difference between the ER and ICU? ›

Patients are evaluated and cared for in the emergency room. Depending on how sick the patients are the emergency room doctor may send them to another area of the hospital called the ICU. The ICU is called the intensive care unit. Patients who are very sick and need specialized care are placed in the ICU.

What is the difference between registered nurse and ER nurse? ›

What is the difference between an ER nurse and a registered nurse? ER nurses are RNs who specialize in emergency care. Some also hold certification as CENs or certified emergency nurses. However, many nurses in the ER are just RNs who have chosen to work in an acute care setting.

What do ICU nurses do differently? ›

Unlike other Registered Nurse jobs, ICU Nurses work with unstable patients that face life-threatening conditions. A patient is considered unstable when their respiratory or cardiovascular systems require constant monitoring due to their weak state.

What is the hardest part of being an ICU nurse? ›

Negative Attitude: Constantly being exposed to death can result in habitual pessimism. Sleep Issues: Many ICU nurses who experience compassion fatigue find they have trouble sleeping or may experience nightmares. Stress and Anxiety: Constant stress and anxiety are two of the most common symptoms of compassion fatigue.

Is ICU nursing harder than Med Surg? ›

Medical-surgical nursing she summarized, is so much harder than critical care nursing. This is exacerbated by these nurses having at least twice if not more patients they must care for in a shift than ICU nurses have.

Is ICU the highest level of care? ›

The acronym CCU can have two meanings when it comes to a type of hospital unit. In some hospitals, it can stand for a critical care unit. This is the same as an intensive care unit (ICU), where those with a variety of critical conditions are provided the highest level of care by trained medical personnel.

What is the next level down from ICU? ›

After the ICU, patients usually will stay at least a few more days in the hospital before they can be discharged. Most patients are transferred to what is called a step-down unit, where they are still very closely monitored before being transferred to a regular hospital floor and then hopefully home.

Which is higher than ICU? ›

High-dependency care units (HDUs), also called “intermediate care units” or “step-down units,” are areas where patient care levels and costs are between the levels found in the ICU and in the general ward.

What nurse is higher than a RN? ›

Position description: To become an advanced practice registered nurse (APRN), you must be an RN ready to take on more of a leadership role in patient care. While RNs often focus on implementing a plan of care, APRNs focus on directing a plan of care.

What level of nursing is higher than an RN? ›

What Are the Levels of Nursing? There are five levels of nursing: Certified Nursing Assistant (CNA), Licensed Practical Nurse (LPN), Registered Nurse (RN), Advanced Practice Registered Nurse (APRN), and Doctor of Nursing Practice (DNP).

What is the greatest strength as a ICU nurse? ›

Example answer: 'I believe my strongest skills as an ICU nurse are my communication and empathy. Both skills help me ensure patients remain calm during procedures, particularly as the ICU ward can receive patients with extensive injuries.

What type of people are ICU nurses? ›

ICU nurses or critical care nurses are highly specialized and trained healthcare personnel who provide nursing care to patients with life-threatening illnesses or conditions. They provide specialized experience, knowledge, and skills that patients need to survive or de-escalate care.

What is your weakness as an ICU nurse? ›

Examples of common nursing weaknesses our experts say they hear include: Paying too much attention to detail. Wanting to do everything at once. Spending too long on paperwork.

What is the hardest level in nursing? ›

Hardest Nursing School Classes
  • Pathophysiology. In this course, students learn how different anatomical systems work and how diseases or injuries affect these systems. ...
  • Pharmacology. ...
  • Medical Surgical 1 (also known as Adult Health 1) ...
  • Evidence-Based Practice.

What is the hardest thing a nurse has to do? ›

Seeing the death of their patients.

"Seeing those patients you took care of die and how devastating it is to the family" is the hardest part of being a nurse, said Melissa, a nurse from Oklahoma city.

Do ICU nurses make more than Med-Surg nurses? ›

Typical Salaries

Salaries for all nurses vary based on their years of experience, area of the country and specific nursing facility. However, overall, ICU nurses make a bit more money than their med-surg peers do and often find that their salaries increase more frequently over their years in the field.

Why do ICU nurses make so much? ›

ICU nurses save lives on a regular basis. For this reason, ICU nurses are paid on average more than regular nurses. Plus, there are many ways to increase your salary as an ICU nurse and these differ state by state.

Why ICU nursing is the best? ›

One of the nice things about being an ICU nurse is that you typically have fewer patients each day than you would in another unit, which means you have more time for each person and you get to form deeper connections with them.

What is the least stressful nursing unit? ›

Institutional Nurses

These nurses administer more basic care and typically don't have to work long hours and overnight shifts, so this field of nursing tends to be low-stress.

Are ICU nurses skilled? ›

ICU nurses must be skilled at making clear-headed decisions and effectively gathering the information they need to make sure they can act in the best manner possible.

What are the three levels of ICU? ›

  • Level 1—Ward based care where the patient does not require organ support (for example, they may need an IV, or oxygen by face mask)
  • Level 2—High dependency unit (HDU). ...
  • Level 3—Intensive care.
May 7, 2005

Does ICU count as critical care? ›

Critical care also is called intensive care. Critical care treatment takes place in an intensive care unit (ICU) in a hospital. Patients may have a serious illness or injury. In the ICU, patients get round-the-clock care by a specially trained team.

Is ICU higher than ER? ›

The emergency department provides immediate medical care to patients arriving at the hospital. That means ED nurses triage and stabilize patients who will then be transferred to the ICU. ICU nurses primarily take care of patients who require a higher level of care than what an emergency nurse typically provides.

What is a step down from ICU called? ›

Step-down nurses specialize in step-down care, a type of critical care that's between ICU and med-surg nursing. In hospitals, step-down units are often called “transitional care units” or “intermediate care units.”

Is ICU rotation hard? ›

The ICU, or Intensive Care Unit, is arguably one of the most challenging rotations. The majority of the patients have complex medical problems, plans for care change daily, and things can take a turn very quickly.

How long can patient stay in ICU? ›

Once a person no longer needs intensive care, they can be transferred to a different ward to continue their recovery before eventually going home. Some people may leave the ICU after a few days. Others may need to stay in the ICU for months or may deteriorate there.

What does Level 4 ICU mean? ›

Level IV NICUs provided the highest level, the most acute care. These nurseries are located in a hospital that can provide surgical repair of complex congenital or acquired conditions.

Who are the highest paid nurses? ›

Certified Registered Nurse Anesthetists (CRNAs) earn a nationwide average of $202,470 per year according to the BLS; this makes CRNAs the highest-paying type nursing job by a significant margin.

What type of RN makes the most? ›

The Certified Registered Nurse Anesthetist consistently ranks as the highest-paid nursing career. That is because Nurse Anesthetists are highly skilled Registered Nurses who work closely with medical staff during medical procedures that require anesthesia.

What are the levels of a RN? ›

RN Levels
  • Level 1 Novice Nurse. The Level I Registered Nurse, under the direction of the Nurse Manager, is accountable for provision of direct care to assigned patients. ...
  • Level 2 Proficient Nurse. ...
  • Level 3 Expert Nurse. ...
  • Senior Level 3 Mentor Nurse. ...
  • Level 4 Assistant Nurse Manager/Clinical Resource Nurse.

What is the lowest level of nursing? ›

As the name suggests, CNAs assist nurses with patient admittance and vitals. It is the lowest-level credential related to the nursing field and the quickest point of entry.

What is higher than a nurse but lower than a doctor? ›

Many people have primary care providers that are NPs or PAs. But what's the difference? In basic terms, a nurse practitioner is a registered nurse (RN) with advanced education and clinical training. A physician assistant is a medical professional with advanced education who is trained in the same way physicians are.

Which nursing degree is best? ›

The BSN is the nursing degree that most employers prefer, and it provides graduates the best career opportunities straight out of school. The minimum requirement for many nursing positions these days is a BSN.

What are the 5 levels of nursing experience? ›

Benner (1984) also detailed the acquisition of nursing expertise and proposed five possible expertise levels: novice, advanced beginner, competent, proficient, and expert.

Is BSN higher than RN? ›

Compared to RN, BSN is a degree, not a job title – it's the next-level nursing education program that can lead to becoming an RN.

Why is ICU nursing stressful? ›

It is often said that working in an ICU can be especially stressful because of the severity of illness of the patients and the subsequent high mortality, giving rise to regular traumatic and ethical issues and challenging daily work.

How many patients should an ICU Nurse have? ›

Because ICU patients require such constant attention, critical-care nurses are typically only caring for one or two patients at a time. Sherman notes that caring for just two patients is enough to occupy your mind and your time for an entire shift.

How hard is ICU nursing? ›

Working in the ICU is incredibly challenging. The hours can be long and caring for critically ill and unstable patients is emotionally and physically demanding.

What is the head nurse of the ICU called? ›

Chief Nursing Officer (CNO)

CNOs oversee the entire nursing program at a healthcare facility and develop policies and procedures that shape how an organization functions. Depending on the structure of the organization, CNOs may work under the CEO of the hospital.

What are the pros and cons of ICU nurse? ›

The pros of your role will include working with fewer patients, being more independent and working closely with doctors. A drawback to the job, however, is having to deal with emotional attachments to patients and coping with more deaths than you might encounter in another nursing specialty.

What are the leadership qualities of ICU nurse? ›

Nursing leadership styles in intensive care units

The authors highlighted the five leadership characteristics from nurses in an adult ICU: leading by example, communication, ability to think outside the management square knowing your staff and stepping up during times of crisis. Boyle at al.

Do ICU nurses make more than Med Surg nurses? ›

Typical Salaries

Salaries for all nurses vary based on their years of experience, area of the country and specific nursing facility. However, overall, ICU nurses make a bit more money than their med-surg peers do and often find that their salaries increase more frequently over their years in the field.

What is an ICU nurse called? ›

A nurse that works in the ICU is called a critical care nurse. Critical care nurses are in charge of treating more acutely ill patients in hospitals, whether they be pediatric, neonatal, or adult.

Is ICU nurse difficult? ›

Working in the ICU is incredibly challenging. The hours can be long and caring for critically ill and unstable patients is emotionally and physically demanding.

Are trauma nurses and ER nurses the same? ›

Typically, ER Nurses care for ill or sick patients. Trauma Registered Nurses, on the other hand, deal with patients for whom “ill” is an understatement of their condition. These are patients who had to be rushed into the ER with serious wounds and injuries. They are in need of serious and urgent medical attention.

What is the hardest nursing unit? ›

Intensive Care Unit (ICU) nurses

ICU is an extremely high-pressure environment and these nurses work with patients who have significant injuries and disease with added morbidity risks. Unstable patients require lifesaving interventions and once stabilized, are transferred to a different unit.

What is the highest paid ICU nurse? ›

While ZipRecruiter is seeing annual salaries as high as $173,500 and as low as $25,500, the majority of Icu Registered Nurse salaries currently range between $101,000 (25th percentile) to $141,500 (75th percentile) with top earners (90th percentile) making $160,000 annually across the United States.

What is the highest ranking nurse in a hospital? ›

Chief Nursing Officer (CNO)

Chief nursing officers are nursing administrators who work within the leadership team of a healthcare organization. They are considered the highest level of nursing leadership.

What is the highest paid nurse? ›

What is the highest-paid nurse? Certified Registered Nurse Anesthetists! Earning $195,610 annually, CRNAs earn significantly more than any other type of nurse or nursing specialty.

What is the average age of an ICU nurse? ›

The average age of an employed intensive care unit nurse is 43 years old. The most common ethnicity of intensive care unit nurses is White (65.8%), followed by Black or African American (11.7%), Asian (8.9%) and Hispanic or Latino (8.9%).

What is the personality of an ICU nurse? ›

If you possess a multi-tracked mind, has a passion for routine, patient familiarity, intimacy, and providing your full-attention to one patient at a time, then the Intensive Care Unit is right for you.

How stressful is ER nursing? ›

The widespread issue of nursing stress and burnout is widely acknowledged. According to a recent article in Nursing World, 75 percent of nurses said they felt stressed, 69 percent frustrated, and 62 percent overwhelmed. Emergency department (ED) nurses face daily stressors on an unimaginable level.

What is the personality of an ER nurse? ›

The personality of ER nurses is calm, cool, and collected even during emergencies and stress. They must also be able to adapt to the ever-changing ER environment.


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