If you’re interested in becoming a ER travel nurse and specialize in working in the Emergency Room (ER) or Intensive Care Unit (ICU), you are probably wondering what you can expect on the job. The jobs of travel nurses, ER nurses and ICU nurses can be very different day-to-day, yet they also overlap in important ways. Working in both the ICU and ER requires exceptional critical-thinking skills, attention to detail, and depth and breadth of expertise.

Yet there are also important differences between these two types of nurses. To understand whether working as an ICU vs ER nurse is right for you, it’s important to get a sense of what the differences between these two types of nurses are. Regardless of which type of assignment you choose, both ER and ICU nurses are critical to our healthcare delivery systems. In both of these roles, you will touch the lives of your patients in profound ways and truly make a difference in the lives of those under your care. 

What Does an ICU Nurse do?

Nurses that work in an Intensive Care Unit provide care for the most vulnerable and severe patients in a hospital setting. The critically ill patients that ICU nurses care for have injuries or illnesses that threaten their lives.

Patients in an ICU setting commonly need care for injuries and illnesses, including:

  • Trauma (such as from a motor vehicle accident);
  • Cardiovascular disorders like acute myocardial infarction (AMI) or angina;
  • Respiratory disorders such as pulmonary embolism or acute respiratory failure;
  • Gastrointestinal disorders;
  • Cancer;
  • Surgery;
  • Shock;
  • Gunshot wounds.

A critical care unit nurse works as part of a greater team providing care to the patient in the ICU. The care team may consist of other registered nurses, physicians assistants, doctors, technicians, and therapists. Since patients in the ICU often have very complex needs, the care team may have additional consultants such as cardiologists and neurologists.

ICU nurses care for multiple patients on the unit at the same time. Responsibilities include assessing and monitoring vital signs of patients, delivering medications, administering treatments and responding to changes in the patient’s status.1

Is ICU Nursing Hard?

Put simply, working as an ICU nurse can be one of the most difficult jobs in an entire hospital. This particular nursing career is not one to be taken lightly. You are on your feet 24/7, so make sure you invest in some of the best shoes for nurses in your closet. ICU nurses care for the illest patients in a hospital setting. This means that every decision they make and every action can affect patient outcomes.

Working in an ICU can also be a very rewarding experience precisely because your actions can have such a large impact. As an ICU nurse, the care you provide for your ICU patients often means the difference between life and death. This responsibility can be difficult for some to manage while at the same time empowering others.

What ICU Nurses Need to Know?

ICU nursing requires extensive knowledge and specialized training in caring for critically ill patients. ICU nurses must be able to apply critical thinking skills to each critical patient they care for. ICU nurses must be familiar with the diagnosis of the patient and its signs and symptoms, treatment protocols, and any possible complications that might arise. 

An intensive care unit nurse must also know how to work together as part of a team. ICU nurses are part of a critical-care team consisting of many others within the critical-care unit. Coordinating with team members to ensure that patient care is always central is a crucial aspect of a critical-care nurse’s job.

Critical-care nurses must also understand how to interact compassionately with the patients under their care and their loved ones. Critical-care nurses are sometimes put in the difficult position of supporting terminal patients and their loved ones. Understanding how to navigate these difficult situations with compassion and care is a hallmark of a great ICU nurse.

How Long Does it Take to be an ICU Nurse?

Like many other nursing specializations, becoming an ICU nurse requires a combination of education and on-the-job training. If you’re interested in becoming an ICU nurse, you’ll need to work on a critical-care unit under the supervision of a preceptor. Once you’ve gained enough hours of experience providing direct care for critically-ill patients in this sector of health care, you’ll be eligible to sit for the certification exam. 

A critical-care nurse is certified through the American Association of Critical Care Nurses (AACN). The Critical Care Certification Exam (CCRN) requires a registered nurse or RN to have at least 1,750 hours providing care to acutely or critically ill adults over the two previous years. At least 875 of those hours must be completed in the previous year2.

The total process for becoming an ICU nurse with a CCRN certification will be at least two years once you are an RN working on a critical-care unit. 

What Does an ER Nurse Do?

The day-to-day job of an Emergency Room (ER) nurse is difficult to describe in specific terms because it can vary so much from shift to shift. The ER is the intake location for patients being treated for medical emergencies, including trauma, cardiovascular disorders, hematological emergencies, respiratory emergencies, shock, substance abuse, and much more.

Emergency room nurses see it all and are expected to work as part of a team providing care to patients of all ages and with all types of emergencies. In any given shift, an emergency nurse may deal with a wide range of medical emergencies based on each patient’s condition. Each shift can bring challenges, but also an opportunity to learn something new to help you become an experienced nurse in the critical care unit.

ike intensive care nurses, emergency room nurses provide direct care for patients experiencing some type of emergency. However, the ER tends to be fast-paced and chaotic. ER nurses are expected to have an “always-on” approach to their shifts.

Emergency department nurses triage patients as they enter the hospital system. They perform an initial assessment of the patient, discuss symptoms the patient is experiencing, and then provide treatment. The preliminary assessment conducted by an emergency room nurse is a crucial early step to treatment. Any major issues are identified, treated if possible, and stabilized, allowing the patient to be routed to the appropriate unit in the hospital for continuing care.

Is ER Nursing Hard?

Being a nurse in the emergency department can be both incredibly challenging and rewarding. Unlike an ICU, where every patient has a known diagnosis and a defined treatment plan, the patients may come into the ER for any number of reasons. Emergency rooms are chaotic, fast-paced, and stressful. Successful ER nurses are comfortable working under pressure in a fluid and dynamic work environment where no shift is the same, and each patient arrives with unique needs3.

What are the Average Salaries of ER and ICU Nurses?

If you’re considering becoming a travel nurse that specializes in an ER or ICU, you’re probably wondering how much these different career paths pay. The average salary of an ICU nurse nationwide according to ZipRecruiter is $95,000 per year.4 In contrast, the nationwide average annual salary for an ER nurse is $89,278 per year.5 

What Traits do ER and ICU Nurses Share?

Are you considering becoming an ER or ICU nurse but aren’t sure which type of nursing position would be a good fit for you? It may be helpful to look at the personality traits that an ER nurse vs ICU nurse share.

Critical-Thinking Skills

Both ICU and ER nurses must use critical thinking on every shift that they work. Critical thinking is a core competency of nursing that is particularly important within the confines of the ER and ICU where the line between life and death can be thin. ER and ICU nurses use critical thinking during their assessment of the patient and to determine appropriate treatments. Each patient presents unique challenges that nurses in both areas will have to work through to provide excellent care.

Sound Judgment

The decisions that ER and ICU nurses make on the job matter. They have a very real impact on the health of their patients. This makes it incredibly important that both ER and ICU nurses exercise sound judgment. Effective nurses in both departments will be able to apply their experiences and knowledge, along with logic, reasoning, and critical-thinking skills to each patient under their care.


Both ER and ICU nurses are experts in their field. While their respective certifications demonstrate that expertise to the public and potential employers, on the job these nurses are the masters of their domain. Their expertise allows them to approach each situation calmly and with confidence, even under the most stressful of circumstances.

Ability to Work as Part of a Team

A core aspect of working as either an ICU or ER nurse is working as part of a team. Understanding how to effectively work together with others on your care team is integral for ensuring successful patient outcomes. This means that ER and ICU nurses are effective communicators, are able to support and facilitate success in their colleagues, provide direction and organize when needed, and ensure that all members of the care team are focused on their patients.

Closing Thoughts

Nursing can be a challenging line of work, especially critical care nursing. This is most true in a hospital’s ICU or ER. ICU nurses care for critically ill patients that may have suffered from trauma, be recovering from surgery, or suffering from a cardiovascular or respiratory disorder. Becoming an ICU nurse takes time, as much of the training for becoming an ICU nurse occurs on the job. 

In contrast to ICU nurses who work with patients for whom a diagnosis has been made, ER nurses must be comfortable with diagnosing and treating patients on-the-fly. As an ER nurse, you never know what you might see on your next shift. This makes the job exciting but is also an indication that it’s not for everyone. ER nurses work in a fast-paced environment where every patient and every shift is unique.

Are you interested in Host Healthcare jobs? Travel nurses with experience working in an ER or ICU are in incredibly high demand at hospitals across the country. If you’re interested in putting your expertise in an ER or ICU to work for you, join our team at Host Healthcare. To learn more about ER travel nursing jobs or ICU travel nursing jobs , contact Host Healthcare today.



  1. Woodruff, David W. Critical Care Nursing Made Incredibly Easy! Vol. Fourth edition, Wolters Kluwer Health, 2015.
  2. Aacn.org, www.aacn.org/certification/get-certified/ccrn-adult
  3.  Jennifer R. Buettner, RN, CEN. Fast Facts for the ER Nurse : Emergency Room Orientation in a Nutshell. Vol. Second edition, Springer Publishing Company, 2013.
  4. “ICU Nurse Annual Salary Nationwide ($95,000 Avg: Jul 2020).” ZipRecruiter, www.ziprecruiter.com/Salaries/ICU-Nurse-Salary.
  5. “Emergency Room Registered Nurse Annual Salary Nationwide ($89,278 Avg: Jul 2020).” ZipRecruiter, www.ziprecruiter.com/Salaries/Emergency-Room-Registered-Nurse-Salary