ER Nurse vs. ICU Nurse: What's the Difference?

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Updated August 29, 2023 · 5 Min Read

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Discover the differences and similarities between ER nurses vs. ICU nurses, including the educational requirements, duties, and salaries.
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Nurse checking clipboard in emergency room Credit: SDI Productions / E+ / Getty Images

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.

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 Nurse ICU Nurse
Degree Required ADN or BSN ADN or BSN
Certification Options Certified Emergency Nurse, Certified Flight Registered Nurses, Certified Pediatric Emergency Nurse, Certified Transport Registered Nurse, Trauma Certified Registered Nurse, and Certified Burn Registered Nurse Acute/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 Responsibilities Triage 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.

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

$74,910
Average Annual ER Nurse Salary

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

$74,920
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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Page Last Reviewed April 27, 2023

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