Brainstorming needed!

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    Hi everyone,

    Wanted to get ideas from anyone in this forum in hopes that it helps me come up with something I hadn't already considered.

    I was a 911 paramedic in a big city for seven years. During my last two years on the job I went to nursing school part time and graduated with a BSN, summa cum laude, from a reputable university. I always had a love for cardiology as I went to a paramedic school that included an advanced cardiology class, and found a love for medical ICU nursing during my senior practicum.

    Fortunately I got hired right out of school, as an RN in an ER. ICUs I talked to at that point were not interested in taking on a new grad, even with the critical care experience I had as a paramedic but ERs were happy to consider me. I'm almost a year into my ER job, and already have my CEN, but I find a very big gap between my detail-oriented fastidious nature and the type of nurse that enjoys an ER job. I do have a charge nurse who thankfully supports my love for sick patients, especially those with cardiac issues, and she very graciously supports any and all chances I get to take on the big room patients. But suffice to say, I want ever so badly to be in a job where I feel I am thriving, and I have no doubt in my mind that it is in an ICU with a cardiac focus. The tough thing is convincing employers of this!

    I have joined the AACN and I read the publications. I have started studying for the CCRN. I continue to research and learn and expand on my knowledge. In the meantime, I've got to ask - are any of you aware of ICUs that would consider someone with my background? Do you have any ideas as to what I can work on to make me a better candidate while I continue to bide my time in the ER?

    Thanks in advance, everyone!
    Joe V likes this.
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  3. 10 Comments so far...

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    Sounds like you'd do well in a cardiac medicine or cardiac surgical floor. My advice would be to start talking to the NM's of those floors, set up a day to shadow one of their nurses. Be sure to soak it all in and ask pertinent questions. Remember although you are just shadowing, leaving a good impression on a staff member can influence them to give their opinion of you to the NM. Believe me, just had someone shadow me and after that exp, I went straight to the director and told them we had to hire her. When I think of people who would do well on our floor (CT-ICU), i'm looking for people who are inquisitive, ask questions, learn quickly, and come from a good solid nursing background. From what you posted, it sounds like you really know what you want. So just be honest, but don't be overconfident.

    Other things you can look into would be PA caths & hemodynamics, vasoactive gtts, typical patient population of the units you are looking at, mech ventilation. We don't expect you to know everything, but if you have a good idea about how we use these things, it might give them the impression that you are ready and willing to learn what they teach you. Also, if you haven't started precepting, you might consider that... or being involved in committees. Both only help distinguish you as a person who goes above and beyond, and will only strengthen your application.
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    If you're really Type-A, you may prefer a Cardiac Surgical ICU over a Cardiac Medical ICU. In Cardiac Surg, there is a lot of bean-counting...chest tube output, urine output, CRRT, titrate drip A according to protocol A, titrate drip B according to protocol B, and so on. There is certainly critical thinking, and very sick patients many times. On the other hand, if you like to fly by the seat of your pants a bit more, you may like the Medical Cardiac ICU. Oh look, my patient's in VT! Pow! Hmmm, I've maxed out furosemide at 20mg/hour and my patient's on BiPap, what next? What do you mean retroperitoneal bleed, he was fine a minute ago. That sort of thing. Really, I'm sure you'll do well no matter where you go.
  6. 0
    Tucson AZ, UAMC cvicu is hiring.

    CVICU in Columbia, South Carolina is hiring.

    You may just have to move.
  7. 0
    Thank you, everyone, for giving me some great information to start working on.

    IHeartDuke - I will admit that I hadn't thought of shadowing at this point as it was something I thought of when I was looking to go into nursing but never thought about doing it when looking to change directions within the field. You have given me some great tips. Thank you!

    RNerd81 - Thanks for the vote of confidence. The surgical vs. medical distinction gave me food for thought, and my gut feeling is that I would prefer the flying by the seat of my pants version. I know sometimes changes can happen because you got behind the eight ball (as the saying goes in paramedicine) and sometimes it just happens, but I like the rapid, critical thinking needed when your patient's presentation suddenly changes. I remember having a sick COPDer who would go into runs of MAT (the only time I can say I have ever really seen that rhythm) when sleeping. I only discovered it because I happened to look at his monitor randomly. I loved that sudden surprise.

    8jimi8ICURN - Thank you for the hiring information. I am willing to move - the problem seems to be that even places I would move to in order to gain the experience I'm looking for seem to still want ICU experience for an ICU job and don't consider the experience I have to be a suitable alternative. I will definitely look into your suggestions - thanks so much!
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    Let me know. I'll splitter recruitment bonus with you.
  9. 0
    I applied for the Tucson job but couldn't find the specific hospital it was in Columbia that was hiring. Feel free to PM me - I'd be so happy to be in an CVICU the money is yours!
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    Palmetto Richland Hit me up on fb I never have luck with the pm system on this website.Fb/8jimi8
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    Also do the pacep.org coned mods. And mention them in your interview. I'm about 3 mi from the hospital.
    Last edit by Esme12 on Aug 18, '12 : Reason: TOS/privacy
  12. 0
    I would keep looking around because while a lot of places do want the previous ICU experience there are plenty that want 1-2 years of ED, ICU, or Telemetry out there (although it seems a lot of the ones with more flexible prerequisites tend to be night shifts). Is it not possible to transfer within your hospital to another unit? Look around some more and if hospitals are having job fairs or career fairs make sure you sign up and attend because meeting the hiring or unit managers in person makes a HUGE difference. I put in several applications for a PRN ED position with no luck, went to a job fair met with the assistant NM and interviewed in person, got an interview with the NM, and was offered full time employment if I wanted it.


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