Which Icu?

Specialties CRNA

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I AM A 5 YEAR MED/SURG NURSE, CURRENTLY WORKING IN A LARGE -TRAUMA CENTER-(IMC). TRANSFERRING IN MAY TO AN ICU. THE PROBLEM IS - I AM NOT SURE WHICH ICU WOULD PROVIDE ME WITH AN EXTENSIVE AND BROAD RANGE OF EXPERIENCE THAT WILL PREPARE ME FOR ANESTHESIA SCHOOL. I'M PLANNING ON WORKING ABOUT 18MONTHS PRIOR TO APPLYING.

THE SICU PATIENTS ACUITY LEVEL IS OFTEN RANKED WITH MY UNIT'S IMC(TRAUMA). I'VE BEEN TOLD BY MANY TRAVEL RN'S THAT OUR IMC IS EQUIVALENT TO A COMMUNITY HOSPITAL'S ICU.

FROM EVERYONE'S EXPERIENCE, WHICH ICU WOULD I BENIFIT FROM :

CARDIOTHORACIC ICU ( HEAVY UNIT- VERY BUSY-VERY SICK PTS)

SICU

MICU

HELP!

:confused: :confused: :confused: :confused: :confused:

I don't think you can go wrong with either one of those ICUs. I think it just depends on what type of patients you are interested in caring for. I prefer SICU because of the types of pts that go there. I have worked MICU and find that the very sick medical pts can be extremely challenging and interesting. However, I prefer the sick surgical/trauma pts. I also think if you are interested in CRNA school, being in a SICU (or even CVICU) may provide you with more contact with the surgical teams, including CRNAs than MICU. Like I said, it really depends on your likes and dislikes. My opinion.

later

Originally posted by RNBEAUTY2003

I AM A 5 YEAR MED/SURG NURSE, CURRENTLY WORKING IN A LARGE -TRAUMA CENTER-(IMC). TRANSFERRING IN MAY TO AN ICU. THE PROBLEM IS - I AM NOT SURE WHICH ICU WOULD PROVIDE ME WITH AN EXTENSIVE AND BROAD RANGE OF EXPERIENCE THAT WILL PREPARE ME FOR ANESTHESIA SCHOOL. I'M PLANNING ON WORKING ABOUT 18MONTHS PRIOR TO APPLYING.

THE SICU PATIENTS ACUITY LEVEL IS OFTEN RANKED WITH MY UNIT'S IMC(TRAUMA). I'VE BEEN TOLD BY MANY TRAVEL RN'S THAT OUR IMC IS EQUIVALENT TO A COMMUNITY HOSPITAL'S ICU.

FROM EVERYONE'S EXPERIENCE, WHICH ICU WOULD I BENIFIT FROM :

CARDIOTHORACIC ICU ( HEAVY UNIT- VERY BUSY-VERY SICK PTS)

SICU

MICU

HELP!

:confused: :confused: :confused: :confused: :confused:

Hands down cardiothoracic they are going to make you understand the heart and lungs like you didn't know existed. The better you know it the better off you'll be thoughout your training and they're going to know that.

Specializes in Critical Care.

Personally, I would recommend that any CRNA prospective go into a Cardiothoracic ICU. Once there learn and try to manage as many CV cases as possible i.e heart bipass and valves. I am sure a MICU may have patients suffering from ARDS, DIC and sepsis which I believe is a nice break from the CV cases. But to be honest you need to seek out the cases that have gtt titrations and learn how to successfully manage that unstable patient that can code at any second. Run those codes blues and push the drugs according the ACLS algo because as a future CRNA, your going to be the team leader and go to person when your patient finally decides to crash in the middle of a case. So developing that ability to cope in high stress situations and formulating a plan to stabilize your patient is your biggest priority. Once you can develop that kind of confidence and find yourself not being challenged by your unstable hearts then your truly ready for the next step - CRNA school.

LT CABGMAN

USAR SRNA starting 2004-Jun

Originally posted by Nitecap

I'd go cv, your dealing with all hemodynamics, swans, multiple vasoactive drips and more acute surgical patients.

I'm working in a 41 bed CV RR in Houston, it's great experience, planning on applying this Dec and by then I will be taking IABP and LVAD and RVAD pts no to mention heart and double lung tranplants. CV is more intense than say medical where you have a lot of chronic pt's on no drips and all you do in turn, suction and Clean do do, that is just not for me. Trauma may be ok esp if it's level I. Best of luck.

I work in a MICU and trust me, I don't just turn, suction, and clean do do. I work at a Level I trauma center where several of our MICU nurses have gone on to anesthesia school. In my MICU, we deal with Swans, tons of vents, lots of vasoactive drips, A-lines, and really complicated patients with several co-morbidities. So I'd check your facts before you make statements like that.

I love the MICU because I see a little bit of everything. Why would I want to work in a CVICU where I see the exact same thing every day? I like the variety that the MICU provides me, and I think it will provide a wonderful experience for anesthesia school.

I agree that a good MICU or SICU is going to give you great experience too. Most large hospitals will provide you with all the experience you need in any ICU. As long as you are getting vents, lines, gtts, and swans you can work in any unit. You will code patients in every ICU and in the Level I Trauma, Tertiary facility I work in the MICU/SICU get the sickest patients. So pick a unit that you find interesting and go with that one. Each person has their preference and I loved the MICU/SICU myself but know people who like hearts better. No one unit is better than the other for getting you ready. Best of luck.

EVERYONE'S INPUT WAS APPRECIATED. I HAVE BEEN LEANING TOWARDS CV BECAUSE READING AND INTERPRETING RHYTHEMS ARE INTERESTING TO ME BUT MY WEAKNESS RIGHT NOW. WE ALL KNOW THAT YOUR WEAKNESS HAVE TO BECOME YOUR STRENGTHS IN ORDER TO SURVIVE IT. I'VE DECIDED TO DO A SHARE DAY ON BOTH UNITS. THIS WAY, I'LL GET THE OPPORTUNITY TO ACTUALLY SEE WHAT'S GOING ON ( IN ADDTION TO ME WALKING ON THE UNITS TAKING SNEAK PEEKS ON MY BREAKS).

AGAIN, THANKS FOR EVEYONE'S ADVICE.

WISH ME LUCK. :imbar

Specializes in CCU (Coronary Care); Clinical Research.

Just wanted to wish you good luck...as far as intrepreting rhythms..you should get that in any ICU that you choose as all of your patients are on tele...however a Cardiac specific ICU you may have more patients coming into the unit with abnormal rhythms that you will treat using antiarryhthmics/TV pacers/cath lab experiences, etc more than you would in other units (at least in my experience)...

I have worked in cardiac medicine ICU with plenty of MICU patients too in the same unit. Currently I work in the Cardio Thoracic ICU with post CABG and Valve patients. I have definitely gained better experience here more than i ever did in medicine. I see swans, multiple vasoactive gtts, IABP, and vents. We see a lot of sick patients at this hospital. This unit is always requiring you to critically think and titrate gtts. It is very busy but I recommend CVICU. You have the blend of cardiac and surgical patients at the same time!! Good luck!!

GO CV! It will be worth it.

Update...

I posted that thread over 7 months ago...wanted to fill everyone in on my decision. I decided on SICU and I'm so glad that I did. Why?

Extensively Broad range of patients.. I take care of Trauma, fresh OR, Transplant, Neuro, ortho, vascular , gen surgery as well as cardiac. Mainly all our pateints , of course are vented. Already I've taken care of EXTREMLY sick patients with PAC, alines, multiple pressors/gtts , proning,TOF monitoring, ICP monitoring, CVVHD, ect..) Our docs often do many procedures at the bedside ( open bellies/washouts). Given a lot of our patients come straight from OR to us...I've been lucky to have a patient (several times) that required agressive fluid resusicatation and blood products. I'm just gaining great exprience and the more experinced nurses are absolutley wonderful. They LOVE to teach....and I pick their brains as often as I can. Also attended two very nice and informing seminars by Barbara Clark Mimms( Hemodynamic titration and also Ventilator Modes). So it's just awesome. I'm amazed how much I'm learning and actually have a true interest in it. I find myself reading SSSOOO much on critical care stuff.

SO anyway...Thanks Everyone Again.

Wish me luck...Take my GRE dec 9th

PS..As my initial post stated...I was told that the previous Trauma IMC that I used to work was comparable to the SICU....AAAHHHH..They were wrong! Bigtime. It's nothing like it. Acutiy is totally different. Glad I made the switch.

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