ICU in community hospital or Stepdown in academic hospital - page 2

Hi to all ICU RN's/CRNA's, I'm a new grad with full-time immersion experience in the ICU and am hoping to become an ICU nurse, and possibly a CRNA one day. I know that I'll need to get... Read More

  1. by   SEWRN
    Congrats, pink4! Sounds like you got yourself a plan! If you feel confident enough though, maybe you can even start immediately in the ICU so that time counts for the requirements to apply for CRNA school =) Also just an FYI, by the time we apply to CRNA if we are to, the CRNA programs would be converted to DNP programs rather than MSN. Just something to think about as you mentally prepare yourself for that =)
  2. by   pink4
    I do feel like I'm confident enough but let's just say my ICU mentors really are pushing me to do the floor first... I really dont want to but they promise me it will make a world of a difference in time management and skill set.. So we will see!

    The university I'm looking at has a dnp program after the msn program but I sure would be happy to skip msn and go straight to dnp like some schools are already doing it!
  3. by   pink4
    I def know though as soon as I hit my 1 yr mark in ICU I will start applying! The worst they can say is to reapply next year!
    What schools you looking to apply SewRN? I'm in Houston, TX so I only have 2 options! Lol
  4. by   SEWRN
    haha pink4, i agree. once i hit my 1 yr mark, i'll start applying if i feel comfortable enough. by 2015, all msn programs must be converted to DNP so there won't be a master's crna program by then. i'm in illinois, so i'm fortunate to have 3 schools close enough =)
  5. by   pink4
    Yay!!!! Its the DNP status nationwide??? I was looking in aana.com and didn't see anything about that? Can you point me to an article or something that says exactly who this applies too?? oh I'm soooo excited!!!
  6. by   pink4
    Never mind I see now.. It states in 2015 the change needs to start, and be in full effect by 2025.. Hmm... Interesting!!!!
  7. by   SEWRN
    Hi pink4! Was just reading this thread as I'm possibly starting crna school next year. Wondering if you ended up applyingand what you're up to now!
  8. by   ghillbert
    Don't plan on CRNA when you start. That's a good way to annoy your colleagues. Plan on becoming the best stepdown/ICU nurse you can, and gaining skill in managing sick ICU patients. Go where the patients are the most acute. You need AT LEAST a year (but preferably more) of acute hemodynamic drip management to be competitive and successful as a SRNA. You will hopefully have a long career - a year or so "delay" will be nothing in the scheme of things, especially if you're learning things.
  9. by   SEWRN
    That is what I focused on--to be a good ICU nurse first before anything else. Fast forward 5 years, I'm accepted to two programs for 2018 that I'm trying to decide between. Didn't think I would make it in either and didn't think I'd have the problem to have to choose! It is a good problem to have though!
  10. by   tofu81
    Sewrn, I am in a similar situation as you. I'll be finishing up my BSN and my long term goal is CRNA. I'm torn between the ICU at my current small community hospital or going to a level 1 trauma hospital thats bigger with more complex cases. I'm curious how it all worked out for you now that it's 5 years later. Did you end up staying at the community hospital the entire time? Looking back what would you do differ or same? Any other advice or feedback would be appreciated. Thx.
  11. by   ICU-BSN
    I had a similar dilemma when I finished school. I felt more drawn to the stepdown offer because of the manager, whereas the ICU (small community hospital) manager did not give me good vibes, at all. In the end though, I knew I wanted to be in an ICU so that's the offer I took. I did my time at that facility and eventually moved on to a large level 1 academic facility. While I was definitely spot on with feeling a lack of good vibes from the manager, having ICU experience opened many doors for me when I was looking to move on.

    If ICU/CRNA is your goal, take the path of least resistance towards that goal. In a year you can apply to that academic facility ICU.
  12. by   SEWRN
    Hi Tofu81,

    I ended up taking the ICU position in the community hospital because as others have advised, it counts toward my ICU experience. I left for a level 1 teaching hospital about a year later. Although there is definitely a difference in acuity between the ICUs in the two hospitals, I'm glad I initially took the ICU position over the stepdown in a teaching hospital--the ICU at the community hospital still had very sick patients at times, and still had a lot of vents, drips, etc. that opened my world to the ICU. I was definitely more prepared by the time I went to the ICU at the teaching hospital. Also t havthere is some truth about having more autonomy in the community hospital because you don't have residents at your fingertips.

    As ICU-BSN stated below, take the path of least resistance to the ICU. Get your foot in the door to any ICU (community or teaching) and transfer when you find yourself ready for more challenging, complex patients. Teaching hospitals do take into account that you already had exposure in an ICU, and will be more willing to take you on into their ICU.

    I also saw your post regarding minimum ICU experience. I also asked that question and was hopeful to apply at the 1-2 year mark. However, after starting in the ICU as a new grad, I wanted to focus on being the best ICU nurse that I can be, and placed CRNA plans temporarily in the back burner to focus on where I needed to be -- to learn critical thinking, care compassionately for these really sick patients, manage complex patients, learn new technical skills, multiple drips, etc.

    At some point, I realized while it is good to have a plan, focusing on the "time" required was a bit irrelevant as people learn at different paces. Most people don't start feeling "comfortable" as a new nurse in the ICU (or any area) until they reach the 2-year mark. At that point, you are just getting your feet wet and actually understanding what you're doing. I didn't feel comfortable taking the plunge until recently after my 5 year mark, and made it into 2 schools in my area. Could I have applied and tried earlier? Yes. Would I have successfully completed a program? Probably so. However, not gaining enough experience/knowledge & critical thinking in much needed areas, and applying/entering too soon might have been done at the expense of my patients' safety when I become an SRNA/CRNA.

    While I wished I applied a little earlier due to time's sake, I'm glad I waited until I felt like I got the ICU nursing out of my system. In short, focus on your learning & development, and being the best ICU nurse you can be; and the timing will work itself out. You'll know when you're ready.

    Hope this helps. Let me know if you have other questions. Happy to help.
  13. by   tofu81
    Thank you so much. I appreciate your sincere feedback. I'm greatful you replied... as I was curious how it all worked out for you since your post was from so long ago. Best of luck to you!

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