Tips for getting into ICU for experienced RNs

[ProgressiveThinking, MSN, CRNA]

Hello!

I recently had an ER job offer, then the employer offered me an ICU position, but ultimately I didn't accept it because I heard A LOT of bad things about the hospital (the agency I work for said multiple travel RNs request to never be sent there ever again). I REALLY want to work in ICU, but this particular hospital just didn't feel right since its had a lot of financial trouble in the past and has a pretty high turnover rate. It's gone bankrupt twice within the past ten years. It's also a very small and basic ICU with medicine and surgical patients only (no neurosurg/vascular/traumas/STEMIs). It does have vents, a-lines, central lines, and pressors though. My old classmates, nursing instructors, and coworkers told me NOT to go there. It is an older dilapidated hospital, but for some reason I feel like I'm passing up on a legitimate shot into critical care. I REALLY was considering sucking it up for a year just to get experience, but I wasn't sure if leaving the VA (veterans hospital) and losing my benefits for mediocre experience was worth it.

My plan is to start applying into other hospitals ICUs since my current hospital hires experienced ICU RNs only. No in house hires without experience. period (weird I know-everybody on my unit complains about it). I preferably want to get into trauma certified hospital. I currently work in PCU and have 2.5 years experience. I float to ICU sometimes to take care of PCU overflow and stable ICU patients. I just started a per diem that usually hires in house for critical care.

What are some things I can do to make myself a better applicant? Would getting my PCCN be helpful or irrelevant? Should I take a critical care course on my own? I already have ACLS and BART (it's required by my current job). I have shadowing at my current job (I float to ICU all the time). I will ask to shadow at my new per diem as well. I fear that a lot of employers will see me leaving the VA as a red flag since benefits are awesome. I'm just kind of bored there and there's no growth.

Thanks!

[emb92250]

I think your basic idea of getting hired into an ICU position at a different hospital is a good idea, but I wouldn't sacrifice and go to the hospital with high turnover and rejected by travelers. I'm a traveler, and we don't go to hospitals with bad reputation either. Even for a 3 month assignment, it's not worth it. (Which hospital, btw, so I can avoid? lol)

There are plenty of reputable hospitals that would love to hire an experienced PCU nurse (that is step-down, right?). Depending on your living situation, you could sacrifice and go to a hospital further away from home, suck up the commute or get a cheap apartment in that area, and commute back home during your time off. There may be tax benefits that could help you save on taxes since you would be incurring duplicate expenses for work. Once you get a 6 months to a year of experience, you could try applying to the hospital that only accepts applications from experienced RNs.

Another thing that could beef up your resume is getting your CCRN (critical care certification). It requires 1750 hours worked in a critical care area with 900 from the last 12 months, and step-down units are considered critical care. Some of the ICU specific questions are going to be tougher for you (i.e. ventilator settings and terminology and troubleshooting) but as long as you understand ABGs and have a good amount of studying/critical thinking, I think you would do ok. I just took it and it was surprisingly easy. I recommend "Pass CCRN" and the books put out by AACN, "Core Curriculum for Critical Care Nursing" to learn the content and "AACN Certification and Core Review for High Acuity and Critical Care" for question practice. You should check out my post about CCRN if your are more interested. Just search CCRN and it'll pop up from a thread titled "CCRN."

Good luck!

[ProgressiveThinking, MSN, CRNA]

I just got an ICU offer at a large teaching facility. I'm taking a $10/hour pay cut (which brings me down to around market average), but it has comparable benefits, and will provide excellent training. I work so much OT and agency that I think I'll hardly feel the difference. Does it kind of suck that I'm leaving an AWESOME job with AWESOME coworkers (we have our toxic people too of course), and AWESOME benefits? Sure does. BUT, I think ICU at a legit trauma center will open up a lot of doors for me in the future, plus it's pretty much the specialty that I've always wanted to work in. It's going to be weird going from the person that people ask advice from to feeling like a new grad.

Some of my coworkers joke around saying I'll probably come back to my unit with my tail tucked between my legs...Oh well. Guess there's only one way to find out !

[Lev, MSN, RN, NP]

I'm leaving my Med surg job where I have awesome coworkers for a job in the ED at a different hospital. I know how you feel. I've heard good things about this ED from someone who had her practicum there. I hope my observations about the department and the manager are correct.

[Ozzy84]

I know it's not the topic to discuss here maybe but u saying step down can apply ccrn certification. But most people saying step down is not eligible to take ccrn instead they need to take progressive care rn certification. I will start to work GI surgical step-down and I really wanna get ccrn since I wAnna go to anesth school.

[mcubed45]

I know it's not the topic to discuss here maybe but u saying step down can apply ccrn certification. But most people saying step down is not eligible to take ccrn instead they need to take progressive care rn certification. I will start to work GI surgical step-down and I really wanna get ccrn since I wAnna go to anesth school.

You're gonna have to work ICU a couple years before applying to CRNA school anyways so you can get your CCRN after you've finished your first year.

[Ozzy84]

You're gonna have to work ICU a couple years before applying to CRNA school anyways so you can get your CCRN after you've finished your first year.

Do u think step down gi surgery unit eligible for ccrn?

[Lev, MSN, RN, NP]

Do u think step down gi surgery unit eligible for ccrn?

Yes, since it is considered "acute and/or critical care."

Do u think step down gi surgery unit eligible for ccrn?

Won't count for getting into CRNA school, though. Getting into CRNA school is about the ICU experience, not about having the CCRN cert.

[Ozzy84]

But at least if I get icu certification, than it would be easy for me to transfer icu. And apply crna school

[whofan, ADN, BSN, RN]

I started on med-surg/stroke unit, and after 15 months got accepted into my hospitals' fellowship for ICU. It was 13 weeks long and provided enough training to make me feel like I was not lost when coming out on my own.I feel know after being on my own for 2 years that I am just feeling comfortable and able to feel competent even though I know there is tons I do not know. My hospital likes to hire from within because they don't have to teach how to be a nurse, but only what to look for in the new area. The experienced med-surg nurses already should have good time management and able to talk to patients and families. It seems that some hospitals that only hire new grads are missing out on a good resource within their own walls. My employer does hire a group of new hires every year but their training is 6 weeks longer. We do have a great mentorship and teamwork as well so even when you are out there you are never alone.

[PacoUSA, BSN, RN]

I started on med-surg/stroke unit, and after 15 months got accepted into my hospitals' fellowship for ICU. It was 13 weeks long and provided enough training to make me feel like I was not lost when coming out on my own.I feel know after being on my own for 2 years that I am just feeling comfortable and able to feel competent even though I know there is tons I do not know. My hospital likes to hire from within because they don't have to teach how to be a nurse, but only what to look for in the new area. The experienced med-surg nurses already should have good time management and able to talk to patients and families. It seems that some hospitals that only hire new grads are missing out on a good resource within their own walls. My employer does hire a group of new hires every year but their training is 6 weeks longer. We do have a great mentorship and teamwork as well so even when you are out there you are never alone.

I am one of those experienced nurses that also wonders why so many new grads are taken right into ICU over experienced nurses. So many ICU jobs out there want either new grads or ICU experience only (usually says ICU or crit care experience preferred but with market saturation the odds without this seem slim). I don't understand why an experienced un-specialized nurse would be looked over. I say boo to the 'breaking old habits' excuse.

I have almost 3 years med surg tele and cardiac tele experience and I'm also a current traveler. Once I'm done with travel I will likely have about 5 years experience and will want to seek a staff RN ICU position then, CICU or CTICU preferred. By that time I would like to have my CCRN certification too. Some say I would be ineligible to take this exam but others say I would not. I'm guessing the certification would make me more marketable and not a deterrent.

Sent from my iPad using allnurses