Best floor for experience prior to ICU

[sedation_season]

Hello everyone -

I will be entering my senior year in a BSN program shortly. My hope would to be to get into an ICU right out of school. However, I plan on working in a large, level 1 trauma hospital (where I'm currently a nurse tech at), and they do not hire new grads. I was wondering what floor (that typically hires new grads) would be the best to prepare for an ICU job in about a year or so. For example, CPCU (where I work now), PACU, ER, if they even hire new grads?

I would like to do my preceptorship for senior year on the floor I decide to work on after graduation. I know experience on any floor would be super beneficial before entering critical care, I was just wondering some opinions.

[wanderlust99]

PACU is critical care. I don't know that I'd recommend PACU as a new nurse. Most PACUs like you to have some ICU experience. Do a preceptorship in an ICU while you're in school....you will learn the most skills IMO, even if you can't get a job in an ICU after school. You will learn a lot. As for floors, a tele floor would be good or a surgical type floor would be busy and would get you comfortable with post op patients.

[blucrna]

Pacu can have some pretty unstable pts but most institutions don't consider it very much of a critical /intensive unit . That's why most crna programs don't accept it as experience.

[MaMaMia1016]

in my experience, pacu nurses are critical care nurses, esp if you are working in a large city hospital. i work in ICU and we frequently have ICU overflow in our PACU. They can manage everything we can.

[RNforLongTime]

At my facility if a pt is on a vent, they don't even SEND them to the PACU, they bring em right on up to me in ICU. The PACU nurse at MY facility isn't quailfied to monitor the vent pt whatsoever. I however am. In general, I'd say a PACU qualifies as critical care.

IF you want floor experience before getting into ICU, I'd say get a position on a cardiac tele step down type unit. Get familiar with EKG's, arrythmias and what not as it's SO helpful to already have that knowledge prior to getting to ICU. One less thing to be overwhelmed about!

Good luck to you!

[jelly221,RN]

The PACU/critical care thing seems to be a matter of opinion, from what I've found in my research on the matter...I have found professional sources that say that it is critical care. However in terms of experience for CRNA school, it sounds like it's not the way to go anyway, so the point is moot.

As for whether a medical IMCU or cardiac IMCU being better experience for a trauma ICU, it seems like it's probably six a one, a half a dozen the other. Neither deals DIRECTLY with trauma- CPCU is obviously all cardiac, while an MPCU would be everything medical under the sun. Renal failure, COPD exacerbations, CHF, diabetic decompesations and complications, infections, and way too many conditions more to list here.

Good luck!!

I work on a Cardiac DOU, and while we get a LOT of MIs, CHF decompensations, open hearts around day 3, post-cath lab (about half with A-lines), etc., we also get a fair amount of the types of patients you listed for MPCU. A LOT of cardiac patients have renal dysfunction, and when they're as sick as ours are, many end up on at least acute dialysis. COPD & DM go hand in hand with cardiac disorders, so I get pts all the time on BiPAP as a last ditch to save them from being tubed, and often DM (usually HHNS pts) who should be on insulin drips (our facility requires insulin drips be in ICU d/t hourly glucose checks). Also, think about the wide variety of things that can masquerade as chest pain- lots of GI things, especially. We seem to have had a lot of psych-type pts lately.

Honestly, I'd say go for a cardiac stepdown, even though you don't want to do a CVICU/CCU- like some other posters have said, the experience you'll get in reading rhythms & ACLS will be very helpful in any ICU.