How did you become a Critical Care Nurse?

Specialties MICU

Published

Ill be finished with my ADN within a year. My only experience by then will be 3 years as a private duty nurse (LPN) with a medically fragile pediatric patient (trach, gtube, nebulizer) Some hospitals somewhat near me still hire adn RN's. I would like to begin getting critical care experience while working toward my bsn. I cant find any new grad orientation or critical care training programs or anything. I guess my best bet is to get into a hospital and get med surg experience? Even if I do that, how would I transfer to SICU?

Help a future CRNA please.

Of course SRNA4U I believe you completely and I'm so glad you guys are here to give me such great advice. I'm thinking now what if I would of thought it was better, in order to show passion for nursing and my will to advance. Im so glad that wont end up happening as you guys are right i will not get hired! Do you have advice for me specifically landing in a SICU unit? Do you think mentioning that would raise red flags? I hope not. I feel like I really need to land in SICU over other units in order to be more competitive. I'm hoping to ace my sciences but I'm worried a little about ending up with B's in sciences maybe even having to retake a C grade class and end up with a B. I'm studying chemistry, organic and inorganic chem now because I feel like it will be my weakness. I'm like 1-2 years away from taking these prereqs (either will take them after my bsn or during, which im doing online)

Up Vote Up Vote ×
Specializes in Nursing Education, ICU.

I agree with you UltrPosh--the ICU is where you should try to get to. For the CRNA programs I know of, critical care experience is a must (obviously there may be exceptions to the rule!)

For what it is worth- I think being a LPN is actually in your favor. Some of my strongest, most mature and professional students were LPNs. And they would be a tremendous asset to any unit. Also saying that you are planning to go back for your BSN shows your "will to advance" and will be attractive to many hospitals because they are either Magnet facilities or are pursuing Magnet status.

But as you've heard from other posters--mum on CRNA school. Get into the unit first, get your BSN then go from there! GOOD LUCK!

Up Vote Up Vote ×

Thanks for your kind words Janet. BSN def I will mention. The hospitals near me really only hire bsn rn's and those are the best hospitals. There are a few that hire adn nurses but all of them mention (bsn preferred) and also require you to enroll for your bsn within a certain time frame, usually 6 months. I plan on enrolling immedially after adn. So I agree they will want to know about bsn but not crna! And yes icu exp is actually required for ALL schools. I don't even think I'd bypass icu if I could. Theres a good reason why its required and 3-5 years is preferred. I am aiming at entering a program after 1 year! Thanks again Janet. Nice to see people praise LPN's!

Up Vote Up Vote ×
Specializes in ICU.
I just don't see why they would have a yearly new grad program if it costs that much. Maybe this "fellowship" is not paid

Just saying - it costs a lot more when your new grads kill people because they don't know anything. I'm saying this as a new grad. My hospital said that it usually cost over $100,000 to train a new grad in ICU, but it's definitely better than skimping on training and not having your new grad recognize an expensive complication that results in a sentinel or never event. $100,000 can be cheap compared to those kinds of things.

Up Vote Up Vote ×
Specializes in Anesthesia, ICU, OR, Med-Surg.
Just saying - it costs a lot more when your new grads kill people because they don't know anything. I'm saying this as a new grad. My hospital said that it usually cost over $100,000 to train a new grad in ICU, but it's definitely better than skimping on training and not having your new grad recognize an expensive complication that results in a sentinel or never event. $100,000 can be cheap compared to those kinds of things.

That seems a little far fetched. New grads in ICU don't kill patients, which is why they work with an assigned preceptor. They definitely don't work alone and ICUs now have fellowships or training classes which offer didactic education paired with a preceptor for the clinical component. I have never heard of a new grad the killed a patient while in the ICU....granted if it was hapenning frequently we would definitely hear about. I will tell anybody, you know what your goals are and go for it. There are a lot of people I call Dream Killers in the nursing world who are very jealous when someone states they have a desire to go to ICU or to become a CRNA. Some people may feel they are not as smart to apply to an anesthesia program or sometimes life may have prevented that person from being able to apply to an anesthesia program so what they do is hate on and make it difficult for others who are trying to go to anesthesia school. If your passion is CRNA, then by all means...go for it. Since we know there are dream killers in the nursing profession, I just wouldn't broadcast what my goals are to everybody. I have seen it time and time again as soon as someone says they want to go to CRNA school, you will be amazed how your so called friends in the ICU and other coworkers will turn against you, some will hate you, etc. It's a shame that some people can't be happy for their fellow nurses, which is why nursing is not always the true profession it claims to be. When docs are in medical school, when they know they want to be an anesthesiologist or a surgeon, you don't hear about their classmates getting mad at them because they chose a certain specialty. Nursing on the other side is totally different. We don't act like the true professionals we should in regards to celebrating each other when we want to pursue higher education. Heck...I used to see it about 10 years ago when it was really bad when ADN and diploma nurses used to hate on those of us who had a BSN or who were pursuing a BSN degree. Well what do you know...many states are requiring a BSN by certain deadlines in order for ADN and diploma nurses to continue practicing in certain states.

Keep your head up and go for it. Smile and just share it with your true friends.

Good Luck!!!

Up Vote Up Vote ×
Specializes in ICU.

Good points thus far. New grad residency spots are a significant investment for hospitals. They often require you to sign a contract to work for 1-3 years in order to get SOME return on their investment.

I believe the absolute best way to prepare for CRNA school is to be the best ICU nurse possible. Focus on the task at hand. You'll have to look into residencies as some may not consider LPN->ADN a new grad. Our hospital has a Critical Care float pool, and the ICU hires from there 99% of the time.

Up Vote Up Vote ×

If you are still in school, I would try to get a job as PCA at the hospital that you would like to work for, preferably in the ICU if you can. I am speaking from personal experience. I worked as a PCA on an ortho floor, did a good job with that and had a year in the hospital system. I also did a ICU preceptorship during my last semester in a SICU, within the same hospital system that I worked for. Once I had graduated I applied for 2 SICU positions in my hospital system, one of which is where I precepted my last semester. I ended up with two offers in the SICU. I believe I got the two offers were because I had already worked for the hospital system as a PCA with a good annual review and I had a contact (my preceptor) in the SICU who could vouch for my work ethic and critical thinking skills. And whatever you do, do not mention CRNA school. Good Luck :)

Up Vote Up Vote ×

SRNA4U, I am currently an OR nurse with aspirations of someday becoming a CRNA. I have no critical care experience so I will have to apply for a position in an ICU someday. You mentioned your friend being an OR nurse, how did your friend transition into the ICU from being in the OR? Did he have other experience than just OR?

Thanks!

Up Vote Up Vote ×
Specializes in Anesthesia, ICU, OR, Med-Surg.

Hi Edel524,

I was in your boat...I was an OR nurse. Since I was active duty Air Force when I was an OR nurse, I ended up going through a Critical Care Fellowship to get my ICU experience. Even though I am in CRNA school now, I still moonlight as an OR nurse PRN. OR nursing is one of a few specialties that still have 4, 6, 8, 10, and 12 hour shifts available. I work 6 hour shifts 1-2 days a week and I'm still maintaining a 4.00 GPA in CRNA school. I worked med-surg for 6 years then I went to OR school in the military where I was moonlighting as a med-surg nurse while working as an OR nurse. When I went to the ICU, I still had my bedside patient skills from working med-surg and it was a seamless transition for me.

Most of my classmates find it hard to work prn because ICU nurses have to work 12 hours shifts whereas I just do a 4 or 6 hour shift. Been in the OR now for 11 years and it is paying off for me in anesthesia school snce we already know the surgical cases, the OR flow of things, and positioning. When we covered positioning in our class lecture, my Program Director actually had me assisting to teach the class. Some of my classmates are voicing their frustration with clinicals because the OR is so fast paced and they're not used to the environment and the tough talk from CRNAs and surgeons. Couple of girls in my class told me they were crying driving home from clinicals because of their preceptors and the surgeons. I'm definitely used to the various personalities in the OR. I havent told any of my preceptors that I am an OR nurse. I'm just going with the flow. I check my anesthesia machine in the morning, interview my patient and document the preanesthesia assessment, start my IV and place an a-line if needed and roll back to the room with my patient and start my induction. Anesthesia is the best job in the world and I can kick myself for starting so late. I'm 40 years old and most of the students in my class are like in their mid 20s but since they really dont have much nursing experience, it's getting them in clinicals. They are very smart in class with good grades but if you can't transfer the volume of information we learned in class and apply it to the patient, what good is the great GPA. Some of them I really wonder how they are going to make it...they whine and cry at every little thing. There are about 6 of us over age 35 with a great amount of nursing experience and we're doing really well clinically. My first day in the OR the anesthesiologist allowed me to place an a-line even though we haven't covered the lecture yet for placement of them. I used the Glidescope to intubate my patient and it was awesome.

Best piece of advice is to get your ICU experience and do the 2 years requirement that most schools are requiring. If you have med-surg experience, ICU will be a good transition for you. If all you have is OR experience, it can be a little challenging. One of my fellow OR nurses went to the ICU and she only had OR experience and they actually had to extend her orientation. She didn't have a lot of confidence but eventually she was able to graduate the critical care program and is now on her own taking care of patients. Also, I wouldn't mention to your ICU nurse manager that you are planning to pursue nurse anesthesia since it is an investment on their part to train you in the ICU and most managers won't hire anyone who they know is no t going to stick around for a while.

Up Vote Up Vote ×

Thanks SRNA4U! That is great advice/insight. It sounds like CRNA school is going great for you! I actually have 8 months L&D experience and almost 2 years of OR so there will definitely be a learning curve if I do go the ICU route!

I love the OR atmosphere but even with only 2 years experience I feel like I am plateauing and getting bored. I have to say that when we bring patients to the ICU from the OR I am amazed (and even a little jealous) of the knowledge and skills that ICU nurses have! I am just a little nervous about what a huge transition that will be.

I am at a point in my life where I'm getting married next month and if I want to pursue this dream I need to do it now before the talk of children comes up :)

Thanks again for the response!

Up Vote Up Vote ×
Specializes in Critical Care at Level 1 trauma center.

I started as a new grad in the ICU. I applied at a level 1 regional trauma center and I flat out told them that I was ultimately wanting to do advanced practice (CRNA). Were I work there is an understanding that most people there are going to be in the ICU for only 2 or 3 years and they accept that. During my hiring process they told me that as long as they give them my best effort for the time I was there they would help me to attain my educational goals. I realize that this is most likely the exception but at my facility we have a 99% employee satisfaction rate and a big part of that is because they are so big on pushing their nurses to go far in their education. They even give us up to $10,000 a year in education compensation. I would definitely recommend following the advice you have been offered here because my situation is by no means the norm. I just wanted to share my experience and tell people that there really are some stellar facilities out there who invest in their nurses and promote the advancement of the nursing profession.

Up Vote Up Vote ×

I was unbelievably lucky. Graduated an ADN program and received my license just a month ago. I was one of the last ADN nurses at my hospital (worked a desk job there while in school) to be grandfathered in (BSN now required for all new hires). I applied for an ICU opening, went down there unannounced and hand delivered my resume to the nurse manager. Got an interview the next day and was hired on the spot, at a level 1 trauma center in NYC. Planning for CRNA school in the future myself. Sorry I sound like I'm bragging - I just realize how hard this is and never expected to get right into the ICU, let alone on the first interview.

Up Vote Up Vote ×
+ Add a Comment