CICU Step down or Operating Room?

  1. I am an aspiring nurse anesthetist. I will be an RN in December of this year. I currently have a dilemma. I have two job offers for a nurse extern position at two different hospitals and in two very different specialties. One is a cardiac ICU step down/telemetry unit and the other is in the Operating Room. I know, very different floors. I know that for most anesthesia schools they require ICU experience and I figure that the telemetry floor is a step in the right direction. However, I have talked to an Anesthetist in the OR during my clinical experience who said he went straight to the OR after nursing school. He said he would recommend OR experience because he was very familliar with all the drugs and that was an advantage for anesthesia school. I don't know what to do, what do you all think?
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  2. 14 Comments

  3. by   cathys01
    You cannot get into a CRNA program without ICU experience. If I had to choose between the two offers you've received, I'd go for the cardiac ICU step down, then move to the ICU (or skip step-down and try to get into the ICU off the bat).

    There are many anesthetists out there who did not have previous ICU experience, but they went to school before the current rules were put in place. OR experience will no longer get you into CRNA school.
  4. by   BULLYDAWGRN
    This is the way I see it. You have to end up in a icu sometime in order to get in crna school, right? Go ahead and get into the icu, you'll have way more exsposure to caring one on one with sick pt's, meaning more interactions with vassoacting drugs and even the same paralysis agents they use in the or. You'll definitly get more hands on vents and hemmodynamic monitoring than you would otherwise in the or. Sure being in the or has it's plus, but you'll certainly learn more in the unit to prepare you for crna school. And as stated before it's required, so why wait...
  5. by   cathys01
    Take the step down experience...or get into an ICU as soon as you can. OR experience will not get you into CRNA school.
  6. by   cathys01
    **This is my third attempt at a reply, the two previous ones appeared to post, but disappeared upon refresh**

    Take the step down position, or try to get into an ICU (ICU experience is required to get into CRNA school). OR experience will not get you into a CRNA program.
  7. by   gasgalcrna
    Cannot get into Anesthesia school with only OR experience. I would go for the ICU and get as much experience as you can with lines and hemodynamic monitoring.

    T
  8. by   cvicu80
    Hello,

    If it was me I would take the CICU step down position. You will get more experiences with lines, drips, and ventilators. When you get out of nursing school you will be able to get into the CVICU alot easier to. Wish you luck!

    JC
  9. by   MethaneMan
    ICU experience. Do not even mess with OR or stepdown. I have always been a big believer that if you want to work ICU, get an ICU job...or in this case, if you want to go to CRNA school, get an ICU job. It is the gold standard for the experience requirement.
  10. by   OURN83
    Thank you for your replies. Trust me, I would love to get into the ICU immediately. I have applied at every hospital in the city for that position. Unfortunately my lack of hospital experience is a major hindrance in the selection process. So my choices are very slim. I am pretty much taking what I can get and it just happened to come down to operating room and CICU step down.
    I think you all have helped me make my decision! Thank you very much.
  11. by   japaho41
    Quote from OURN83
    Thank you for your replies. Trust me, I would love to get into the ICU immediately. I have applied at every hospital in the city for that position. Unfortunately my lack of hospital experience is a major hindrance in the selection process. So my choices are very slim. I am pretty much taking what I can get and it just happened to come down to operating room and CICU step down.
    I think you all have helped me make my decision! Thank you very much.
    No, it is not lack of experience many ICU's only get new grads applying to working there depending on where you are at. If there are no jobs in your area branch out, they are there trust me. Even if you had to move to work in an ICU would be more beneficial in the long run then wasting time in a step down if you plan to go back to school.
  12. by   medulla
    Hey, I was in your same boat. I have always wanted to be a CRNA and worked very hard at getting myself in position to become one. Its difficult when the doors to an ICU aren't opened to you because you are a new grad and the managers don't know you because you weren't a CNA on the floor or unit clerk or some other ancillary position that seemed to help new grads get hired over me, grrrr. Anyway I ended up taking a job in a Telemetry step down unit, as a new grad, and it was a great experience. Don't let anyone tell you it is a waste of time to gain experience on a tele unit because quite frankly new grads need to learn how to time manage and develop tasking/technical skills before learning everything required to be an effective ICU nurse, in my opinion. I worked in a tele unit for two years and I learned a lot. Then I got a job in a CVICU, worked there for a year, applied to CRNA school and got accepted all at the age of 23. So the experience gained on a tele unit will make you more comfortable in an ICU and will help the transition to CRNA school. But I only know what worked for me. Do whatever you like.
  13. by   DIGNOUT
    Quote from japaho41
    No, it is not lack of experience many ICU's only get new grads applying to working there depending on where you are at. If there are no jobs in your area branch out, they are there trust me. Even if you had to move to work in an ICU would be more beneficial in the long run then wasting time in a step down if you plan to go back to school.
    I agree ICU experience is imperative and a qualifier for most anesthesia programs (with the ER accepted at *some*). I went to the CICU directly as a new grad and it worked out well for me.

    We might want to avoid the use of "wasting time" as describing any nursing experience, however. It may be a beneficial stepping stone for your particular situation, and who knows? Something may come down the pipeline sooner than you think.

    Just a thought.
  14. by   MethaneMan
    Quote from DIGNOUT
    We might want to avoid the use of "wasting time" as describing any nursing experience.
    I don't have a problem with "wasting time" being used to describe a clinical experience other than ICU for an aspiring crna student. It is the man's or woman's opinion. If time is of the essence for the individual then, in fact, time is being lost if application prerequisites are not being actively pursued.

    Look, ICU work is not brain surgery or rocket science (as the saying goes). It is demanding, requires attention to detail, and (here we go again) in my opinion usually attracts nursings best and brightest. If you want to be a crna, then you damn-well better be among the best and brightest. So, if that is certainly one's future, then the ICU should be no problem.

    As well, if you are pursuing an ICU gig for the hopes of landing a coveted crna school seat, you should be looking for a high profile trauma center/teaching center gig. As most of us know these places are usually into gaining Magnet nursing status if they don't already have it. That being the case, the inexperienced ICU new hire will be going through a comprehensive orientation process. Again, for the sharp individual, this should suffice in preparing a nurse to be at least average starting out. I have worked with many ICU nurses that have made a career of being average and there is nothing wrong with that. I say all of this with the background of a six year ICU veteran and will be starting crna school myself this fall. Here it is...my final opinion...go find an ICU job if you are sharp, motivated, and focused on becoming a crna in a timely fashion!

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