ICU Requirement: LTAC ICU

[ArmyTwin, CRNA]

Until a few days ago I knew nothing about Long Term Acute Care ICUs. But from what I've read I've gathered that these ICUs are cost effective ways of treating the most critically ill patients who have exceeded the funds/time available on their insurance policies. Therefore, the patients are transported from short term acute care (traditional) hospitals to a long term acute care hospitals. There is a LTAC hospital in my area and I will be interviewing soon for the ICU there. I have found little to no information as to whether the ICU in this setting is acceptable except for one school in Kansas which list LTAC ICU experience as acceptable. Most schools simply state 1 year of ICU experience is required....with no distinction...

If my patients in the LTAC ICU suffer from several complications and severe comorbidities and are vented, have multiple lines including PA Catheter's/Swan including pressors or vasoactives do you think my ICU experience will be acceptable? Do you know of anyone who was accepted to anesthesia school with this ICU experience?

Thanks in advance

[rrnr]

If your patients in the LTACHs ICU are as described (basically, sick and unstable) then I see no reason why it should not count towards the ICU requirements for CRNA school. However, the patients in the LTACH ICUs in my area are not like that at all. While they do have multiple comorbidities, they are not on pressors and are considered relatively stable. Pretty much the only reason we send patients to an LTACH is we haven't been able to get them off then vent, and even then, only if that is the only reason the patient is still in the ICU. The LTACHs here also regularly turn down patients because they are considered too unstable. With that being said, LTACH ICUs could be totally different elsewhere, that is just my impression of the ones in my area. I hope that helps

[ArmyTwin, CRNA]

If your patients in the LTACHs ICU are as described (basically, sick and unstable) then I see no reason why it should not count towards the ICU requirements for CRNA school. However, the patients in the LTACH ICUs in my area are not like that at all. While they do have multiple comorbidities, they are not on pressors and are considered relatively stable. Pretty much the only reason we send patients to an LTACH is we haven't been able to get them off then vent, and even then, only if that is the only reason the patient is still in the ICU. The LTACHs here also regularly turn down patients because they are considered too unstable. With that being said, LTACH ICUs could be totally different elsewhere, that is just my impression of the ones in my area. I hope that helps

Thanks for your response rrnr! So it looks like this ICU experience could be evaluated to ensure that I have gained the knowledge and exposure that CRNA schools are looking for. I just wanted to be sure that I wouldn't be automatically ruled out before I got a chance to interview and prove my (future) competence.

[wtbcrna, MSN, DNP, CRNA]

I think one of the important things about critical care experience is that you get experience taking care of as many patients as possible that are inherently unstable. With a LTACH ICU I would think that you are basically taking care of long term stable ICU patients.

[ArmyTwin, CRNA]

I think one of the important things about critical care experience is that you get experience taking care of as many patients as possible that are inherently unstable. With a LTACH ICU I would think that you are basically taking care of long term stable ICU patients.

Thanks so much wtbcrna! Also, with this type of experience other ICU doors may open for me...I'm extremely hopeful! :)

[wtbcrna, MSN, DNP, CRNA]

Thanks so much wtbcrna! Also, with this type of experience other ICU doors may open for me...I'm extremely hopeful! :)

I think if you cannot get a regular ICU job this would be a great start.

[ArmyTwin, CRNA]

Yeah, it's pretty tough in my current location.

[ArmyTwin, CRNA]

Update: So I have a few opportunities at my fingertips and I was wondering which position would be most beneficial if my ultimate goal is CRNA school.

Should I take the LTAC ICU position, a Tele RN position, or an ER position? (Tele and ER are at big hospitals)

I just don't want to get stuck in a specialty that won't help me get to a real ICU...

Thanks for any advice

[Go-GetterRN]

Its worth checking out, but i dont think that ltac icu will have pts on drips or with PA caths. I would suggest the tele position or even the ER in the large hospital because you could get some experience and then move to their ICU.

The LTACH would be decent experience to prepare you for icu because you would get experience with vent settings.

[icuRNmaggie, BSN, RN]

That is a tough decision. I would suggest taking a position in a large teaching facility over an LTACH because of the opportunities to transfer into other areas.

The telemetry position will give you an opportunity to build a knowledge base and open doors for you to transfer to many specialty areas.

[ArmyTwin, CRNA]

Ok, so I was leaning in the Telemetry direction myself because of what I've read...that Tele is like an ICU Stepdown. I'm kind of an amateur when it comes to other specialties/floors because my first job after nursing school was in the OR. I have no floor experience...I love the OR but...there is so much more that I would like to accomplish.

[icuRNmaggie, BSN, RN]

On a telemetry unit or progressive care unit you will see a lot of CHF, strokes, patients pre and post cardiac catheterization and a ton of other patients who bear close watching. You will learn to give certain non titratable drips such as integrelin, angiomax, diltiazem and amiodarone. You may be trained in Ultrafiltration for CHF patients. You will learn about non invasive ventilation with BiPAP, arrhythmias and a thousand other things. All skills you can put on a resume. They may even send you to a critical care course.

It is a great place to start a career.