Why SICU??

suzanne4, RN · Jun 19, 2006

it depends on the facility and the types of patients that they get, the more complex the better. If you think about it. The more pressor experience the better. Balloon pump experience, etc. also adds in to the equation.

The nurses that I have seen get in the easiest were the ones that had at least one year of a busy CVICU.

dfk, RN, CRNA · Jun 19, 2006

hey greg, IMHO, sicu is great b/c u get a variety of just about everything, especially vents and pressors.. especially post op issues.. even a busy MICU is good too.. my only issue with cvicu is the routine.. yea, you get great heart/pump/pressor experience, but hell, people nowadays are extubated/de-lined/ambulating 24hrs post-op.

i work in a level I nyc trauma sicu.. for me, i learned more in my first two months than i would have should i have stayed upstate at my level II icu.. pa's and cvp's are very routine.. and the vents are rather common as well. sepsis, complex surgery cases, vascular, trauma, etc... i don't think i would have made it as soon if i didn't make the move downstate. i even get great neuro cases as well. with that said, i would definitely recommend as diverse/critical and as much experience.. interviewers love it and it's also great to hear that "you have great clinical experience" - -

enjoy !

heimanb · Jun 28, 2006

Yes, I've always heard that SICU is preferred in many cases because of the diversity in experience you can get. For example, take a MVA with spleen lac, frontal lobe brain contusions, and perforated bowel. Comes back direct from the OR post-exploratory lap with splenectomy, hyperventilated via the vent to control ICP, and develops a tension pneumo five minutes after arrival to the unit. Surprise! Time to put in a chest tube. And are those pupils equal? Better get neuro down here, get ready to push some mannitol, looks like they gave too much fluid in the OR. Then in a day or so they patient is in full-blown ARDS and getting septic from the bowel perf. Time to put in a Swan. The nurse is making multiple vent changes, tweaking some vasoactive drips to control BP, maybe if this patient is very unlucky they will progress into renal failure and require CVVHD. This is just one example, but pretty common in the surgical/trauma unit I work in. Not to mention the familiarity you get with the nursing care required with different operative procedures.

skipaway · Jun 28, 2006

looks like they gave too much fluid in the OR.

They gave the right amount, the patient's alive when they got to you!

rn29306 · Jun 28, 2006

...looks like they gave too much fluid in the OR.

I used to say this in the unit all the time, when I didn't know better.

Until you have managed massive fluid shifts in the OR with profuse bleeding, don't be so quick to judge.

skipaway · Jun 28, 2006

I used to say this in the unit all the time, when I didn't know better.
Until you have managed massive fluid shifts in the OR with profuse bleeding, don't be so quick to judge.

:yeah:

MmacFN · Jun 28, 2006

SICU/CVICU

these seem to be the best two for the highest exposure to swans.

If you dont/cant work there, make sure to take the CCRN as its an excellent review of hemodynamics. Better than nothing.

japaho41 · Jul 17, 2006

SICU = variety of post-surgical patients, trauma, fluid resusitation, vasopressors, sepsis, ARDS, lots of vents

CVICU- I call sometimes a heart factory, advantange everyone post CABG comes out with a swan, vent, nitro, and usually a vasopressor. If they are sick you will occassionally balloon pump. Disadvantage- most are extubated within 12-24 hours and up OOB and transfer out on day 2.

MICU sepsis, ards, pulm conditions, renal failure,

91CRN · Jul 18, 2006

I would certainly agree that SICU is the best experience. I have experience in almost every kind of unit. Every one has it's ins and outs. SICU is hands down the most relavent for CRNA training. A previous poster was comparing MICU to SICU and that was very telling. How often will you see sepsis or ards in an OR suite? MICU pts are generally NOT surgical candidates and most CRNAs don't respond to emergencies around the hospital, (at least not in my neck of the woods). Major vascular cases is where it's at. Believe me, I am not happy that the last 7 years I've spent in the ER is (in most programs) not even considered. I've learned a TON in the ER--gotten all kinds of certifications--TNCC-MICN etc., but reluctantly I agree--most of the pts I start on vasoaction I transfer to the ICU ASAP---same with vents. We stabilize and transfer--get ready for the next train wreck. Critical thinking, you betchya, critical care--not so much--long term that is. On the way by. I am pretty old--45 and am hoping to apply to CRNA programs next spring/summer. I'd like to hear more about this dirty rumor that the over 40's statistically have a higher failure rate. Can anyone with news on that front post or PM me please? I think I read that in one of the CRNA threads here. I've been heavily researching programs/statistics and have not run across such a thing:( Hope it's not true!

GregRN · Jul 19, 2006

Great perspectives and info. Thanks everyone.

azor · Nov 26, 2007

ICU,ICU,what of NICU?Isn't it part of the ICU?I am currently in med-surg and definitely will like to go in for CRNA but i like NICU.Can that be accepted and what is the parameter of their acceptance?Thanks.