Best floor for experience prior to ICU

MegNeoNurse · Feb 12, 2012

It sounds like you have a good path planned for jump starting your nursing career :). What type of ICU do you aspire to work in? Trauma/transplant, burn, neuro, cardiac? Depending on the type of unit, that's the type of floor I would try to get a preceptorship in if I were you. I would definately work in a progressive care type unit, as you mentioned with CPCU. This would be a good unit as the patients would be borderline complex, on tele, and youll become familiar with many meds you will also see iin ICU. Plus you might get to practice your ACLS skills (something only an ICU nurse would be excited about...) Hope this helps, good luck!

Biffbradford · Feb 12, 2012

Right. Seek those kinds of patients that you hope to work with in the ICU.

By what my friend in a tele / general medical floor tells me, that's practically an ICU itself! :uhoh3:

sapphire18 · Feb 15, 2012

PACU definitely qualifies as critical care.

PMFB-RN, RN · Feb 15, 2012

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.

*** Best would be a critical care residency program for new grads going directly into critical care. These are usually 6-12 months long and fully paid. If the hospital is an old fashioned and does not have such a program for new grads then my suggestion would a busy tele floor.

ckh23, BSN, RN · Feb 15, 2012

PACU definitely qualifies as critical care.

I disagree.

sapphire18 · Feb 15, 2012

I disagree.

Ok? Yes it is very different than a traditional ICU but PACU takes care of vented patients; patients recovering from surgery and coming out of anesthesia can be very unstable. Then again I've never worked PACU so if you'd care to expand on your response I'm all ears.

ckh23, BSN, RN · Feb 15, 2012

So if you have never worked in a PACU how can you claim it is critical care? And yes the PACU can take care of vented patients, but so does an LTACH and they are not considered critical care. Critical care involves caring for those that are extremely sick over a longer period of time that you would see in the PACU.

Critical Care is more than just people of vents and pressors. You really need your critical thinking skills and able to intervene when the patient starts going down hill. You need to be able to think about the disease process and prepare for what can happen. You have to account for multiple drips, compatibilities, blood transfusions, dialysis. You are working with invasive monitoring from central lines and cvp to swans. You need to know what the values from those invasive monitors mean and how you are going to treat them. These types of people just don't show up in the PACU, and if for some reason they do it is extremely brief. In my facility, these patients that become unstable introp go directly to the ICU after surgery and bypass the PACU completely.

Now before anyone gets their feelings hurt, I am not putting down PACU nursing. They do play a pivitol role in taking care of patients immediately post op. What am I saying is that it is my opinion that PACU nursing is not critical care due to reasons listed above.

MomRN0913 · Feb 15, 2012

PACU is considered critical care. However, getting in is almost impossible. I had been trying as an MICU nurse. It's where the ICU'ers go when they want to take their adrenaline down a notch, but remain critical care.

You can have a patient out of surgery on multiple drips, decompensating, blood transfusions, central lines, art lines, CVP. You need critical care experience as it is a critical care area. I have sent patients in crappy condition to the OR, who come out needing all this interventions in the PACU as well.

So, getting PACU as a new grad, might actually be harder than getting ICU.

sapphire18 · Feb 15, 2012

So if you have never worked in a PACU how can you claim it is critical care? And yes the PACU can take care of vented patients, but so does an LTACH and they are not considered critical care. Critical care involves caring for those that are extremely sick over a longer period of time that you would see in the PACU.
Critical Care is more than just people of vents and pressors.QUOTE]
I'm basing this on what I know of PACUs and PACU nursing- just because one doesn't work in a certain specialty area doesn't mean that they don't know anything about it. An acute, vented post-op patient is much different than a stable trached vent that you would see in an LTAC facility. Critical care is more than just vents and pressors but the length of time that you take care of the patient doesn't include or exclude anything from being a certain acuity of care either. I do appreciate your insight though..I'm assuming you've worked PACU?
As MomRN stated, PACU is probably tougher to get into as a new grad, and many hospitals do not accept nurses without critical care experience prior to working in the PACU.

PMFB-RN, RN · Feb 15, 2012

PACU definitely qualifies as critical care.

*** PACU is certainly NOT critical care. Try to get into CRNA school with years of PACU experience but not ICU experience and you will see.

MomRN0913 · Feb 15, 2012

Wake up to a career in PACU nursing

Lippincott, the Beacon of Nursing School Textbooks believes it is.