Published Jun 1, 2003
I'm job hunting and I need some advice. I just interviewed at a medical/resp. ICU at a Level I trauma center and was very impressed. In your opinion, does the MICU or SICU offer better experience for CRNA school? The SICU at this particular hospital does not hire new grads. In addition, I was wondering if working days or nights would affect what kind of experience I get. The nurse manager mentioned that on day shift the nurses are required to do rounds with the docs and answer questions just like the residents do-- this sounds like a great experience. However, night shift pays 20% more! So, what should I do? MICU at this hospital or SICU at another hospital (or ask to transfer after working there a year). Day or night shift for the best experience? Thanks!
In my opinion, it does not really matter about MICU or SICU as long as it is a large academic center. Big teaching hopitals have higher acuity and better experience. You need to look at what type of patient population you want to work with. MICU can get very sick complicated patients and tend to be more long term. SICU will have more lines, drains, big dressings and higher turnover of patients. It's all about what you like. I prefer SICU, but I also enjoy MICU. SICU may also get you more exposure to the surgical team, and provide some insight into the types of things you will see as a CRNA.
As for day/ night. Depending on the hospital, days may provide you with more exposure to the MDs, rounds, and travelling with ICU patients to various procedures. This is why most places orient new people to days for most of their orientation. Nights also has it's own set of experiences (Nights may get more trauma admissions and some hositals do in house CTs at night). Day shift is more hectic with all the extra people and "white coats" around, even if the patient care is not busier. Nights allows you more time to actually take care of the patient, and ICU patients can crash and burn at any hour! I love nights and I enjoy the extra pay. You may get some valuable experiences on days that are not always available at night, but if you need the extra $$$, then it's an easy decision.
Go for days, the experience of interacting with Docs like that was invaluable for me. You also feel like much more of the team and your input will be taken into consideration. The school I go to prefers SICU experience. I don't think it makes a difference but I don't make admissions decisions.
Emerald, I think you are splitting hairs, you can call a unit "M" or "S" icu but the truth of the matter at a big teaching hospital is that when they need the beds patients get placed. I am sure they will try to keep surgical on the S side but you could get anything.
I also think that a night shift would get a little more autonomy because you won't have somebody there holding your hand all day and you will have to learn to think on your feet --so to speak.
I know also that in some places that when pts need invasive lines placed they will do them in the early am before rounds. Another thing about icu is Murphys Law. The crap always seems top hit the fan when you are on nights ( less staff, including mds, lab, xray, techs).
These are just my views and I am sure they differ depending on what part of the country you work.
An admissions committee is going to be more concerned about the actual experience you have gained then the intials of the unit. Go where you are going to get the most advanced monitoring modalities and the widest variety of acutely ill patients. An MICU in a large medical center experience will still offer a better variety than an SICU in a little community hospital. Good Luck!
EmeraldNYL, BSN, RN
Thanks for your advice guys. I was worried if I might need SICU experience as opposed to MICU experience, but the nurse manager said that in this MICU I interviewed at they use every type of invasive line imaginable and it seems I would get a broad experience there. She also mentioned that a number of people working in that unit had gone on to CRNA school.
I agree with most of the advice you have received so far. I have worked, briefly( 6 months), in a SICU at a teaching hospital and saw some really sick patients. For the last 14 months I have worked in a MICU in a bigger teaching hospital and have seen a lot of sick patients. THe acuity may have been a little worse in the SICU and I got more exposure with anesthesia personal, but both experiences were good. The best advice I think is to talk with the program directors of the programs you are interested in and see if they have a preference. When I spoke to the program director at the school I applied to, she said it didn't matter. She was more impressed that it was the biggest teaching hospital in the state. Side note, most of my experience as a nurse came from working in a big level one trauma ER, I worked there 3 years and probably learned to think more on my feet than either ICU I worked in.
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