Best job for new grad who wants to go to CRNA school

[Jacks007]

Hello! I just graduated from an accelerated 2nd degree BSN program. I have four years experience as an EMT-B in a large city. My goal is to become a CRNA after gaining ICU experience.

My predicament is this:

Should I accept a progressive ventilator stepdown unit (PSVU) position at a level I trauma center? They work closely with all the ICUs in their hospital and I would have the opportunity to apply to an ICU at this hospital within 6 months.

OR:

Should I apply for ICU positions at nearby non-trauma hospitals to get critical care experience right away? These hospitals have mostly night shift ICU positions available.

I guess I'm wondering if the trauma designation is a bigger factor to acceptance into CRNA school or would it be better for me to have actually worked in an ICU for a longer amount of time?

I would ideally like to apply after obtaining 2 years experience. Thanks for your input!

[DreameRN, BSN]

Just my 2 cents, but I'd go with the ICU every time. That's what schools want to see. Regardless of how the stepdown is presented to you, high acuity, etc....It is still a stepdown unit. Which means that the patients have been deemed stable enough to be out of ICU--don't get me wrong, it's probably a busy, tough unit and you'd learn plenty. Bu...they aren't ICU.

If your goal is CRNA, you are just delaying that goal by going to stepdown. Trauma experience is nice to have but it's not an end all be all by any means. I think only 2 of my class has trauma experience. It is by far better to have more time and more exposure and experience to critically ill patients (at least from an admissions perspective).

Get into an ICU and once you have some experience there, if you are still feeling a pull towards trauma, try to transfer into a trauma ICU, or pick up PRN at another hospital if you can. There's a ton of options, but if it were me and again just my 2 cents, and I have the goal of CRNA, I'll go ICU everytime.

[ipd_RN92]

Just my 2 cents, but I'd go with the ICU every time. That's what schools want to see. Regardless of how the stepdown is presented to you, high acuity, etc....It is still a stepdown unit. Which means that the patients have been deemed stable enough to be out of ICU--don't get me wrong, it's probably a busy, tough unit and you'd learn plenty. Bu...they aren't ICU.

If your goal is CRNA, you are just delaying that goal by going to stepdown. Trauma experience is nice to have but it's not an end all be all by any means. I think only 2 of my class has trauma experience. It is by far better to have more time and more exposure and experience to critically ill patients (at least from an admissions perspective).

Get into an ICU and once you have some experience there, if you are still feeling a pull towards trauma, try to transfer into a trauma ICU, or pick up PRN at another hospital if you can. There's a ton of options, but if it were me and again just my 2 cents, and I have the goal of CRNA, I'll go ICU everytime.

^ Sound advice here. I will add that it is important to look at the QUALITY of ICU experience each unit offers in terms of the patient population, acuity, and treatment modalities commonly used (i.e. invasive lines, mechanical ventilation, vasoactive infusions). Cardiac, trauma, or a large surgical ICU "generally" (there are always exceptions) tends to offer the most valuable and well-rounded experience for prospective CRNAs, as you will be interacting with anesthesia providers frequently and often recovering patients directly from the operating room.

Stepdown experience is valuable if you cant get directly into ICU out of school (better than starting on med-surg for sure!) and honestly 6 months isn't long to wait if the ICU at that hospital will offer you the best quality experience. It really depends on what your timeline is to get back into school. I did a year on stepdown afte graduating (hospital wouldn't let me transfer before then), then moved to Trauma ICU and have been in this specialty for about 3 years now. Of course, I was also 22, unmarried with no kids, as a new grad and knew I wanted to take the time to mature and develop my skill set before hurrying back into school. Doesnt hurt that I have my car paid off and some money in the bank to go to school with either! It all depends on your personal goals and circumstances.

Best of luck!

[HalfBoiled, BSN, RN]

ICU immediately.