Best places to gain experience before going to the ICU

JustBeachyNurse, LPN · Oct 13, 2012

I'm currently enrolled in a LVN/LPN program here in Texas and I'm approximately 2 months shy of graduating and taking my NCLEX. While I've done my rotations in clinicals, I've become very interested in the CCU/MICU/NICU units in our hospital. As far as most hospitals I've looked into, they will not take any LVN/LPN to their ICU units, which is understandable, but a bit of a killjoy. Once I'm done with school I intend to work at least a year to gain hands on experience before I go back for my RN, but my question is where in the hospital would be the best place to gain experience for CCU/MICU/NICU? I know there is Med-Surg, Ortho, Oncology, PCCU, and ED, but if ya'll could be so kind as to give me suggestions on the best places to get alot of experience to prep for the intensive units. I've been suggested PCCU because in the hospital they say that its the most difficult floor, and if you can work that floor you can work any other. Any suggestions and personal experiences would be awesome! Thank you!

Because if limitations in scope of practice (inability to push most critical IV drugs, initiate a blood transfusion, not able to perform an admissions assessment independently without RN oversight, not able to initiate a care plan or patient teaching,not permitted to triage patients as per state limitations on scope of reactive of LPN vs RN) you will have a difficult time finding a critical care unit willing to hire an LPN. Even states like TX that have a broader scope of practice there are little to no critical care nursing jobs for LPN/LVNs. Couple that with the large number of diploma, associates and bachelor prepared RNs seeking work and I don't think you will have much luck fulfilling your dream working in ICU/MICU/NICU as an LPN. Also in relation to specific equipment and procedures required in a critical care unit. Such as ECMO, IABP, invasive ICP monitoring. In fact many hospitals no longer have floor nursing positions for LPNs. I think you'll also have difficulty finding work in ED as that is also considered a critical unit.

try focusing on what positions are available to gain working experience as an LPN as you prepare to transition to RN. In the med surgical roles you will develop your assessment and critical thinking skills that are imperative to have as a critical care nurse. You must develop your research and resource skills also.

RubySlippers06 · Oct 13, 2012

Where I am from, the only places an LPN/LVN are LTC, Psych, and I think some home care agencies

matricia90 · Jan 18, 2013

I am currently working in the NICU an I am an LPN. I live in Canada and its a new concept that they are starting to introduce and so far it is very successful. Keep working toward you goals because it could happen down in your state when you least expect it. Make sure you get experience that will move you towards your goal. I got in at the ER in my home town and that really added a great component to my resume and e posed me to many great experiences.

HouTx, BSN, MSN, EdD · Jan 18, 2013

(my clinical background is all ICU) Don't confuse technical tasks with nursing care..... ICU & other "high tech" settings have a lot of equipment deal with, but all that stuff is directly dependent on the physician - nurse is just carrying out physician orders. BUT ICU nurses also have to have a much deeper understanding of disease processes, physiology & pharmacology in order to effectively manage those very unstable patients.

I encourage you to get a MedSurg position and work very hard to learn everything you can about what is going on with each and every patient you care for. This means looking everything up - trying to understand exactly why the physician is selecting a particular drug or treatment. Get a clear understanding of how each drug actually works. Learn to do an in-depth physical assessment. Volunteer to care for the most complex patients. Become an expert at understanding lab results and what they mean. Become proficient at communicating with physicians and other team members. I know that this may seem like a tall order, but you're not going to be successful in any critical care environment unless you are a "happy learner" and enjoy mastering new challenges.

Then, when it comes time to further your education & make that move into a critical care unit, all you will need to do is learn all the 'tech' stuff and how to work with the gizmos.