Best places to gain experience before going to the ICU

[Sephrin]

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!

[Whts_Ur_Emergency?]

The ER is an excellent place to prepare for critical care because you get experience with drips and things as well as learning to read telemetry, but in critical care you need well developed assessment skills where as in the ER you are using a focused assessment. As an LPN you may have trouble getting an ER position as they are replacing LPNs in areas like the ER with RNs because it is not efficient to hire both due to the fact that LPNs can't IV push or make initial assessments or triage. I dont recommend going into the ER as a new grad for anyone because you need well developed skills to practice well in there. Med surg is your best bet because you get a variety of diagnoses, and can perfect your skills while learning to juggle 5-6 Patients. What ever you do don't do LTC if you are ultimately wanting to go further with your education because you have upwards of 50 patients and no time to develop assessment skills all you do is pass meds and it's hard to get back in to a hospital after that. Even though the pay is better, be smart! Good luck:)

[turnforthenurse, MSN, NP]

The ER would be a good background but ER nursing and ICU nursing are very different...and as the pp mentioned, you really need to have well-developed skills in the ICU. ERs tend to only do focused assessments on their patients. LPNs do work in the ER, but it depends on the area. Where I work, LPNs work in the fast track. And the ER can be daunting for new grads, but it's not impossible. See if your potential employer offers an internship for new grads because that will help get your foundation down; otherwise, make sure your potential employer offers a lengthy orientation process. A few weeks isn't going to cut it. Working on a progressive care unit would also be an excellent way to get your foot in the door to the ICU later on. Progressive care nurses work with critically ill patients but they are on the more stable end of the spectrum (according to the AACN). Typically patients are on telemetry so you will get your EKG-reading skills down pat and we also work with drips, but of course each place is different. On my unit, we can work with dopamine, NTG (titrate to chest pain only, though, not BP), cardizem, lasix, dobutamine (weaning, usually if they transferred from ICU to us), heparin, octreotide, integrillin and amiodorone.