Better ICU experience for CRNA school

[runningbull]

Hey everybody, I am looking at two job offers and was wondering which would be better for CRNA school. Job 1 is in a transplant unit (liver, lung, kidney, pancreas) and deals with pre-transplant pts with end-stage organ failure as well as post-surgical transplant pts and some other pts with acute issues (DKA, GI bleed, etc). The only issue I see in this ICU is that there is a ICU in the same hospital that takes all of the cardiac patients (CABG, Heart Transplant, etc). Would the lack of cardiac pts make me a weak candidate for CRNA school? I will still see Swan-ganz, CVP, Art lines, gtts, many ventilated pts, and occasional ECMO (1x every 3 months) just not "heart patients (IABP, VADs, etc)

Job #2 a general ICU in a smaller hospital. This ICU sees a little bit of everything, including cardiac (immediate recovery of post-op CABG, cath lab, valve replacements, MI, Stroke, Cardiac Arrest, IABP). However, this ICU does not deal with trasnplants, VADs, or ECMO which would be seen at the larger hospital.

So my main question is, would it be better for crna school to have experience with a little bit of everything including some cardiac patients (CABG, MI, IABP, Artic Sun, etc) and give up some of the things I would experience in a larger hospital (transplants, rare ECMO)? Or would it be better to be in the larger hospital and see NO cardiac cases but have the chance of seeing an ECMO and caring for pre and post-transplant pts?

Thanks in advance to all replies and thanks for reading!

[ckh23, BSN, RN]

CTICU is not the end all be all. Some schools may have a preference, but in reality sick patients are sick patients. In my class the CTICU nurses are about a 1/4 if the class with the majority coming from surgical trauma ICU experience.

I vote for the transplant unit.

[runningbull]

Thank you for the input, it's nice to hear from someone with some inside perspective. It seems like all I ever hear about anymore is how CVICU is the golden standard for crna school, so I wasn't sure which would be best.

Thanks again. Congrats and good luck with school

[Goose Xx, MSN, RN, EMT-P, CRNA]

I worked in a surgical ICU that did all the abdominal transplant (liver,kidney,pancreas). Awesome experience for CRNA school.

[AlphaAgonist]

Larger hospital

[runningbull]

Sounds like everyone agrees on the transplant ICU in the larger hospital. The only concern I have is that it is not a surgical ICU. It is more of a holding cell for sick transplant potentials and a place for transplant recipients to come when they require ICU stays (they are considered "service" after Tx and don't go to any other ICU).

Thanks for the replies, I think this would be the better job to take in terms of learning experience.

[Goose Xx, MSN, RN, EMT-P, CRNA]

Sounds like everyone agrees on the transplant ICU in the larger hospital. The only concern I have is that it is not a surgical ICU. It is more of a holding cell for sick transplant potentials and a place for transplant recipients to come when they require ICU stays (they are considered "service" after Tx and don't go to any other ICU). Thanks for the replies I think this would be the better job to take in terms of learning experience.[/quote']

Those pre-transplants are some of the sickest I've taken care of. Not sure you would get that complexity outside of the ICU though. We had patients intubated on multiple pressors, CVVH, SWANs with nitric or flolan in hepatopulmonary failure waiting for livers. Unfortunately, transplant ICUs are pretty specific and not always easy to get in to.

[runningbull]

Great point, Goose. Even though it will mostly be a narrow patient population, there are many many issues plaguing this population and every pt will be different in their own way.