Brainstorming needed!

Sounds like you'd do well in a cardiac medicine or cardiac surgical floor. My advice would be to start talking to the NM's of those floors, set up a day to shadow one of their nurses. Be sure to soak it all in and ask pertinent questions. Remember although you are just shadowing, leaving a good impression on a staff member can influence them to give their opinion of you to the NM. Believe me, just had someone shadow me and after that exp, I went straight to the director and told them we had to hire her. When I think of people who would do well on our floor (CT-ICU), i'm looking for people who are inquisitive, ask questions, learn quickly, and come from a good solid nursing background. From what you posted, it sounds like you really know what you want. So just be honest, but don't be overconfident.

Other things you can look into would be PA caths & hemodynamics, vasoactive gtts, typical patient population of the units you are looking at, mech ventilation. We don't expect you to know everything, but if you have a good idea about how we use these things, it might give them the impression that you are ready and willing to learn what they teach you. Also, if you haven't started precepting, you might consider that... or being involved in committees. Both only help distinguish you as a person who goes above and beyond, and will only strengthen your application.

If you're really Type-A, you may prefer a Cardiac Surgical ICU over a Cardiac Medical ICU. In Cardiac Surg, there is a lot of bean-counting...chest tube output, urine output, CRRT, titrate drip A according to protocol A, titrate drip B according to protocol B, and so on. There is certainly critical thinking, and very sick patients many times. On the other hand, if you like to fly by the seat of your pants a bit more, you may like the Medical Cardiac ICU. Oh look, my patient's in VT! Pow! Hmmm, I've maxed out furosemide at 20mg/hour and my patient's on BiPap, what next? What do you mean retroperitoneal bleed, he was fine a minute ago. That sort of thing. Really, I'm sure you'll do well no matter where you go.

Tucson AZ, UAMC cvicu is hiring.

CVICU in Columbia, South Carolina is hiring.

You may just have to move.

Thank you, everyone, for giving me some great information to start working on.

IHeartDuke - I will admit that I hadn't thought of shadowing at this point as it was something I thought of when I was looking to go into nursing but never thought about doing it when looking to change directions within the field. You have given me some great tips. Thank you!

RNerd81 - Thanks for the vote of confidence. The surgical vs. medical distinction gave me food for thought, and my gut feeling is that I would prefer the flying by the seat of my pants version. I know sometimes changes can happen because you got behind the eight ball (as the saying goes in paramedicine) and sometimes it just happens, but I like the rapid, critical thinking needed when your patient's presentation suddenly changes. I remember having a sick COPDer who would go into runs of MAT (the only time I can say I have ever really seen that rhythm) when sleeping. I only discovered it because I happened to look at his monitor randomly. I loved that sudden surprise.

8jimi8ICURN - Thank you for the hiring information. I am willing to move - the problem seems to be that even places I would move to in order to gain the experience I'm looking for seem to still want ICU experience for an ICU job and don't consider the experience I have to be a suitable alternative. I will definitely look into your suggestions - thanks so much!

Let me know. I'll splitter recruitment bonus with you.

I applied for the Tucson job but couldn't find the specific hospital it was in Columbia that was hiring. Feel free to PM me - I'd be so happy to be in an CVICU the money is yours! :)

Palmetto Richland Hit me up on fb I never have luck with the pm system on this website.Fb/8jimi8

Also do the pacep.org coned mods. And mention them in your interview. I'm about 3 mi from the hospital.

I would keep looking around because while a lot of places do want the previous ICU experience there are plenty that want 1-2 years of ED, ICU, or Telemetry out there (although it seems a lot of the ones with more flexible prerequisites tend to be night shifts). Is it not possible to transfer within your hospital to another unit? Look around some more and if hospitals are having job fairs or career fairs make sure you sign up and attend because meeting the hiring or unit managers in person makes a HUGE difference. I put in several applications for a PRN ED position with no luck, went to a job fair met with the assistant NM and interviewed in person, got an interview with the NM, and was offered full time employment if I wanted it.

8jimi8: I'll send you a message now on FB. I know FB is weird in that you have to look at "Other" under messages to make sure you see them from non-friends. Thanks!

SpEdtacular: The original plan was for me to transfer within my hospital. Unfortunately the ICU there is so painfully short of patients that they are hiring no one, and are even having ICU RNs come to the ED to cross train so that they can work their full shifts. I had looked for job fairs and there's not much here. I think I suffer from living in a desirable state so it's a tough job market...hence me being willing to move somewhere else to get some great experience. I will keep my eyes open for more job fairs, though - thanks for the idea.