CV experience

braden74 · Jan 15, 2003

well we have 3 med/surg icu's (soon to be 4), 2 cvicu's, a ccu, a ticu, and a neuro icu so everyone is kind of sectioned off. each patient has there place. we get a lot of cvvhd on our unit and post liver and kidney transplants. the majority of our patients are esld, crf, and mods. that keeps us busy enough. i just want to get some heart experience.

SunDevilRN · Jan 15, 2003

Our heart unit is special because our hospital is so large. In addition to open heart pts we take everything else. If we have an open bed we are up for any type of admit. It's nice to have to luxury of having such a diverse pt population. The only type of pts I don't have a large amount of experience with is neuro pts. Other than that we get a very large variety. I'm just thankful for working in such a large facility which allows me this diversity. I feel that is one of the benefits of working in a large hospital.

zzzzzgirl · Jan 16, 2003

Can you offer any advice? I will graduate from an accel BSN program this April (NAU). I can either stay in AZ or go to a smaller town in the NW for my ICU. It sounds as if you recommend CVICU. Here the question:

*Will I get enough experience in an ICU in the smaller hospital with only 10-12 beds? Should I ask them which procedures they perform at that hospital? What should I ask the hosp. before applying? I'm in Chandler, do you have any recommendations about where to go, where I might want to avoid?

I'm worried that a school would look at my year experience and say that ICU wasn't busy enough, or you didn't get enough xyz there.

Thank you in advance!

zzzzzgirl

braden74 · Jan 16, 2003

From what I have heard you need to work in a medium to large ICU. A small unit will most likely not have the acuity that a larger unit will and you might not get the experiences you need. Ask the program directors at the schools you are thinking of going to but I believe a larger unit is your best bet.

I personally moved from the NW to AZ to get that kind of experience. I know there are large hospitals up in the NW but you have to live in cities I don't much enjoy. I love being in AZ and the hospitals here offer everything I need.

I work at Good Sam. I highly recommend it. There are other hospitals where you can get good experience too but I know that our managers are some of the most supportive around. That means a lot, especially as a new grad.

PM me if you want more info.

Brad

g8rlimey · Jan 16, 2003

ZZZgirl:

If you are definitely going to pursue CRNA, I would work in a teaching hospital if at all possible. Not that the experience in a smaller ICU isn't worthy, but I believe you're clinical experience is more likely to be questioned if you come from a smaller ICU.

Working at a teaching facility is also a very different focus from that of a community hospital. Dealing with residents and fellows in the middle of the nite is a pain sometimes, but can be a very beneficial learning experience both clinically and professionally.

If you like hearts, go CVICU, it's what I enjoy, but you can get ALL the experience you need from a trauma or general medical/surgical ICU. Crazy traumas and GI bleeds can work you over, but can be the fix of adrenaline many of us need on a regular basis.

If you are thinking of applying for a CVICU position, some of the ?'s I would ask: Cases per day, is it a fast-track heart program (bread and butter cases)--good to try, but can get monotonous, do they do asc./desc. aortic aneuryms (lot's of fun), do they have a fellowship for CT surgeons (sicker patients more likely), peds congenital hearts are very challenging--my old unit did adults and pedis--pretty amazing to take care of a 39-weeker post-transposition hooked up to ECMO on 15 gtts, do they have a heart/lung transplant program--very rewarding. That's all I can think of for now. I don't know if any of the hospitals in Phoenix area offer these kinds of programs, but keep your options open. Good luck

London88 · Jan 16, 2003

If you are going to work in a community hospital, the main thing to consider is the size of the ICU, and the procedures they do. I work in a community hospital with a twenty bed combined critical care unit. We get many swans, tripple A repairs, lot of titrating of vasoactive drugs etc. I have worked in both a teaching, and a community hospital. One of the things I will say in favor of the community hospital is that it is the place to develop autonomy. You learn to think on your feet, and act fast because you do not have the luxury of having a resident or fellow on hand. A code is a code no matter where it occurs. I learned to manage codes w/o a physician always present at the community hospital because the house physician will respond to an emergency in another part of the hospital before he reponds to ICU. The reason being that they are confident that the ICU nurses can manage a code w/o a physician present. I am not knocking the medical center experience in any way, as I learned a lot at the medical center. However I know that many of people on this website do not have the time to work in both types of facilities, as the main objective is to get their ICU experience in the shortest time possible. I consider myself fortunate to have been exposed to both types of facilities in my 7 years of critical care nursing.

zzzzzgirl · Jan 16, 2003

I'm always amazed at how quickly you all answer back with answers straight from the brain, the heart and your gut! I take all of your advice into consideration for the future!

Bless,

zzzzzgirl

meandragonbrett · Jan 16, 2003

The hospital where I volunteer at has a CVICU and CPTICU and I plan on working in one of those. We have right at 2000 beds at the main campus. We've also got 4 MICUs a SICU and NICU (neuro) and some other small units.

Brett