which would you choose?

[goinforit]

Hi all, I am mostly a lurker here on this site and now am in need of some advice. I will be graduating from nursing school in 2 weeks and have been offered two different ICU positions. My goal is to get 3 years of experience and then go on to CRNA school so I would like to make myself the most attractive candidate possible.

Choice 1. A 28 bed ICU which does medical,surgical,cardio and neuro. They are a level 2 trauma center and from my shadow days there, every other patient was on a vent and there was what looked to be very high levels of acuity. The orientation is 12 weeks long, but I have been told that extending that if needed is not a problem. I have been offered a day time position as well if that makes any difference. The unit is a brand new unit, meaning around two weeks old by my start date, and uses computer charting. The hospital does not have a great reputation as a whole, let me preface that I did do 1 year of clinicals on the telemetry floor and learned a ton but the nurses were pretty frazzled. My time in the ICU showed it to be so much different, the nurses worked as a team and were pretty upbeat and positive.

Choice 2. An 18 bed Neuro/Surgical ICU at a level 1 trauma center, the manager says that they also recieve the majority of the traumas on their unit. So you just don't get the Medicals and the cardiovascular per say unless neuro is the main problem. The orientation is 16 weeks long and have also been told that extending that is not a problem. I have been offered a night position. The hospital uses paper charting, they are going to convert to computer charting in the next year to 18 months. The hospital has a great reputation and the nurses also worked as a team and were upbeat.

There are other personal factors I am considering such as drive time, cna's,etc. but am mainly wondering which one looks the most appealing specifically for CRNA prep. Thanks in advance for any replies!

[suzanne4, RN]

If both programs are equal distance from you, and nothing else is different; I would state the first facility where you get a bigger variety of patients and the CV patients with all of the drips. Does this facility actually do open heart surgery? If so, then that seals it?

Where do the open heart patients go to at the other facility?

[goinforit]

Thank you suzzane4 for your quick response, I have to make my decision in the next 7 days.

The first choice does indeed do open heart surgeries, they put a big emphasis on their cardiac care. At the other facility the open hearts are sent to the CVICU.

Can I just say that I am so excited to be graduating!! The first leg of my journey is complete, now for the experience and then to get into CRNA school.

[srna wannabe]

Goinforit,

It probably depends on where you apply. I work for a large University Hospital with a decent rep and it seems like alot of people from our hospital get accepted to the various anesthesia programs around town. The program I'm attending is also located in a University setting so maybe they think its like putting square pegs in square holes. Start calling the programs you're interested in to find out what their requirements are. Often they have meet and greets about their programs and they will tell you what they're looking for in an applicant. You can ask- what types of experience in what settings do your applicants typically have, GRE scores, yrs experience etc. I love that you're allowing yourself 3 years of experience. I have many more than that (7-8 in icus) and I still don't think I know it all or ever will.

[kimmie518]

Those are some awesome opportunities to choose from! Man I'm jealous.

Good luck in whatever you do choose!

[goinforit]

srna wannabe, I agree, you will always be learning which is part of what pulled me to nursing in the first place. I took your advice and called all six of the programs I have contemplated applying to and did get through to one right away. I am hailing from Missouri by the way if anyone here has gone to CRNA school in the midwest region and can recommend a school I would appreciate it. Anyway I digress, after telling the director about my two choices (he was familiar with the two hospitals) he felt that he would prefer that students get that cardiac component so he would go with the first choice. He also said that the second choice was an incredible hospital and that I could likely float over to the CVICU once I had gotten my bearings and felt comfortable on the neuro/surgical ICU. I guess that since my plan is to get about 3 years of experience I didn't want to be hopping all over the place. I want to build up a good reputation and get glowing references.

By the way my six programs (based on geographical desireablility) are:

1.Truman Medical Center School of Nurse Anesthesia

2.University of Kansas Medical Center Program of Nurse Anesthesia

3.Newman University Nurse Anesthesia Program

4.Webster University Nurse Anesthesia Program

5.St. John's School of Nurse Anesthesia

6.Barnes-Jewish COllege at Washington University Medical Center Nurse Anesthesia Program

Anyone have the skinny on these programs?

[srna wannabe]

I think there is a sticky with the rankings from U.S. news and world report. If you want CRNA feedback do a search for Nurse Anesthetist forums on google. There are forums dedicated toCRNAs/SRNAs and wannabes.

I like your tenacity- that's what it take from what I hear. I'll tell you in a few months

good luck

[UCDSICURN]

If you can get all that variety in the 1st ICU, that's where I would go. Level 2 trauma centers are just fine, most are only lacking the research/education requirement for Level 1 certification. And as I've told everyone else, do not get caught up in certification levels as it means nothing outside of trauma and NICU's.

Go for the big case mix. Worst case scenario, you leave there after a year or so for greener pastures.

Just my 2 cents.

[ready4crna?]

Goin-

Your list of schools are mostly university programs. Although UCDS is right, the level II may have intermittent equality to level 1 in actual patient acuity depending on what geographic area the hospital is located, Go with the level 1 trauma experience. The surgical experience afforded at a level 1 center will have a consistently higher acuity. The fact that it is a trauma unit means that you will have the experience of caring for a sick surgical patient with comorbidities that need to be medically managed.

[japaho41]

Both choices sound really good. If I were you I would pick the unit that does the variety, as long as the acuity is there. Like a previous post has stated don't get hung up on the trauma level distinction between 1 & 2. At the staff nursing level you would never know the difference. Best of luck

[Summitk2]

I'm assuming you've looked into the CVICU at hosptial #2? If you had a job prospect there, would it be a hands-down winner over the other 2? If so, perhaps you should position yourself to move there once the opportunity comes up.

The question then becomes, which option between the ones you have, would be the best to get you into this teaching hospital CVICU? Perhaps it's more cardiovascular exposure (option #1), or maybe it's being in the same hospital with networking opportunities (option #2).

I wouldn't focus so much on how you chart or your working hours--these are secondary (you're going to have to do all shifts and all types of charting sooner or later). It's the bedside opportunities you're looking for that will get you into NA school. Your comments on the team environment is important however, to your development as an ICU nurse. You need people around you who will be patient, answer questions, walk with you through mistakes, and encourage your growth.

[goinforit]

Well, I am officially done taking tests and all that's left is the ceremony!!:balloons:

Summitk2- The CVICU wasn't hiring anymore people, and the Neuro/Surgical unit just expanded the unit by 6 beds and had three nurses leave to go on to CRNA school. I like the way you think though, and I have been contemplating the same things. The day I shadowed there at option 2 I talked with a float nurse that only worked at that hospital and only between their three ICU's, she indicated that it wasn't uncommon to get crosstrained in all the ICU's if you indicated that you wanted to.

Here's another question: Is there a big difference between the teaching hospital environment vs the nonteaching? If so, what would you consider the pros and cons to both? Just a couple more days left to make my decision, thanks for everyones input so far!