I'm a new grad with full-time immersion experience in the ICU and am hoping to become an ICU nurse, and possibly a CRNA one day. I know that I'll need to get experience in the ICU as a prerequisite, however I do have a dilemma that I would appreciate some advice on:
I have a job offer in an ICU at a smaller community hospital (where I did my immersion) and a potential job offer on a stepdown unit at a large, university teaching hospital. I am stuck in between the two because I feel that the patient acuity in the smaller hospital would not give me enough learning experience to prepare me for CRNA school (~30% mechanically ventilated, but more opportunities for titratable drips/ART)---most of the very critical patients are transferred out into teaching hospitals and we also get stepdown patients since the hospital doesn't have a stepdown unit. If I take the job offer, I THINK I might have to eventually apply to a teaching hospital's ICU in order to gain adequate experience.
On the other hand, the teaching hospital would give me a wider range of learning experiences but I might have to start on a stepdown unit and not be guaranteed an internal transfer to an ICU. So I might lose some time in the ICU. If I choose this option, I hope to transfer to an ICU in less than a year.
So my question from your experience, is it better to start at smaller hosp ICU and apply to larger hosp later? or it is better/realistic to start at the larger hospital's stepdown and do internal transfer?
which would be a better/quicker/more "guaranteed" option to gaining ICU experience (n an academic center one day) that would ultimately benefit my goal of becoming an ICU nurse and becoming a CRNA one day? This is simply a question of which would be a better option to get to my career goal and not where I can "get my feet wet" as I am very confident I will be able to pick up skills quickly even if I am to start in an ICU immediately.
