LTAC TO ICU

[Dindin14]

Hello everyone, I've been an RN for 4 years mainly in LTAC working as a fulltime float. Recently moved to a smaller town and work parttime at a rehab center. I feel redundant I desperately desire to challenge myself and thinking so I want to get into ICU. This is huge for me because it's an area i've always been scared of, cause i felt i was never good enough. Finally I faced my fears and took my resume to an icu unit and was told that I needed the critical care course. I'm currently registered for the course, in hopes that through the clinicals, I can get my foot in. Please what advice do you guys have for a fairly experienced nurse working in totally different specialty.

Thank you

[bellegrl10]

Your situation sounds familiar. Nursing is my second career coming from a background in laboratory research. I left research, entered an accelerated BSN program, graduated in 2005 and found a job in a step-down medical telemetry unit in NYC. I was exposed to patient on critical drips; critical line, drains, and tubes; tracheostomies and mechanical ventilation, complex wound care, etc in addition to having "walkie-talkie" patients.

After 3 years of night shift in the step-down, I left NY and move to Florida and excepted a position in Med-Tele unit. I soon learned that those skills I nurtured in the NYC step-down unit were primarily ICU skills in here in Florida. I worked in the same Med-Surg unit for number of years, but felt unchallenged and frustrated in my job, even after working as preceptor, charge resource and charge nurse. My ANM saw my frustration and recommended me for a per diem nursing position in local LTACH.

During this time nursing administration and management saw the need to advance Med-Surg/Med-Tele unit into progressive care units (PCU) that could provide the skilled staff for the complex patient populations. The hospital and nursing education department provided the MS-MT nursing staff with the courses and training for PCU nursing. I took the education and training and returned to work, and after a year, decided to pursue ICU and have not regretted the decision nor have I left the per diem LTACH position.

In my experience, the nursing knowledge and skills in the LTACH and the ICU support each other. The acute care training and skills of the ICU feed into the LTACH and vice versa. For example, my LTACH experience with vents and weaning trials, lines, wound care, codes, falls, decannulations, bedside dialysis, and mobility has made it a lot easier to focus on EKG critical drips, sedation and rapid sequence intubation and various modes of hemodynamic monitoring (SwanGanz, A Lines, Flo track) that is essential to ICU nursing.

You should look into seeing if the new facility has an ICU-focused nurse educator and/or clinical nurse specialist that can offer advice, guidance, and preceptorship while training for the ICU setting. Do they offer internships with progress reviews? Regardless, these individuals are key in helping you understand how to cope with the learning process of caring for the critically ill.

I also recommend looking into the AACN and joining a local chapter. They offer tons of great education! Don't forget critical care nursing websites (ICUfaqs.com), YouTube, Twitter and Allnurses also have great resources. Look into investing on critical care reference books like Critical Care Nursing Made Easy, Critical Care Demystified and aforementioned AACN's Essentials of Critical Care Nursing.

The LTACH I work in provides tons of computer-based learning modules on a wide variety of nursing topics. Investigate if LTACHs has such educational gems, over even purchasing CBLs from outside resources like PESI Healthcare, PEARLS Review etc.

Finally, ask your new coworkers how they managed to learn and navigate the transition from LTACH to ICU. It does take a while in getting to know, but you will find the super-nurse in the group- that fountain of ICU resource that happily guide you in this new endeavor.