CRNA and ICU Nurses Please Help!!!!

Specialties CRNA

Published

Hi Guys, I just graduated from an accelerated BSN program in August. I plan to apply to CRNA school after a couple years of ICU experience. I have been interviewing for ICU jobs and have received 2 job offers.:yeah::yelclap: The first position is at a level 1 trauma center in Surgical ICU 7pm-7am. The problem: when I applied for the position, it was posted as a Surgical ICU position. Once I went to the interview, the manager explained to me that I would cross train for Intermediate(Step Down, 20 bed unit combined). I am only interested in the Surgical ICU. I do not want to work in Intermedicate or Step Down. They offer 16 weeks of training along with a residency program that last for 12 months. I am afraid that if I take this position, I may end up working a great deal of time in Intermediate which would not help me in getting the ICU experience that I need to prepare for CRNA school.

The second job offer is at a smaller hospital, 299 beds to be exact. They have an ICU that consists of 12 beds. If I take the position, I would be an ICU nurse. The manager told me that they are a general ICU and take all types of ICU patients. She says that I would see and experience a great deal. This facility also does not have residents. The training is 12 weeks and if needed I could ask for more training time. The position is also during the day 7am-7pm.

I am not sure which position I should take that will help me the most in the long run. I am affraid that if I take the Surgical ICU/cross train Intermediate position that I may not get the experience that I need to go on to CRNA school. If I take the ICU position at the smaller facility, would I still get accepted into a CRNA program? Those of you that are CRNA's, in CRNA school, or ICU nurse's...please provide me with the best advice possible.:confused:

Thanks.

Specializes in Anesthesia.
There is no time committment or penalty. I just don't want to spend the majority of my time on step down.

I am not big believer that Level 1 ICUs gives you any better experience for nurse anesthesia school. The military programs are two of the top rated programs in the country and they both take students from a variety of backgrounds(OB, ER, OR, ICU, NICU). The students from these programs are some of the best in the country, and probably the majority of them do not have Level 1 ICU experience.

I like the idea of training program at the bigger hospital, but I would probably pick the smaller hospital if I were in your shoes.

Up Vote Up Vote ×

I would go with the smaller hospital and general ICU. Level I trauma center experience is not required by CRNA schools. Of course you could call the schools you are interested in and ask them. CVICU is what most schools are looking for. But in general it does not matter a whole lot. Once you go to CRNA school they will tell you to forget everything about nursing. ICU experience is an AANA requirement not a CRNA school requirement. The amount of time spent in ICU has no relationship to how you are going to do in CRNA school. Your grades, GRE scores matter more. If your grades and GRE scores are not very good then you can look for other things to improve your resume such as level I trauma center ICU, good recommendations, volunteer work, shadowing CRNA/MDA, etc.

Another reason is residency. In order to enroll at CRNA program you need min. of 1 year ICU experience after training/residency. This is a requirement for all schools. If you pick 12 months residency that means you will be able to start only after 2 years and start applying only after a year. If you pick smaller hospital and train for 12 weeks you can start applying right away as long as you have 1 year of full-time ICU experience post training/residency by the time the program starts.

Residency programs are great. But even after 12 months of residency program you are not gonna become a great ICU nurse. In order to become a proficient ICU nurse you need at least 2-3 years in ICU taking your own patients. Residency program will teach you the nursing school again, which you do not need. The most important things you need after taking your NCLEX are experience and CCRN after 1 year.

Up Vote Up Vote ×
Specializes in cardiac, ICU, education.
If you pick smaller hospital and train for 12 weeks you can start applying right away as long as you have 1 year of full-time ICU experience post training/residency by the time the program starts.

Residency programs are great. But even after 12 months of residency program you are not gonna become a great ICU nurse. In order to become a proficient ICU nurse you need at least 2-3 years in ICU taking your own patients.

There is a big difference between precepting (first 12 weeks) and the rest of a residency. I don't know of any residency programs after the first 12 weeks where you are not taking your own patients. Most residency programs (after orientation) are 8-hour learning learning sessions once a month with a clinical coach/mentor back-up but you are still on your own. You are in a cohort with other 1-year grads and you are out of "training" after the first 12 weeks.

The outcomes of a residency program are invaluable: high rate of retention, decreased stress by graduate nurses, improved organization and prioritization of care, faster acquisition of skills and critical learning abilities, and increased satisfaction in the first year of practice.

Rosenfeld, P. (2004). Nurse Residency Program: A 5-Year Evaluation from the Participants' Perspective. Journal of Nursing Administration, 34, 188-194.

Again vanasd, talk to the program(s) you want to get into to see what they require and see what kind of residency program the hospital has. It should not just be a repeat of school. The purpose of the residency is actually to make you a competent nurse faster than if you were not in a residency program. The better programs have content experts and trained preceptors, not just someone they asked on the floor who had been there a long time. Good luck.

Up Vote Up Vote ×

Residency program is still a residency program even if you take your own patients. Your ICU experience will not start counting until you are off of residency.

Up Vote Up Vote ×
Specializes in Anesthesia.
There is a big difference between precepting (first 12 weeks) and the rest of a residency. I don't know of any residency programs after the first 12 weeks where you are not taking your own patients. Most residency programs (after orientation) are 8-hour learning learning sessions once a month with a clinical coach/mentor back-up but you are still on your own. You are in a cohort with other 1-year grads and you are out of "training" after the first 12 weeks.

The outcomes of a residency program are invaluable: high rate of retention, decreased stress by graduate nurses, improved organization and prioritization of care, faster acquisition of skills and critical learning abilities, and increased satisfaction in the first year of practice.

Rosenfeld, P. (2004). Nurse Residency Program: A 5-Year Evaluation from the Participants' Perspective. Journal of Nursing Administration, 34, 188-194.

Again vanasd, talk to the program(s) you want to get into to see what they require and see what kind of residency program the hospital has. It should not just be a repeat of school. The purpose of the residency is actually to make you a competent nurse faster than if you were not in a residency program. The better programs have content experts and trained preceptors, not just someone they asked on the floor who had been there a long time. Good luck.

MSN I understand what you are saying about residency programs making better ICU nurses overall, but there is no correlation between different ICUs/residencies and how you do in nurse anesthesia school.

The "best" ICU nurses don't necessarily make the best CRNAs.

The only true correlations that have been linked to overall success/graduation in nurse anesthesia school are science gpa, motivation (lol..try to measure that one), cognitive flexibility, age (younger

When picking a nurse anesthesia school you need to find one that will teach you to be an independent provider. You should be proficient in doing all your cases without supervision by graduation. In other words you shouldn't need an MDA. Have competence to do all your own regional blocks (central and peripheral) with stim & ultrasound guidance for pnbs and be able to do your own CVLs. This will give you the ability to work anywhere upon graduation not just in an ACT practice.

Up Vote Up Vote ×
Specializes in cardiac, ICU, education.
MSN I understand what you are saying about residency programs making better ICU nurses overall, but there is no correlation between different ICUs/residencies and how you do in nurse anesthesia school.

wtbcrna - That would make a great research study. Our dean use to be a CRNA instructor at Rush, I might bring that idea up.

Residency program is still a residency program even if you take your own patients.

bibibi: With all due respect, couldn't disagree more.

Up Vote Up Vote ×

bibibi: With all due respect, couldn't disagree more.

I was talking from crna school appllication and enrollment point of view.I don't think any crna school accepts residency as part of 1 year ICU work experience even if you have been taking your own patients.

Up Vote Up Vote ×
Specializes in Anesthesia.
wtbcrna - That would make a great research study. Our dean use to be a CRNA instructor at Rush, I might bring that idea up.

QUOTE]

Hi MSN10,

That actually came from research studies, and the motivation/cognitive flexability comes from a the book "A Resource for Nurse Anesthesia Educators".

It is a required book for one my DNAP classes.

Up Vote Up Vote ×
Specializes in cardiac, ICU, education.
hat actually came from research studies, and the motivation/cognitive flexability comes from a the book "A Resource for Nurse Anesthesia Educators".

I should have been more clear. I meant do a study about nurse residency outcomes regarding entry into an APN field. Are nurses who graduate from an accredited residency program more likely to become APN's or are they more successful in those programs? We already know the outcomes of valid residency programs. Unfortunately there are hospitals that come up with their own programs that lack a valid curriculum and re-teach RN school instead of teaching higher level thinking - something the nurse resident needs in their professional career.

bibibi

I don't think any crna school accepts residency as part of 1 year ICU work experience even if you have been taking your own patients.

The one in our state does because certified residency programs actually get nurses to the competent level in a more timely and reliable fashion (Benner's model). We know what their experiences are and more importantly, critical thinking is the most important deliverable in one of these programs. A skill I think is extremely important for any nurse much less APN.

Up Vote Up Vote ×
Specializes in Anesthesia.

I am fan of residency programs since I began my ICU career with one them years ago. There just isn't a lot of overlap in what you learn in the ICU and what you do day to day in anesthesia. It does sound like a good study though.

Up Vote Up Vote ×
+ Add a Comment