CTICU or Trauma/SICU

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Hi everyone,

trying to decide which offer to take aiming to apply for CRNA school in a couple of years....

A: The CTICU does not have transplant or ECMO, mostly CABG and Valves, still it is a CT, so swan every post-op. I don't have cardiac experience so really looking forward to learn heart well....

B: The SICU is a level I trauma center that has liver transplants post-op ( that has swans sometimes), lots of trauma ( gsw, mva, etc...), don't have ECMO, they prone the pt for ARDS mostly

possible C: still have a couple interview schedule for CTICU, one of them are a big center with transplants as well as ecmo ( but I heard they don't train anyone who is less than a year in the unit for ECMO). This place is 1 and half hour drive from my apartment.... ( have two young kids, 3 hours commute seem horrible...)

any advise?

Is A a good place to start? is CTICU still has the best shot for CRNA school? Does the experience with heart transplant or ECMO matters a great deal?

appreciated!

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Specializes in Nursing-Anesthesia.

Honestly, A OR B are just fine. I worked trauma/SICU and saw it all. Liver transplants will have you running and using your mind a hell of a lot more than a stable heart valve. I also felt as though I was more versatile than some of the students in my class who just worked CV. Both look excellent on resumes however. I would personally pick the unit that was more adaptable with my lifestyle and kids schedules. Good luck!

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Either one will be fine. It just does not matter. As long as you have consistently good, acute patients, either one will serve you well. Just FYI, please don't get caught up with ECMO. It is almost irrelevant. It will neither make or break your application or career. Same with Swan lines, which are slowly going the way of the dinosaur as well. If I absolutely had to choose, I would go Surgical/Trauma, as there are usually more systems involved, more services and specialties, and more generalized learning, but really, it does not matter at all.

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Thank you so much!

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thanks a million, I am so glad to know that ECMO and swan do not matter as much as I thought! I was so obsessed with it...

Still not quiet sure what part of the experience is most helpful in anesthesia career? I heard that acuity and hemodynamic monitoring are important, but what else? thanks

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It's what you make of the experience and how intelligently you can speak on it during your school interviews. I worked on a Level 1 trauma MICU, and I got into my top 2 choices. We use pressors, sedatives and pralytics on our unit almost everyday. Also, we have patients with central lines, arterial and CVP monitoring. I had other people who aspire to be CRNAs tell me switch into SICU or CTICU because apparently those are the only units that schools prefer. I have to make a footnote and say that, I had a high GPA, CCRN-CMC, and leadership to go along with that. I would advice you to pick the Level 1 trauma unit.

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Thanks a lot for your insights! My Gpa is definitely not going to help. I am doing some graduate level courses and hope it helps, so far all As. Will get CCRN for sure...I think experience is something I have more control right now....

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Specializes in Anesthesia.

I agree with SRNA2020 about the MICU experience. I worked in a teaching hospital MICU (in reality it was mixed with surgery and neurosurgery patients), and a lot of our MICU patients were SICK with a lot of lines and multiple pressors. I learned WAY more from the medicine patient population than I did with the surgical population. I didn't do hearts though.

A lot of our traumas went to surgery, were resuscitated, and then extubated shortly thereafter. There's a nice turnover of patients. Sure, you get your bad patients who need to be transfused with the level 1, but for the most part I would say the medicine patient population is a lot sicker at baseline which means patients stay on the unit for a lot longer which can become trying. My hospital had a lot of traumas and most seemed to be younger GSWs and MVAs, but some SICU patients do end up getting transferred to the medicine service, and some of the sicker medicine patients end up needing surgery, so there's a lot of overlap.

With all that being said I'd have to agree with BigPapaCRNA. Both sound fine, but the SICU seems more generalized which makes it sound more appealing. The fact that my ICU was more of a general ICU I think has helped me more than anything in CRNA school so far. You can always contact the PD of the programs that you're interested in and see which one they prefer as well.

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thanks a million, I am so glad to know that ECMO and swan do not matter as much as I thought! I was so obsessed with it...

Still not quiet sure what part of the experience is most helpful in anesthesia career? I heard that acuity and hemodynamic monitoring are important, but what else? thanks

I'm not sure why everyone keeps saying that swans are being phased out. Every CCU/CVICU I have worked (when I was a traveler) uses them often. Every post cardiac surgery patient has them from my experience. Swan experience is valuable, but not the "be all end all". But it's better to understand them than to not. Just my opinion tho.

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