Dilemma! Cardiac PCU or CVICU??

[Jmlr]

Hello! I have been offered new grad positions in both a Cardiac Surgical PCU and a CVICU. Both level 1 trauma facilities within the same Hospital System but at different locations. I am a new grad and always knew that I had an interest in the cardiac specialty so I am pleased with these two options!

I did my residency in a cardiac PCU so I know that I love the patient population and pace of this kind of unit. I have also shadowed and did two clinical shifts in CVICU so I am also familiar with this patient population and pace. I started nursing school thinking that I wanted to go into an CVICU position, I like the complexity of the CVICU patient but after shadowing and clinical rotation experience I felt that the pace was a bit too slow for me, I know I might feel differently when I am actually working there.

Not sure exactly where I see myself in the next couple of years but I do know that I am interested in PACU, Cath Lab and potentially NP or a CRNA. Now I know that I will need ICU experience to be a CRNA, but does PCU experience count at all? And I am not set on CRNA. I am in my late 30's and not sure if I am going to want to go back for that schooling. The future is hard to predict until I start working in the profession.

So to compare the two positions

Cardiac Surgical PCU- Days, reasonable commute, less pay, level 1 trauma

CVICU- Nights, reasonable commute, $5 more for night shift, level 1 trauma, I know other new grads from my program that will be working nights at this facility (different units)

My dilemma is I think I will enjoy PCU but its a day position and I really prefer night shift because it will work better with my kids schedule. CVICU is nights but I am afraid the pace might be too slow, but from what I've been told having CVICU experience down the road opens a lot of doors for other positions. The recruiter thinks that the PCU is a better well rounded choice.

I would love for you all to give me your two cents on which sounds like the better choice from your experience in this profession. I know ultimately it is my decision :) Thanks in advance for your help!

[WestCoastSunRN, MSN, CNS]

I think it's funny that you think the pace at Level 1 CVICU will be too slow. I don't mean that snarky -- I think maybe you haven't spent enough time in one? If you are getting offered CVICU as a new grad --- TAKE IT. This coming from a long-time ICU nurse (including CVICU) -- I'm a total critical care geek, but based on what you have shared about potential hopes and dreams in nursing, this is a no-brainer (provided they give you an appropriate orientation).

Trust me. You have much to learn. It will not be slow.

Oh and CONGRATS on the offers! They are both awesome (but take the ICU).

[Jmlr]

Thank you so much for your thoughts on this it is very helpful! I really value your opinion!

[RotorRunner]

CVICU. If they are willing invest that sort of effort into training you, take it. You can't go wrong by gaining critical care experience. It'll be a learning curve for sure, but it will be rewarding.

PCU experience will likely not count for CRNA school. They are going to be looking for critical care experience. A year or two of CVICU experience in a level one facility will be perfect.

[OrganizedChaos, LVN]

CVICU. Hands down. I would jump on that.

[adventure_rn, MSN, NP]

Have to agree with all of the above. CTICU will give you an incredible, in-depth understanding of hemodynamics, which will serve you well in any field of bedside or advanced practice nursing. In addition, it would be much easier to move from ICU into a PCU down the road than vice versa.

I only have limited experience in CTICU from nursing school clinicals, but I do understand what you mean about the pace as an ICU nurse. If your patients are stable at the moment, you might spend some of your shift sitting watching the monitor, putting in your vitals, doing assessments, checking gases, and slowly titrating drips. However, stable patients are stable until they aren't. ICU patients can turn on a dime, and a fairly straightforward shift can go haywire in a heartbeat.

From what I understand, the most critical period in the CTICU is right after they've rolled a fresh heart out of the OR. On night shift, you probably won't be seeing as much of that, since you won't have scheduled cardiac surgery at 0200 (although you might see some emergent cases). However, the great thing about downtime in the ICU is that you can use it to learn, and the CTICU has a ridiculously steep learning curve. My guess is that as a day shift PCU nurse, you'd have some days where you'd be too busy to even pee, let alone seek out new learning opportunities.

Additionally, great coworkers can make a dragging 12-hour shift go a lot faster. If a coworker and I have some fairly stable NICU babies on vents/drips, we may spend several hours chatting in between our cares (and are well-paid to do it). After a handful of hectic shifts, you may really appreciate the occasional downtime.

[Jmlr]

Thank you everyone for your responses, it really helped in making my decision. I did accept the CVICU position and I start in a couple of weeks! I am excited and nervous at the same, but I am really looking forward to learning how to care for these patients 😊