I need advice on how to get ICU job for already practicing NP

[osenbaby]

Hi There, I have been interested in becoming a CRNA for the past 10 years. In fact, this was one of the reasons I changed careers into nursing nine years ago. I had even shadowed crna and used every opprotunity to spend some time in the the OR to be sure of what I wanted to do. After my acelerated BSN program, I was encouraged by professors and family to apply for the NP program. At that time I protested, but everyone said, that doesn't stop you from becoming a crna. nevertheless, I applied on the deadline date and not only got accepted but got a full ride scholarship with extra stipends and grants. Then everyone's reaction was oh, you can't let that money go to waste, just do the APN program. I did it but was very divided internally as I felt I should have taken an ICU position instead. I completed the program 5 years ago and due to challenges not planned for including having to refuse a surgical ICU job in a big hospital due to being placed on bedrest with a very challenging pregnancy ( which I eventually lost) and then proceeding to have kids afterwards, with all the financial challenges I pretty much resigned to just practicing as an ANP.

However that desire to be a CRNA has never diminished. Instead it has increased, the more I have continued to work as an inpatient NP (hospitalist). Now I have decided to pursue my dreams. My biggest challenge has been getting an ICU RN job. I have even applied for IMU ( I have some experience in that) positions, but a part of me feels like since most of my recent clinical experiences have been as an APN, that is likely discouraging recruiters from considering my resume for an interview.

I need advice, on what steps I can take to land a RN ICU job. Please anyone who has gone through this transition, or gone through the application process or has any info is welcome to give their input.

FYI: Academically, I think I might be ok to apply with my GPA ( BSN-3.85, MSN- 3.77, ) A in all my science prereqs to apply.

Thanks

[DeBerham]

I'm not sure if this will be helpful or not, but just my 2 cents:

I think you might have a difficult time getting into the ICU for 3 reasons:

1) You have not (as far as I can tell) done any floor nursing in the past 5 years. Not to diminish what you have done, but it's an entirely different environment than what you have experienced outside of nursing school. You have a lot of great training and I'm sure you have the knowledge base, but when it comes down to it, a lot of what a nurse does on any unit is managing time. I'm certainly not saying that you cannot, however a hiring manager may not be willing to take the risk.

2) You may be viewed as being "overqualified" for the position. There may be a fear among unit managers about having someone who is used to writing out orders autonomously suddenly being required to take them. While ICU nurses tend to be "type A" personalities and usually don't have a problem speaking up, I think you will have to prove somehow that you will be willing to step into this new role.

3) Why? The unit manager would be crazy not to ask you this question. You are taking a step that most people would consider backwards. If you tell her or him the truth that you want to be a CRNA and are only using this job as a stepping stone they would rightfully question your dedication to the unit. Your orientation will likely be between 3 and 6 months. What if you are accepted to a program after a year? That manager just spent thousands of dollars on your orientation for basically 9 months (optimistically) worth of work. Budgets at most hospitals are extremely tight and the unit manager's primary concern is keeping her area running, not your long term career goals....

ICU -> CRNA School -> CRNA is the usual progression of things, but have you contacted any programs? Can you segue your advance practice acute care experience into a program? I don't see why you couldn't. I think it might be in how you sell it to them. If you absolutely have to get ICU experience spread your resume out and prepare to move or be prepared to work in a non critical area to build up your skill set for a year or two before you go into critical care. I think you're going to find this to be a uphill battle.

Good luck

[SRNA4U, BSN, DNP, RN, CRNA]

I think you have a great shot of getting into an ICU. Don't let people get you down. In the ICU where I work, we currently have a FNP who works PRN in the SICU along side of us and she is great. She applied to CRNA school and was accepted. I wouldn't tell the management that you are planning to apply for CRNA school though, which could hurt your chances of getting a position there. I know many people that have had to keep their CRNA dream and goals a secret from management and coworkers. For some reason, when people find out you are planning to pursue the CRNA route, many of them get jealous and envious and will do things to prevent you from succeeding. When I interviewed at my CRNA program, I met a girl who was also interviewing. Her work environment in the ICU at a well known and respected teaching hospital in Baltimore was very toxic. She had applied for CRNA school without ever telling anyone and once she got accepted, she quit her job and became a travel nurse until she started CRNA school. It's a shame what some people have to go through and I know lots of money are spent in training people in the ICU but the reality is that all of us use our experience as a stepping stone forward to pursue bigger and better things. Management knows that the requirement for CRNA school is ICU experience. If you go through an internship, most hospitals want at least a 2 year commitment. Nowadays, its very hard to find ICUs that do on-the-job training. Most have fellowship programs that provide didactic as well as the clinical training for you to succeed.

If I were you, I would go for it and apply for an ICU position/fellowship and continue to pursue your dreams and don't let anyone stand in your way.

[SRNA4U, BSN, DNP, RN, CRNA]

Also, once you get your ICU experience, you can apply for a Post-Masters Certificate program in Nurse Anesthesia since you already have your MSN. It worked for me. I had my MSN in Nursing Education and I already had the ICU experience and I applied to 5 civilian CRNA programs and was accepted into 4 out of the 5 schools, all which had post-masters programs for nurses who already have their MSN. The great thing is that your course load is a lot lighter compared to the MSN CRNA students since you already have the core courses such as research, theory, ethics, pharmacology, physiology, and health assessment. Post-masters programs just require you to take the anesthesia courses and then you graduate with a certificate in anesthesia, which allows you to sit for your board exam.

I start my program in Jan 2014 and I'm just taking Pharmacology and Physiology since my MSN was in a non-clinical specialty. When I start my program, basically I will be taking only 2-3 classes a quarter which is a lot better than taking 5-6 classes a quarter.

Good luck to you.

[osenbaby]

Thanks for you advice. It was really helpful

[traumaRUs, MSN, APRN]

Just another piece of advice - make sure you keep your NP malpractice insurance while you work in the ICU.