ICU aspirations: what should I do?

whipping girl in 07, RN · Dec 13, 2008

Hmmm, that's a tough spot. Why weren't you able to start in ICU as a new grad? I think most ICU, especially CTICU/SICU, nurse managers understand their units are training grounds for future CRNAs. The ones I've worked with in the past have been happy to have you for a couple of years if that's your career goal. I've worked in the same SICU, now just prn, for over five years, and most of the nurses that were there when I started are gone...some have moved, some have gone to other units in the hospital or other hospitals, some have gone to CRNA school, one or two teach nursing school, some have retired or are staying home with kids. They can't expect you to stay forever.

Having said that, have you been able to talk to your NM? Were you up-front about your career aspirations when you were interviewed? My original plan was to work in the ICU for two or three years and then go to CRNA school, but I had two more kids and came to the realization that I wouldn't be happy as a CRNA, even though I'd make more money. I also came to the realization that the ICU wasn't the place for me either, and I explored other options. I'm now a metabolic support nurse, and I couldn't be happier with my job. I still work prn in the unit because I need the money! But when I interviewed for my ICU jobs (3 total), when the NM asked me where I saw myself in 5 years (or whatever variation of that question), I told them CRNA school. That answer did not keep me from getting the job at all. I was hired all three times.

If you don't have much longer till you don't have to pay the money back, I'd hang in for a little longer. But if it keeps you 6 or 12 or more months from making the extra money you'd make as a CRNA, it's not worth it. ER, OR, PACU, and Cath lab are all critical care areas, but it is not the same as ICU experience and for most programs, while that experience may make you more well rounded, it will not really help with anesthesia/hemodynamic management of a surgical patient, which is what you do as a CRNA.

Hope you find your path.

tonyccrn · Dec 14, 2008

knobby

so am I missing something. you were hired out of nursing school into the ICU, but you are working in stepdown now.

two scenerios I can think of and I will give you my suggestions. as something similar happened to me.

1. its a tough floor to work on and hiring people is difficult so they want to keep the people they ahve. not letting you move up to the ICU.

2. they do not think you are ready yet.

I was hired into a two step program that transitions you into the icu, after my 9 months when i should have went, they did not let me transfer. my situation was number 1, it was a very hard floor to keep staff on and hire too. so they did not like to loose the people they had. so I applied at another hospital's ICU the next couple days after I found this out, got offered the job and the next day i worked I came in and handed in my two week notice.

now yesterday was my last day at work in the ICU as I am starting anesthesia school in a couple of weeks.

I would not let this job hold you back from your goals, start looking for other icu positions at other hospitals, and DO NOT tell anyone about your goals of being a CRNA, i have seen it to many times where people will not take you into the icu becasue of that.

just my opinion

tony

Burnenup · Dec 14, 2008

Hey Knobby! oh, you sound so frustrated! Sounds like they are hanging onto you while youre still obligated! My suggestion is to work like you have never worked before, if you are not already working yourself to the bone, get some good references, but then know when to look elsewhere for some REAL ICU experience. I mean start circulating your resume at other facilities if you have to. You will have an awesome resume because #1-you will have fulfilled a contract obligation, and #2-step down after being a new grad looks good too.

Another year in an ICU somewhere is not going to hurt when applying to schools. I just finished a BCC course with a 2 year obligation; this after working as a house sup and in the ICU for about 10 months in a smaller level 4 facility. Hopefully I will have a strong resume and more importantly, KNOWLEDGE by the time I am ready to go for it!

so my advice.....fulfill your obligation and then move on! but put your best effort forth now, it will pay off.

knobby1 · Dec 14, 2008

I think about whether I'm ready too. I have heard both - and + feedback. I accept both kinds and work hard to improve, as anyone should.

I just talked to two friends who have been hired into ICUs with much less experience than me. I think being "ready" depends on the perspective somewhat. It's impossible to gather totally unbiased information on a nurse. I have tried to set the record strait but it doesn't seem to matter. I havn't done anything grossly negligent but I have made mistakes here and there. Either way, I think it's time to move on from my first nursing job anyway. Time to clear the slate and find people who support me.

I was SNA president, student of the year and graduated with honors from nursing school. I know I can do it.

knobby1 · Dec 16, 2008

You have a point about the contract obligation. Something to think about... I do have some good references already from my current job, clinicals and other connections. I think I will apply to whatever comes up and just see. I am thinking of cashing out my 401K to pay off my debt, before it disappears. : )

tonyccrn · Dec 16, 2008

hey knobby,

dont worry about that 1200 you will have to repay back. if you can get in another icu, do it. Do not wait to fulfill their obligation, the obviosly didnt hold up their end of the bargain. just think that 1200 you will have to pay back will be holding you back atleast 6 more months of applying to crna school. provided you get another icu job and in school. 6 months earlier because you are out of this contract, and that is even if they let you at the end of yoru obligation. if everything works out you will be working as a crna 6 months earlier and that 1200 you spent to get out of a contract will be nothing.

tony

loveanesthesia · Dec 19, 2008

You have a point about the contract obligation. Something to think about... I do have some good references already from my current job, clinicals and other connections. I think I will apply to whatever comes up and just see. I am thinking of cashing out my 401K to pay off my debt, before it disappears. : )

Maybe it's because I'm a little older, but I would just be patient and stick out the next 8 months, looking for a good ICU position to immediately go to ASAP after the 2 years. In my 20's I was very impatient, so I may not have followed this advise! I bet you are actually one of the strongest nurses in the step-down unit and that's why they won't let you go.

krzysiu · Dec 20, 2008

I was hired first thing out of nursing school into an ICU position. I expected there would be some training but the prospect of working in the ICU has been pushed back several times over 16 months with no definite dates to move to ICU. I don't know if word has gotten out about my CRNA aspirations or not. I am a newer nurse but I feel compitent to proficient most of the time. Mangagement is pushing toward retaining as many experienced nurses in the step-down unit I work in now, and has tightened up the ICU transfers to only 4 to 8 per year. I did sign a two year contract with the hospital, so if I left today, I would have to repay $1200 or so.
Am I being impatient? Should I be looking elsewhere? Should I look for experience in the ED while waiting my turn to transfer to the ICU in 6, 9, 12 or more months?
frustrated

Take control of your destiny. I recommend a CV-ICU. It will get you a feel for hemodynamics. As an RN, you should be able to quite easily find a job that meets YOUR needs. Do what you gotta do to realize your goals. Time goes quick. Get into a solid ICU ASAP. Despite being a good experience, many schools won't count time in an ER as critical care experience. If the money becomes an issue tell them there was a breach of contract. You were hired for an ICU position and it never happened. If there is an ICU differential within the hospital, tell them while waiting for the position you were hired for you missed out on all the extra earning potential and call it even. Get out and get what you want and need to be in a good position for CRNA school.

knobby1 · Feb 3, 2009

Thanks for all of your input. I ended up calling a friend who graduated a year behind me. He was working in an ICU in a trauma 1 facility. I started applying and found a position in his unit. I had a great interview and got the job!

I gave notice to my previous job and of course I will have to pay back what I owe but I think it was a good move. This way I can start applying to schools earlier and it seems like this is the best time of year to get the jump on CRNA applications.

There happened to be another nurse from the step-down where I used to work that is now on this unit. He was just accepted to CRNA school.

I am very excited for this new opportunity. I understand I will still have some learning to do, bridging the gap between the step-down and this new unit. I just get a good feeling from the manager and the staff. They don't mind having people move on from this unit after a year or two. They are progressive that way. It's a great unit too. They have a group of docs who find whatever excuse they can to admit them to this floor.

Thanks again for all of your encouragement!

Burnenup · Feb 3, 2009

CONGRATULATIONS!!!! :yeah: