ICU Charge nurse Vs. ICU floor nurse to become CRNA

ArmaniX, MSN, APRN · Jun 3, 2015

How could you be a charge nurse when you have no experience caring for the icu patient?

Maybe I read something wrong but a charge nurse should be a resource and without actual icu patient experience you will be pointless as a charge. My opinion.

I recommend you take the bedside position.

ICUCharger · Jun 3, 2015

I do have a little ICU experience but not much. Charge nurse also has a lot to do with leadership which I have many years of which is why they offered it to me. Also have a charge experience on my current unit(we rotate charge duties). But the question has to do with getting into CRNA school and if it would help me out by doing floor or charge

klone, MSN, RN · Jun 3, 2015

Charge nurse also has a lot to do with leadership which I have many years of which is why they offered it to me.

Charge nurse has a lot to do with CLINICAL leadership. A charge nurse is an expert in that role, and a resource for the nursing staff. One cannot be an expert and resource if one has very little experience in the nursing role.

I know that's not answering your question about CRNA school, but I think the issue we brought up is the more immediate concern.

Here.I.Stand, BSN, RN · Jun 3, 2015

Tthe idea of the ICU charge nurse having no ICU experience is... one of the worst ideas I have heard in my life. How are the floor nurses supposed to bounce ideas off you, look to you for guidance, if you don't know how to take care of critical patients? What are you going to do in a situation where you might have multiple admits coming at once? That has happened in my ICU. we have had mass casualty situations where multiple trauma patients are admitted at once (e.g. mass shooting, infrastructural disasters, multicar pileups, that sort of thing.) What are you going to do if there are several sick calls for one shift, the staffing office can't give you enough float nurses, and you have to take a patient or two? This actually happens quite frequently. Are you going to have to ask the floor nurses how to take care of your patient because you have no ICU experience?

I'm sorry, this is not meant as an attack on you, but the fact that you asked this question shows you really don't know what you do not know. It's scary when new grads don't know what they do not know, but it is absolutely terrifying for an ICU charge nurse not to know what he does not know. I have no military experience. Would I be qualified to hold a rank above yours? Of course not. Likewise, you are not qualified to work as an ICU charge nurse, in charge of ICU nurses.

As far as the question asked in your thread title, CRNA school requires critical care experience. At this point you have none. For the sake of your colleagues and current and future patients, take the floor job

HouTx, BSN, MSN, EdD · Jun 3, 2015

Typical ICU staff don't need much 'leadership' other than making bed assignments, making sure routine 'tasks' (crash cart check, fridge temps, supply orders, etc) are done and maybe ensuring that everyone has coverage to take a lunch break - otherwise, they are fairly autonomous. The 'charge' nurse is usually expected to act as the expert resource and jump in whenever a helping hand is needed. An important aspect of this role in any specialty unit is credibility as a clinical expert - that can't be faked.

I agree -I would advise going with the staff position and soaking up as much learning as possible.

FloatRN19 · Jun 3, 2015

The ICU chargers I run into are expert icu nurses. They can do everything, support when needed and take patients when need be. I haven't come across a single icu nurse who wasn't driven. they don't need a leader, they need an expert who can have their back and offer their clinical experience and judgement from their time as a floor icu nurse. Id take the floor job and revisit becoming a charge in a year or two.

OhioCCRN, MSN, NP · Jun 3, 2015

Charge nurse in an ICU is not about ' previous leadership' ICU nurses are extremely independent in their practice and do not necessarily need ' a leader' they need a resource: which you are not at this point.

I would take the bedside position because it is the best way you can learn to be clinically competent for the CRNA school

LadyFree28, BSN, LPN, RN · Jun 3, 2015

Short answer: take the staff nurse position, soak up knowledge, stay in the position for a few years-minimal five, THEN apply to CRNA school.

Here.I.Stand, BSN, RN · Jun 3, 2015

What HouTx said. We ICU nurses are quite the driven bunch. I can't recall ever meeting one who needed leadership in the directional sense. When the fit hits the shan, we don't need a boy king. We need Earnest Shackleton. In other words somebody who knows what the heck needs to be done, can get into those icy waters with us, and ROW.

littlepeopleRNICU · Jun 3, 2015

I would take the bedside position. Bedside patient care is going to be the best experience to help you in CRNA school, unless you routinely take patients on a regular basis as charge. That experience is going to teach you the most about managing hemodynamics, sedation, a crashing patient, etc., when YOU are the one ultimately responsible for the patient and getting the most "practice".

I also would personally not feel effective as a charge nurse to a unit where I didn't have at least a couple solid years of experience.

So, I say go bedside by FAR.

Pheebz777, BSN, RN · Jun 4, 2015

As what was already mentioned, I do hope you understand the complexity the ICU charge nurse role entails as compared to leadership roles you have experienced in the past. As an ICU charge nurse, you must be familiar with the various body systems and how they interact with one another as well as numerous critical drips that abound in the ICU. For example: you have a post-op patient with history of renal failure on a dilaudid drip for pain management. 2nd day post op patient is not responding, but vitals are stable, ABGs normal on the higher side of respiratory acidosis, no urine output for the past 3 hours. How would you manage this patient.

There are several basic procedures that you must be an expert to help new ICU nurses or assist in trouble shooting. Setting up an arterial line, setting up patient for ICP monitoring, managing balloon pumps, and you definitely need to be an expert in ACLS to the point where you already can anticipate what the MD would order during code blues.

This is just the clinical aspect of a charge nurse's responsibility. You would probably be better off as an ICU nurse manager if you possess great leadership skills and have some critical care experience. But it's always best to start at the bottom as a floor nurse. Get some certifications (ex. CCRN, CMC, etc.). Being a charge nurse or floor nurse has no bearing on whether or not it would help you in going to school as a CRNA.