ICU experience

[Dbb82]

I've been in my MICU for over 8 months now. Other experiences are PACU for 2 years and ER for 4.5 years. As I have said in the other thread, the acuity level of my unit is not that great. It's merely nothing but stable vented nursing home patients that you turn Q2. I feel like I have hit a brick wall in learning what I need to learn while being up here. I want to go to a busier and more acute hospitals, however can't leave right now due to them reimbursing my tuition, as well as me needing enough vacation time for my wedding out of the country this June.

I have an interview coming up in May and I am a wreck. Former grads told me not to worry since they only ask personal stuff, not anything clinical, but I am not too confident about this. The good thing is, the director is a very "word of mouth" type of guy, and it only took a phone call from a former grad for him to personally contact me to send in my application.

I understand that I need to be fulltime critical care by the time I start, but would it hurt to go per diem at a different and more acuite cticu/cvicu's? My plan A is to stay here until there's an opening to the cardiac care unit or the cticu (not a busy kind)... Plan B is to just take the reimbursement hit and seek a job elsewhere. The only thing is... there aren't that many open positions at the more acute hospitals. Most are part-time's or per diems. Would it hurt to just take 2 per diem jobs at a more acute unit? Plus it's not like i'll just work 3 times a month there since I need to pay my bills.

advice?

[RhinoRocketRN]

I would personally Pick up the per diem job and keep this one. You try to get a new job, if you do get it I'm assuming you'll start late April with proper resignation . By the time of the interview in may you will still be on orientation. Is that going to be helpful to you? Is the stress if a new job going to be beneficial/ will you get off for your wedding? These are things to take into consideration.

[missnurse01, MSN, RN]

get a job in a higher acuity but trying to get your foot in the door with per diem. they are not going to teach you anything working as a per diem, and you will not get the high acuity pts. But it may lead to a full time job offer in that high acuity unit. as a per diem you can also ask the unit educators if you can take additional classes for critical care throughout the year, etc. I would also work as much as you can on that higher acuity unit, even as a per diem, to get lots of exposure. Go in every room that is doing something you are unfamiliar with. You can learn a lot like that, I never had a formal crit care instruction course!

[chudder]

It's possible that there is more to learn at your current job by digging deeper into the pathophysiology and pharmacology of anything and everything going on with your patient. Can you explain, to a molecular level, the acute and chronic changes occurring in, for example, a diabetic patient? How exactly does X, Y or Z medication work? Is there more to it? What alternatives are there, and why was this one chosen?

You may want to seek out higher acuity patients elsewhere, but I agree that you will likely not get sick patients if you are per diem.