ICU position after BSN graduation

shoegalRN, RN · May 17, 2011

This is my plan... should I not include on my applications that my long-term (10 year or longer) goal is to be a CRNA? I thought that advancing the nursing profession, wanting to be an advanced practice nurse, etc. would look good on an application. Plus it's true =) Do you think that mentioning that on an application could harm my chances at a job?

Ten years or longer I wouldn't mention that. Most places wanted to know your plans that would include 2-3 years out. I went on an interview that asked where did I see myself within the next year. And it was for a telementry floor and I said in the ICU. That put me right out of the running.

If your plans includes CRNA school 10 years down the road, I just say just say "I want to grow as a nurse in this field of nursing and learn as much as I can, including getting my CCRN in the near future."

Good luck!

Kelly Fineman · May 29, 2011

Thank- you everyone for your advice, I REALLY appreciate it. But no one commented on working as an EMT while in nursing school and whether this has any correlation with ICU or critical care nursing? or if it would boost my resume enough to help me land a job in the ICU after graduation? any advice on this??

nurseprnRN, BSN, RN · May 30, 2011

that's because emt is not on the ladder in nursing. emt skills are skills, but they are not nursing. if you want to work as an emt for pay while you're in school because you need the money, fine. but don't expect it to give you any advantage as a new nursing grad, and don't go spouting off about it. seriously. i say this in the most caring possible way.

one of your biggest professional challenges will be leaving your emt-ness behind you and accepting/internalizing the role of a novice nurse. nursing school, not being an emt, prepares you for that role. that's probably why nobody in nursing here mentions it, and why when you get hired by a nursing department nobody will much care about it. they need nurses. be one.

Kelly Fineman · May 30, 2011

ACTUALLY, most of what I learned in EMT school was then retaught in the first few quarters at the Nursing school I attend. So, you are wrong, the skills do overlap. I am proud of earning my EMT degree and I will probably never leave my " EMT-ness" behind. Whether or not it gives me an advantage when I apply for a job does not ignore the fact that those basic abilities I learned in EMT school are most certainly essential for nursing- and enhanced my understanding of nursing at the least. I did not intend to go " spouting off about it" but I do intend to put it on my resume. There are certain life- saving proficiencies I learned while becoming an EMT that will stick with me throughout my career and that will without a doubt improve my competency when I become a nurse. I understand that you are a professional and have had your degree for many years and that your level of education most likely far exceeds mine, and that of course there is much more to being an ICU nurse when compared to an EMT. Nevertheless, coming from my experience speaking with multiple ICU nurses CRNA's, and anesthesiologists, EMT skills=basic ICU nursing skills.

nurseprnRN, BSN, RN · May 30, 2011

"overlapping skills" isn't the issue, if by skills you mean assessing level of consciousness, scene safety, delegation, transfers, field assessment of injury, taking vs, inserting ivs, giving meds, cpr, acls, reporting findings, and charting. some of that you'll get in nursing school, and some you won't. my point was, and pardon me if i made it imperfectly, was that nursing is a different set of philosphical approaches to patient assessment and intervention independent of emt skills. don't think that the first few quarters of nursing school will make much progress on them, though lord knows we try.

i stand by my assertion that being an emt may give you a leg up on some skills but it does not, inherently, per se, give you an advantage in your professional achievement of a novice nursing identity and ethic. that's why when you interview for a nursing job they will be more interested in your nursing identity and less in your emt-ness. you asked, and you can put this discussion away for a few years and let me know how it looks to you after a a few years of practicing as a registered nurse.

(you're right on my education and experience, btw. been there, done that, including icu and out-of-hospital emergency care and transport, probably since before you were in preschool. welcome to the profession!)

Kelly Fineman · May 30, 2011

OK. I now understand what you are saying, and I agree with you on everything up to the point of what I know so far. Thank-you for your advice. It's just hard to face that I may have to let much of my EMT training go to waste. I will definently let you know if and when I ever make it as an ICU nurse. Do you work as an ICU nurse (or did you in the past)? If so, I'd like to ask you for further advice on the matter. I''m really trying to do everything I possibly can to become a CRNA int the future, and in a reasonable amount of time so I will take any advice you have:)

Kelly Fineman · May 30, 2011

what I meant was I do not plan to become a CNA after graduation, but that I do plan to eventually go to school to earn my CRNA license later on after working in the ICU of course. I was inquiring about working as a CNA while in nursing school only. Sorry for the confusion!

Kelly Fineman · May 30, 2011

But won't I be investing at least a 1-2 years in the ICU if I decide to apply to CRNA school? I don't know fo any CRNA schools that will accept an RN with less than 1-2 years experience. Are you saying they'd rather hire someone who will stick around for longer than that?

nurseprnRN, BSN, RN · May 30, 2011

i worked pacu for one year, then went to icu and eventually got my master's in cardiovascular/thoracic and became a clinical specialist. don't ever think any learning is wasted-- it sure as heck isn't. it's been a good long time since i was younger and prettier and able to work double shifts in the icu, but there is an awful lot that i can use even now. one of the most important things you learn in icu is when to ask for help or more information.

and this: my best icu experience was in a world-class icu where we got patients from all over the world as well as locally-- trauma, open heart, transplant, medical, surgical, neurosurg-- all sorts of it. once i was sitting in the break room and sarah, an older nurse who i revered because she could do anything, take the most complex patients, never broke a sweat, and was a patient and generous teacher to the house staff and newbies like me, came in. i asked her impulsively how long it took before she wasn't nervous before every shift. she told me that she had gradually realized that she had learned enough to feel comfortable with anything we could get, but that every day, every day before report began she had a little frisson of nerves. she said the day she lost that was the day she had to stop, because that little jolt meant she had stayed sharp. i never forgot that as i went up the clinical ladder to the top over the next several years and suddenly realized that now i could handle anything that came in the door, teach the house staff, and precept new people. and i still felt it. and i still get it in my present job, which isn't even in the hospital.

while it's different now that i work for myself as a legal nurse consultant and certified life care planner, but the learning never goes away. don't mourn, organize, said joe hill. :) you can do that with your head, too. you want to be a nurse, be a nurse. you'll never regret it. the doors it opens, you'll never be able to guess, but it's a great life.

Pediatric Critical Care Columnist · May 30, 2011

I've worked with an RN who was an EMT first. He really believed that his EMT-ness made him somehow better at ICU nursing than the rest of us, but he soon learned that the skills his EMT-ness gave him were only the tip of the iceberg in the ICU. Yes, he could pop an IV into a dehydrated, septic child, he could rattle off a PALS algorithm and he could do a head-to-toe assessment quickly and efficiently. But he had difficulty with keeping himself organized, ongoing assessments and communicating concerns to more senior staff. He also tended to neglect the more routine aspects of patient care. He came with a bit of an attitude, and a desire to become a transport nurse, but alienated a lot of people very quickly. The other nurses on the transport team threatened to quit if he was selected to join them. Last I heard, he was only working per diem as an RN and was back on the "bus".