Interview for Transitional ICU Position

OrganizedChaos, LVN · Sep 10, 2015

I honestly think the thank you I sent cinched my offer for the OR. I sent the thank you on a Tuesday, and got the call with the offer 2 days later. I have sent thank yous for every interview I have had, even before becoming an RN. Please keep us updated OC, Fingers crossed for you!!

I really hope it does get me the job. I would love to work at that hospital & the NM was just lovely. We just clicked amazingly. :) She is interviewing until tomorrow so hopefully I will find out next week. Thank you!

am27 · Sep 11, 2015

Honestly OP, I'm really happy for you and I'm excited for you. I'm pretty sure that if you showed any fraction of this genuine passion you've shown here in your posts throughout your application/interview process, you landed the position. In my state, LPN/LVNs aren't hired in hospitals so my post asking if you meant TCU wasn't meant to be snarky (honestly). Where I live, LPNs are employed in clinics, LTC, home care, etc. so unless this isn't the case in other states, it sounds like you found an amazing opportunity. I believe scoring an interview is the hardest part about landing a great position so I'm hoping you hear good news. I work on a similar kind of unit and I had a moment of forgetting trying to prove points and I wanted to tell you that I really appreciate your enthusiasm and passion! I think those are some of the most important attributes when being a nurse anywhere, but actually caring is even more important in critical patients. It seems like you enjoy a challenge and I respect that. Keeping my fingers crossed for you!

OrganizedChaos, LVN · Sep 11, 2015

Honestly OP, I'm really happy for you and I'm excited for you. I'm pretty sure that if you showed any fraction of this genuine passion you've shown here in your posts throughout your application/interview process, you landed the position. In my state, LPN/LVNs aren't hired in hospitals so my post asking if you meant TCU wasn't meant to be snarky (honestly). Where I live, LPNs are employed in clinics, LTC, home care, etc. so unless this isn't the case in other states, it sounds like you found an amazing opportunity. I believe scoring an interview is the hardest part about landing a great position so I'm hoping you hear good news. I work on a similar kind of unit and I had a moment of forgetting trying to prove points and I wanted to tell you that I really appreciate your enthusiasm and passion! I think those are some of the most important attributes when being a nurse anywhere, but actually caring is even more important in critical patients. It seems like you enjoy a challenge and I respect that. Keeping my fingers crossed for you!

Thank you.

calivianya, BSN, RN · Sep 14, 2015

During the interview she said the nurse to patient ratio is 4-6:1. If I get the job, should I accept or turn it down? If 5 is too many when titrating drips, should I be concerned?

Man, I'm good at responding to posts a little late. :)

I would probably still take it for the experience in your shoes (non-acute care experience). I would just get the heck out of there as soon as I was able to transfer.

It's a bad mix when you get them sick enough to need drips but not sick enough to have a tube in their mouths yet, and you have that many of them. I have found true stepdown patients are often anxious because they really do feel bad and know something is wrong (good old feeling of impending doom), so they can be high maintenance patients since they are scared and don't want to be alone. They can be real call light riders, and when they stop riding their call lights, you're not getting a break to catch up on charting - they stopped using it because they just went altered and are deteriorating, so you're still going to spend your whole night in that room. Keeping up with drips on top of that is a challenge.

It really depends on the overall acuity of your hospital. My PRN job is in a combined stepdown/ICU, and the stepdown level patients are sicker than some of the ICU patients were at my first job. If it is overall a lower acuity facility it shouldn't be too bad - but if your interview was in a large referral center type hospital, you are going to be in for quite the adventure with those sorts of ratios - the sort of adventure where you put out fires all shift but don't have much time to be proactive about anything.

I am crossing my fingers for you! It really is an amazing opportunity either way.

OrganizedChaos, LVN · Sep 14, 2015

Man, I'm good at responding to posts a little late. :)
I would probably still take it for the experience in your shoes (non-acute care experience). I would just get the heck out of there as soon as I was able to transfer.
It's a bad mix when you get them sick enough to need drips but not sick enough to have a tube in their mouths yet, and you have that many of them. I have found true stepdown patients are often anxious because they really do feel bad and know something is wrong (good old feeling of impending doom), so they can be high maintenance patients since they are scared and don't want to be alone. They can be real call light riders, and when they stop riding their call lights, you're not getting a break to catch up on charting - they stopped using it because they just went altered and are deteriorating, so you're still going to spend your whole night in that room. Keeping up with drips on top of that is a challenge.
It really depends on the overall acuity of your hospital. My PRN job is in a combined stepdown/ICU, and the stepdown level patients are sicker than some of the ICU patients were at my first job. If it is overall a lower acuity facility it shouldn't be too bad - but if your interview was in a large referral center type hospital, you are going to be in for quite the adventure with those sorts of ratios - the sort of adventure where you put out fires all shift but don't have much time to be proactive about anything.
I am crossing my fingers for you! It really is an amazing opportunity either way.

Thanks & that's great advice! I'll probably stick in there while I get my RN then after that start looking for another job. Or who knows how bad it is, it might not be that bad. But it sounds like an amazing learning opportunity for me & I still can't get over how awesome the NM was. We hit it off so great! I haven't heard anything yet, but today is only Monday. I'm crossing my fingers that I hear something this week.

VANurse2010 · Sep 15, 2015

The ratio 4 to 5 is doable if these gtts are non titratable such as lasix, amiodarone protocol, or integrelin, Angiomax, post heart cath etc.
I am guessing that your unit has stable stepdown patients and post Cath pts or CABG pts.
That is usually very "cookie cutter" if all goes well.
Pts on insulin gtts for DKA and precedex for dts can be very busy and a 5-6 ratio without a tech is unsafe.
If you like a challenge, take the job. You will learn skills that you can take with you anywhere in life. You should be given 12 weeks of orientation and ideally a critical care course.

I personally don't think Precedex has any business outside a real ICU.

OrganizedChaos, LVN · Sep 16, 2015

So I didn't get the TICU position. I was hopeful but at the same time I kinda knew I wouldn't get it since I have no acute care experience & the other candidates most likely do.

I want to thank everyone who helped me. I can't thank everyone enough. I really have grown as a nurse. I look back on my interviews from a few years ago & shudder. I love AN because I continue to learn & grow as a nurse.

I have decided to continue to pursue my education & quit applying to jobs. As much as I want to go back to work, clearly it isn't in the cards for me right now - or any more as an LVN. I realize now that it is more important to go to school & became an RN so I can get acute care experience because I will not get that experience as an LVN.

RescueNinjaKy · Sep 16, 2015

If you're really desperate for acute experience, North Dakota is always hiring. Rn or lpn. There are 3 lpns that work on my floor, and like I said I'm on a cardiac progressive care unit.

icuRNmaggie, BSN, RN · Sep 16, 2015

So sorry OC. I am sure you made a good impression.

If you do decide to go back to work someday, I think that your directness and humor would make you a natural for a position in Behavioral Health.

All hospitals need pt safety aides or sitters. It is a nice gig for a college student because you could study while they are sleeping.

OrganizedChaos, LVN · Sep 16, 2015

If you're really desperate for acute experience, North Dakota is always hiring. Rn or lpn. There are 3 lpns that work on my floor, and like I said I'm on a cardiac progressive care unit.

LOL! No, I'm not *that* desperate. Plus I couldn't move that far from my family.

WKShadowNP, DNP, APRN · Sep 16, 2015

Can you tech in an ER while you're in school?

OrganizedChaos, LVN · Sep 16, 2015

So sorry OC. I am sure you made a good impression.
If you do decide to go back to work someday, I think that your directness and humor would make you a natural for a position in Behavioral Health.
All hospitals need pt safety aides or sitters. It is a nice gig for a college student because you could study while they are sleeping.

Thank you. I do like behavioral health, it interests me a lot (as does corrections). I would like to do that but I can't work nights for health reasons.