Is SICU really the preferred ICU of choice when becoming a CRNA?

WolfpackRed · Aug 12, 2012

My ICU experience was medical for ~2yrs followed by neuro ICU ~18months (both adult) prior to starting anesthesia school.

You will hear and see many opinions on which is the "best" ICU to get experience in. in my class we have a good mix from every ICU background: trauma, surgical, medical, CV, cardiac, and neuro.

Ms.HoneyBadgerRN · Aug 13, 2012

Yeah, I've been reading a lot of threads and everyone has mixed reviews. I guess I am just having trouble picking one over the other. Both units would provide me with surgical and trauma experience. The neuro unit is smaller (16-beds) while the surgical unit is larger (40-unit). The other appealing factor is that the surgical unit gets all different types of surgeries including transplants. The neuro unit is involved in trauma such as stab and gunshot wounds and MVA's. I wish I could just float to both so I could have my cake and eat it too.

RN2784 · Aug 13, 2012

Either will be fine as long as acuity level is high and your target schools don't specify certain types of units.

CABGx4, ASN, BSN, MSN, CRNA · Aug 13, 2012

I don't think there is a big difference as far as increasing your odds of getting into school. What matters is how much you learn and excel at your position. FYI I had 2 yrs MICU and 2 CTICU. Good luck

Ms.HoneyBadgerRN · Aug 14, 2012

Thanks guys! Another concern I have is that the Neuro ICU is very outdated. From what I saw most of the equipment looked newer, but the monitors were really old. However, the manager did say that they will be getting new monitors in October. Otherwise I think I would learn a lot there.

naptime14 · Aug 15, 2012

In my opinion, SICU all the way. You will get more exposure to a variety of things and will get more exposure to the anesthesia team. You will also have a larger array of meds, drips, lines and procedures. I've been in the SICU/CTICU for 6 years so of course I would say that, but I occassionally get floated to Neuro ICU, Medical ICU and Cardiac ICU (in a large teaching hospital). But like someone said earlier, it may not increase your odds either way. From my experience and conversations with fellow ICU nurses, most come from the SICU, CTICU or Medical ICU. Never heard of any coming from the Neuro ICU (yet).

naptime14 · Aug 15, 2012

if you are having a hard time deciding, have you considered the ICU float pool? You will get exposure to everything that way.

SICUlove · Aug 15, 2012

I think you should consider a few things with this decision. First, beyond what would look good for CRNA school, how do the individual units compare in terms of work culture, schedule, etc.? You will be spending 1 or 2 years there so you don't want to be with miserable co-workers! If you don't get in the first time, you need to be comfortable staying in that unit because you like it. This was important with me in deciding between ICUs and I made the right choice and love my job and co-workers. Have you shadowed both units?

Also, does the hospital have a CRNA program? My SICU has a reputation for having consistent turnover due to CRNA school but my school knows what kind of skill set people from my unit arrive with and that offers them some idea in what I know/don't know. I don't think my interview was as difficult as others from people out of state because they are trying to get a feel for what that candidate was competent with day to day. With me, I think they knew more of what they were getting.

I think it would look good for you to branch out from neuro to SICU and make you a more diverse candidate. I work in a level I trauma hospital in the SICU and we see a lot of neuro trauma too (we've had EVD's and bolts lately, most with extensive concurrent ortho injuries) so hopefully you'll get some neuro patients there. I got anesthesia and surgery references from my unit and I think the exposure to the OR team/CRNAs was helpful.

Good luck with your decision and best wishes in your pursuit! I can't remove all bias because I really enjoy my unit as a whole and work with my best friends that I've made while here :-) I'm going to Duke in Spring.

So here is my current dilemma...I am currently between choosing jobs in either the Neuro ICU or the SICU. Both jobs are at the same level 1 trauma hospital in downtown Detroit. My plan is to eventually become a CRNA and I want to make the best choice so I can get into CRNA school. I currently work on a stroke/cardiac unit and I love my neuro patients, so I feel it would be easier for me transition into the neuro ICU. On the other hand, I wouldn't mind getting out of my comfort zone and expanding my knowledge base into another area of practice. I've also heard that SICU's tend to be "farms" or "breading grounds" for CRNA's. I guess I just don't know enough about SICU to know that I would like working there.
If anyone has any experience in these areas or has gotten into CRNA school with either one of these backgrounds I would really appreciate your feedback! Thanks everyone!

Ms.HoneyBadgerRN · Aug 15, 2012

@SICUlove: You have totally read my mind! One thing I have learned working as a nurse for the past year is that working with people you like (and those who later become your best friends) really makes all the difference. I can pretty much get along with anyone and put on my happy face when I need too, but working with people you legitimately like really changes the whole dynamic of the floor. I definitely want a supportive group of people to work with especially because I am going to learning for a while and teamwork is so essential when you're a nurse no matter where you work.

The hospital itself does not have a CRNA program, however, it is a teaching hospital and it is a clinical site to several of the nursing schools (including CRNA) in the area. I do know however that schools are really impressed by those who have work experience in this specific SICU.

I have been doing countless hours on these 2 units because I really do want to make the right decision not only for me, but my future career. According to what I have read on the internet, this blog and what I have heard from those familiar with the SICU the comments are the same across the board "it's great!" Those who work there love their job and those who know of the unit say that it is a phenomenal unit. So what's not to like?

I also thought about the benefits of being exposed to the surgical culture and the OR/Anesthesia team and how that would not only help with a future reference, but also how it would help me transition into that area of care. I also think that SICU would be a legitimately interesting place to work. This unit not only gets your normal surgical cases they also see trauma surg pts, transplants, open hearts, and over flow from the neurosurg unit. I really don't think I would have a problem becoming interested in my job if I worked there. Plus I'm just a curious person who likes to learn new things anyway.

When I originally started this journey I was pro-neuro all the way, but I guess now it's nice to have more than one option.

SICUlove · Aug 16, 2012

Keep us posted on what you choose!