Need advice on which career path to take.

[Amy3901]

Hello all, I welcome advice from someone who has knowledge in this matter. First of all my long term goal is to become a CRNA. Background, I precepted in neuro icu, since they have no job openings, I have applied to the neuro pcu and a perioperative program. I have been offered the job on neuro pcu and I interview tomorrow with perioperative. The perioperative program is 6 months of paid training plus a two yer contract with the hospital. My concern is I may not get the critical care experience that most CRNA schools require. So... Should I take neuro pcu in hopes of moving to NI in the near future or should I take the perioperative program (if they offer it to me). Is perioperative in any way considered critical care? Thanks, Amy

[manusko]

I would go for the PCU job with hopes of getting into the ICU. A regular ICU or CCU has been what most people have suggested. Some programs will take high acuity PACU and ER, but a lot require ICU.

[TNARN]

I agree with taking the PCU job. I have been a ER nurse for 3 years and many programs I have contacted want me to have ICU/CCU. I'm sure your could get experience taking care of critical care patients in periop, but you have to think of your application in relationship to everyone else.

Hope You Get It!!!

[Amy3901]

Thank you for your responses... I love this board, it is so nice to be able to bounce ideas off of so many nurses with so many different experiences! I am going to contact the NM on the Neuro PCU Monday and let her know that I have made my decision. Along with your comments, I felt the Neuro PCU was a better fit for me during my interview. Thanks! Amy

[WolfpackRed]

Amy, getting ICU experience will the safest choice long-term; however contact any prospective schools and ask how they define critical care. Some will take ER, OR and other "critical" areas even peds experience.

[acupofgas]

The Council on Accreditation of Nurse Anesthesia Educational Programs requires a minimum of a year ICU experience. This is an accreditation standard. I do not know what programs are taking ER and PACU in lieu of this requirement. So even though you did not get into the Neuro ICU, try obtaining a position in any ICU setting would be the best way to gain the most appropriate clinical experience.

[manusko]

Critical care can be in a ER and PACU if the patient load meets that requirement. If you work in a low level ICU you may not meet the requirement either. The requirement includes patients that require invasive monitoring and need to make critical judgements for patients on drips and other medications. Critical is mostly ICUs but not entirely.

[WolfpackRed]

The Council on Accreditation of Nurse Anesthesia Educational Programs requires a minimum of a year ICU experience. This is an accreditation standard. I do not know what programs are taking ER and PACU in lieu of this requirement. So even though you did not get into the Neuro ICU, try obtaining a position in any ICU setting would be the best way to gain the most appropriate clinical experience.

I apologize if I gave the wrong information, however I was of the understanding that admission to a programonly required a minimum of one year critical care expereince and it was up to the school to define "critical care". According to the AANA website under the section on requirements for becoming a CRNA it lists acute care experience, but give ICU and ER as examples.

[CRNA, DNSc]

The Council on Accreditation requires 1 year ACUTE care experience as an RN. Program are free to make requirements beyond (or more specific) that of the council but can not accept least than the COA.

[I_See_You_RN]

Yes the council does say acute and does include ER as an example but that does NOT reflect what most schools,.. I would bet to argue 99.9% of schools want... and therefore that clause is meaningless. 99.9% of schools do not accept ER, OR, or PACU. The .1% that may accept PACU would need extensive documentation or proof that your particular PACU consistently boards high acuity SICU patients. OR nurses whether circulating or scrub do not exercise their critical nursing skills 99% of the time. In fact, other than "on the table/off the table" they don't really touch the patient. (the OR, however, could not be run without them as they are the ones that keep the patients safe).

ER nursing: These nurses do demonstrate a lot of critical skills and are amazing at stabilizing a patient enough to transport them, but keeping a true high acuity patient in the ER for days is almost unheard of. Yes they are extremely capable when the fire is really burning but CRNA schools also want to be sure that you understand the changing care of a patient who's been on drips for days, who developed a PE, who's CO and renal function is steadily deteriorating. And there is also the question of consistency. Although a certain hospital might get a lot of high acuity ER patients they still have the same amount of broken fingers, simple lacerations, and homeless people wanting a warm bed. A 12 hour shift could mean 8 hours of non-acute patients. could be the same thing in the ICU, but there is less chance of this.

To answer the original poster, I would take the job that does not contract me for 2 years so that I would be flexible if a better opportunity was to arise.

[CCRNDiva, BSN, RN]

I've noted some schools will accept ED or PACU experience but they did stipulate the experience should be within a level I trauma center where the RN had experience with invasive monitoring, vasoactive and sedative gtts.

I agree with the above poster, I wouldn't take a job where I would be contracted for 2 yrs. I would be too afraid to miss the opportunity of an open ICU position. Good luck in journey!

[clintcron]

More importantly, you will be in way over ur head without adult icu. I spent a year in the pediatric icu, and I can honestly say that crna school would have eaten me alive, clinically, had I not spent the last two years in an adult cvicu. Just get the icu experience in the most acute area ur hospital provides. Period.