Needs some advices about experience

jin,

I know there were more than a few in my interview sessions (I interviewed at three schools) who were declined for the very same reason. It might not be bad idea to indeed change to a place that has higher acuity patients. You don't want the first time you really 'play' with a swan to be in the patient you are helping put it in on! Same for the drips--from what i gather from friends you have finished and are practicing, you gotta be comfy with them, what little bits do, vs. large amts, what effect they have on different VS,etc.

Just some thoughts from the peanut gallery! Good Luck and hang in there!

--K

I was working in a SICU in a large teaching regional med center where the Trauma team was putting in less and less PA caths and only using Dopamine and Levophed. I got maybe 5 PA caths my first year with the same mentality in assigning most sick pt's to most experienced nurses. A buddy in the same unit applied to 8 different CRNA programs and was turned down by 7 for lack of swan and gtt experience. Alternate at school 8. I decided that would not be me and transferred to Open Heart Recovery ICU where every pt comes back with a swan and all gtt's already hanging and available to use per ordered protocols. I am much more autonomous and things just click when you use them everday.

I am in agreement that you want as much experience with these as possible. It is one thing to memorize which drugs do what and what your PA numbers mean and totally another to have it ingrained through your own experience.

What to do in the meantime prior to your next interview? Talk to a nurse manager in a unit where you can get more experience about the possibility of working PRN. Or speak to your nurse manager about getting assigned the sickest patients and the ones with the PA caths. If you provide sound rational "I need the experience while the more experienced nurses are around to back me up and help. I don't want my turn to come when it's all newbies and there is nobody to turn to for help". If you go into your next interview with an identified weakness and a plan to make up some of your experience, it may show you have addressed a weak area and strengthen your interview.

I have applied to 5 programs. All applications are still pending at this time.

Best of luck to you.

Jin,

Don't be discouraged... even if this year is not the year. But start today in finding a way to get all of the CABG recovery cases you can. That post-op repetition can prepare you for any fluid volume status situation out there. And it will make you comfortable (not just familiar) with CV gtts, when to use volume expanders (albumin, hetastarch), how to react to high and low COs, and a workable knowledge of CI. In our hospital, I specifically chose it because they encourage new RNs to get in and "get dirty" with anything they want to learn about. Just remember that any experience you learn from will make you a better CRNA in the end.

If the hospital you are working for will not put you on these cases, for goodness sakes find one that will! They are out there. Since my precetorship ended until the end of my 1st year as an RN, my CVICU let me take 25-30 post-op CABG & Valves. I also had around 10 IABPs. I was always asking to take those cases (and at times, maybe a little annoying) But I gained the necessary experience and knowledge quickly. I know you can, too.

Do not be discourage. Hope it work out for you in the other interview. I find it odd however that they email you and did not send you a formal letter of decline. May I ask which school is this?