Neuro ICU vs. Transplant ICU for CRNA School

I recently was offered both positions within a large level 1 trauma hospital. Both intrigue me but I'd like the best experience for CRNA School. Any advice? Thanks!!

[BSN16]

hmm im not sure if it will make that much of a difference considering they are both ICU.

As a neuro ICU nurse though i probably make use of more sedative agents than a transplant ICU would. Which may be better than a transplant ICU? However, more surgical experience with transplant. I think either or would be good for CRNA school

I'd say go for whichever has the best money/lifestyle/etc. We have nurses from all types of ICU in each class for my program. 25% of my class has a neuro background. My personal opinion would be the transplant ICU just because it sounds more fun with sicker patients and I love anything SICU related.

If by transplant, you mean heart/lung and liver, then definitely that. If not, toss up.

Its abdominal transplants so liver and kidneys..

Its abdominal transplants so liver and kidneys..

Do the transplant over neuro. Liver transplants are some of the most unstable and difficult patients you will encounter, especially in the OR. It will serve you very well I think.

[jfratian, MSN, RN]

Wouldn't a neuro ICU be pretty lite on the sedation and pain meds so that patient's mental state could be realistically assessed? I've never worked in a neuro ICU, but it seems that a surgical ICU would be a better fit.

[BSN16]

Wouldn't a neuro ICU be pretty lite on the sedation and pain meds so that patient's mental state could be realistically assessed? I've never worked in a neuro ICU, but it seems that a surgical ICU would be a better fit.

It depends. Yes, maybe a fresh moderate head bleed that i'm observing i dont want to sedate him to assess his mental status. That being said the patient next door who is intubated with an EVD and an ICP in the 30's, sedate...sedate...sedate!

It depends. Yes, maybe a fresh moderate head bleed that i'm observing i dont want to sedate him to assess his mental status. That being said the patient next door who is intubated with an EVD and an ICP in the 30's, sedate...sedate...sedate!

I understand what you are saying. I was floated to a Neuro ICU a few months ago. I had a patient on various sedative medications such as Ketamine, which I never used or seen in other ICUs such as Cardiac and Trauma. Those drips are at a set rate and usually not missed with. Not good for CRNA school in my opinion. Neuro patients are hard for me to deal with on a daily basis. I personally would not pick that.

To the OP...Pick Transplant. You will have more familiarity with titrating drips, Swans, Art line, etc. Patients getting weaned and extubated quickly. I would also advise trying to get a year of Heart Transplant in before CRNA school.

[lasvegasnurs]

Neuro is a pretty pigeonholed specialty with very minimal conditions and comorbidites. Sure you get to see lots of cool stuff, but overall exposure to other aspects of medicine are limited compared to many other ICU's.... but for application purposes as long as its adult ICU most programs dont care (as long as you tell them you deal with all the different drugs and invasive monitoring).

[BSN16]

I understand what you are saying. I was floated to a Neuro ICU a few months ago. I had a patient on various sedative medications such as Ketamine, which I never used or seen in other ICUs such as Cardiac and Trauma. Those drips are at a set rate and usually not missed with. Not good for CRNA school in my opinion. Neuro patients are hard for me to deal with on a daily basis. I personally would not pick that.

To the OP...Pick Transplant. You will have more familiarity with titrating drips, Swans, Art line, etc. Patients getting weaned and extubated quickly. I would also advise trying to get a year of Heart Transplant in before CRNA school.

Depends on the facility i guess, we dont use ketamine. We use vec which is a titratable drug with TOF

[MYSTICOOKIEBEAR]

I am a Cardiac/Transplant ICU and having worked dozens of shifts in other ICUs (SICU, MICU, CCU, NICU). My advice is go with the Transplant ICU. It will give you more experiences with SWANs, vasoactive drips, fluid resuscitation, aggressive extubation protocols, titrating sedation, and hemodynamics.

[marienm, RN, CCRN]

My hospital only does kidneys, kidney/pancreas, and pancreas...I really lke these patients, but the kidneys are usually pretty stable and extubated before they leave the OR/recovery room. Sometimes they're on anti-hypertensive gtts if needed, and occationally on cotinuous bladder irrigation, but other than frequent labs, urine monitoring, and the occasional IV insulin/dextrose/bicarb for hyperkalemia, they are not *usually* very exciting. I've never taken care of a liver, heart/lung, or intestinal transplant...I'm sure they're a much different learning experience. So, OP, if the transplant service truly does all tranplants, you'd probably learn a lot!

I've only rarely floated to Neuro (as a trauma center, I think ours has a fair-share of head bleeds as well as CVAs, status epilepticus, etc) but my impression is that those patients travel the most intra-hospital because many of them get scanned daily. So, there's that.

As an aside, we use ketamine for burn patients to contol/dissociate pain. Nurses don't titrate it, the MD adjusts the dose. For a vented pt, we almost always have another sedative and another analgesic running as well that the RN can titrate. A patient can be extubated with ketamine running, though we don't do it often. We use paralytics (like the vecuronium mentioned above) for ventilator compliance...always in combination with sedatives and pain control, not patients we are trying to extubate.