Neuro ICU vs. Transplant ICU for CRNA School

[Chelse.RN]

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!!

[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.