OR/floor nurse before CRNA school?

[Dre2416, BSN, RN]

My school has a program to train us in OR nursing while in RN school. This is an extra internship in summer. My plan is to do my best to gain an ICU position out of school but in case I cant get a position would experience in the OR or a floor nurse be better to allign me to transfer into the ICU?

[CPhT2RNstudent]

I would think ER would be great (dealing with critical patients), then med/surg, then OR. In the OR you do not do much care (at least not at the OR in my hospital). You may put in foleys, document what is going on in the case, etc. In the OR you only have one patient, the anes. team member is caring for the patient, surgeons are doing the procedure. Bottom line, I am not bagging on OR nurses, they do a great job, it just does not seem like a good way to get your foot in the door for ICU or CRNA. I have been in ICU at a trauma I for a few years and have not seen one nurse come to us from the OR. Look for an ICU internship.

[gobluern]

I work in the O.R. and in ICU part time. It can be done. You just have to bother enough nurse managers.

[mbrowder30]

The hustle and bustle of OR RN'ing will prep you for ICU be best. I've been a CCRN for about a year now and have worked with a variety of RNs coming fresh from undergrad, ER, the floor, and the OR. All of the ER RNs I've worked with have ended up going back to the ER (they are not one in the same in regards to acuity, culture, etc.). Working on the floor is probably the farthest from ICU. It also depends on what kind of ICU you want to get into. Good luck! :)

[stunt362]

I started in ER and then transferred to ICU. Definitely the best option as you will get a lot of practice with your skills in ER (IVs, foleys, codes, etc.).

[gemini81sg]

I started out on a Med/Surg floor, a very busy one that had a lot of variety in regards to patient disease processes. I found this to be a very good place to start as a new grad as it allowed me to get a solid foundation in my nursing skills from an inpatient standpoint. I bugged my nurse manager the entire first year about transferring to the ICU. I was told time and time again that "all nurses should at least do one year on Med/Surg before going to the ICU, but two years is better yet".

I eventually transferred to a CV-ICU in a bigger city. Best decision I ever made. I learned all about hemodynamics, cardiac output monitoring, vasoactive drips, swan ganz catheters, art lines, mechanical ventilation, etc. This is what CRNA programs want out of their applicants. CV-ICU also includes experience with heart and lung transplants, VADs, CVVH, ECMO, Balloon pumps, TAHs, etc.

Because this was a big city there seemed to be open positions on the unit all the time. The unit is very high stress, high intensity (usually a code or two per week) and I think that is why there seemed to be a high turnover. This is the only ICU I know of that hires new grads on a regular basis. My initial training was 6 months minimal, which included many weeks of classroom and online training. It was a very stressful unit, but I loved the busyness, the constant new challenges and the adrenaline rush that came with working on this unit.

So you may want to look into going to a bigger city, but I would strongly suggest getting a good solid year on a Med/Surg unit. I think it most closely resembles the type of care you will give once you are in the ICU. I have also worked in the ED and while this area does permit lots of general nursing skills, you don't have the same ability to study your patient's cases and problem solve by trending patient data/history to assessment data the same way you do in the inpatient setting. Also, your physical assessment skills are much more 'focused' in the ED, whereas on Med/Surg you are doing a more thorough assessment which will strengthen these skills.

Hope this helps! Good luck! :)