Path to CRNA/ ICU, please help!

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Hello everyone! I am looking for some advice on my path to becoming a CRNA. I am looking for pretty specific advice on my situation so this may be a little lengthy so bear with me. Any help would be greatly appreciated!!

A bit about myself:

I am a 23yo male from Southern California. I am currently in my first year of a BSN program in Flagstaff, Arizona at NAU (will be 25 when I graduate). I have worked as a Vet Tech for several years at an emergency vet which is where my interest in anesthesia developed (not just interested in the money). I have experience in intubation, monitoring, recovery etc.. and I feel as though I have a good understanding of what CRNAs do and I am sure this is what I want to do.

I went to community college for several years before transferring. I didn't do too great there (because I was young and foolish and wasn't trying). I have gotten straight As since transferring, including As in all college science classes i have taken. I plan on taking gen chem, O chem, biochem and possibly physics or other classes the next couple summers (not included in my program) to further my education.

My goal:

Become a CRNA and live in southern California. I would ideally like to attend the Kaiser CRNA program through Cal State Fullerton. The requirements for this program include 1yr ICU expereince:

  • Minimum of one year of current full time clinical registered nursing experience in adult critical care ICU. The Adult ICU requirement can be satisfied by working in any kind of Adult ICU environment, such as a Medical ICU, Surgical ICU, Coronary Care Unit, Trauma ICU, Cardiovascular ICU, Neuro ICU, Burn ICU, and CT ICU. The following experience is NOT considered adult critical care: emergency room, post anesthesia care unit, step down unit, and cath lab.

However on their site under how to be a competitive applicant it says this:

  • Have at least 2-3 years of current adult ICU experience in a large metropolitan teaching facility

This is where I need advice.

My goal is to get back to SoCal asap. I miss my family and the beach. However, I would also like to be able to become a CRNA asap (ideally by the time I'm 30-32). I am willing to do whatever it takes to make that happen.

The way I see it I have a few options:

1-Do my preceptorship at the local hospital, FMC (which is a level 1 trauma center, but I'm pretty sure doesn't count as a large metropolitan teaching facility) and try to get hired straight into the ICU here. Work here for a couple years then try to transfer to a large teaching hospital ICU in San Diego or LA. It sounds like I could have a good chance of getting hired into the ICU here if I do well in clinicians and volunteer but it could take a while to get into a large teaching hospital after starting here.

2-Do my preceptorship at a large teaching hospital in Phoenix/Tucson and try to get hired into the ICU there straight out of school. This seems like it could be the fastest but would not be ideal since I do not have an interest in living in Phoenix and feel as though it would be hard to get hired straight into the ICU.

3-Do my preceptorship at the local hospital and try to get hired at a large teaching hospital in San Diego or LA. I'm not sure if i'd be able to get straight into the ICU this way, but could start in a different department and try to work my way up within the hospital? This seems like it might be the slowest option but would get me back home the fastest.

Basically my questions is which route do I pursue? I know this dependent on a lot of different factors, but having a specific goal to work toward has always been helpful for me.

I know I am thinking about all this a little early, but I know this is what I want to do. I just want to reach the requirement as soon as possible, that way when I am confident enough in my abilities and knowledge to apply to the program there will be nothing stopping me.

Thank you for reading! Any input or advice either related to my question or not would be greatly appreciated!

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FMC is a joke and you won't find a true academic medical center in Phoenix except maybe MMC. You're best bet after school is UMC in Tucson (double the trauma volume of anyone in the state + heart/lung transplants, ECMO etc) or go straight to Cali.

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Thanks for the reply! I will look into UMC as well as MMC.

Do you think it would be better to go there or somewhere in Cali over FMC even if I couldn't get straight into the ICU? Lets say I apply to each and get offered ICU at FMC but med/surg or something at the others, do you think would be a better to try to work my way up at the other hospitals or gain experience at FMC and then apply to a larger hospital?

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On an application to a CRNA program, an ICU at FMC may not look any different than an ICU at Duke, but your experience vary to a large degree. I know several ICU nurses at FMC who have to cross-train to the ED or PICU to keep their hours. So on one hand, you may get everything you need to jump ship from FMC straight into a CRNA program. On the other, you may find yourself wishing you'd had a more robust experience. I'll give them credit for their education department though. It's pretty well-organized/well-run.

Of note, FMC is only designated as a level 2 trauma center by the American College of Surgeons. They just meet the criteria to call themselves a "state" level 1 in Arizona. They (and a few others) humorously manage to leave that detail out in their marketing.

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Well I definitely want to have good experience before starting CRNA school so I can make the most of it. I have also heard the education/training at FMC is good, but haven't heard much else. It sounds like it may not be a bad idea to start there if I could get into the ICU residency program but seems like I should definitely go somewhere busier before applying to get more experience?

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Specializes in Critical Care and ED.

You have to be prepared that you might not get straight into the ICU. There are some places that have new grad programs but they are competitive. You want to make sure that you maintain the highest grades you can while in school. Grades and a high GPA will open all the doors for you. They are even more important when you come to apply to CRNA school. Remember that you shouldn't be in a hurry to get into CRNA school, but should for now focus on getting into the ICU and becoming confident in that area first. There is a lot to learn and 1 year in ICU isn't really enough to gain all the knowledge and confidence you'll need. If you can't get into the ICU straight away then try to get a position in an acute area, like tele, med-surg, step-down or the ED, to put you in a good place to transfer to the ICU.

Also, make your goals include getting your ACLS and CCRN certifications. You will almost certainly need your CCRN to apply for CRNA school, and there may be a requirement of minimum practice in ICU to be eligible for that. Aim for the biggest hospital with the highest acuity patients, preferably a level 1 facility, as that is the way you'll get the most experience and the most exposure to critical patients.

Good luck!

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Thank you for your input! I definitely don't expect to get straight into the ICU and know that it would take a lot of hard work, but I definitely would like to. I am fully prepared for the reality that I will likely have to work in another department first and would love to work in the ED if ICU is not an option (I know that won't be easy either). And yes CCRN is required for the program which I believe you need at least a year of experience to be able to get. I definitely would like to become a CRNA as soon as possible but am not going to rush through bedside nursing to get to that, I know that putting in the time and hard work in the ICU and getting that exposure is very important for becoming a good anesthetist. I do not plan on applying until I know I am ready and have enough experience to make the most of the program, I can't imagine being at that point after only one year. I did not mean to sound arrogant, I know I have a long way to go and a lot to learn before any of this can become a reality, but I like to set my goals high and would absolutely love to get into the ICU as quickly as possible.

I plan on getting ACLS asap and of course CCRN when I am eligible. Are there any other certifications I should be looking into? Other than getting good grades, which of course is extremely important, do you have any other recommendations of things I can do to help me get into the ICU straight out of school?

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Specializes in Emergency / Disaster.

I know how brains work.... you are doing homework and get easily sidetracked on all your future things to do. Don't let it trap you. Keep focused on what is going on right now. Get through school. Sometimes we get so distracted by the things we WANT to do, we aren't able to concentrate as much on the things we NEED to do (ask me how I know...). As hard as it may be to not "daydream" about getting to where you want to be 5 years down the road, none of it will happen if you fail out of next semester because you can't focus.

Focus on today and whatever you can do today to better your situation for tomorrow. You can't work on tomorrow - until tomorrow. There are a few hundred days between now and when your situation will change and a few hundred outcomes are possible. Eliminate some of your stress and decide you really can't do anything about that until your last round of finals.

Good luck to you. It will all become clear in time.

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I guess I am getting a bit ahead of myself. I just like to plan things, but you are right I'm sure many things will change by then. I'm guess I am mainly just trying to decide where I should do my preceptorship since I know I will have a better chance of getting hired wherever I do it. You are right though I am a bit of a stress case so I should probably just relax and deal with it when I have to instead of worrying about it now.

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Specializes in Pediatrics.

You can ABSOLUTELY do your preceptorship locally and get hired into an ICU in a metroplex! you can also try to do your preceptorship in the bigger phoenix facilities and then get hired in LA or Sandiego! my advice is to try to do a summer internship at a hospital with a good name the summer before your last year of nursing school!

Advice: when interviewing for these jobs, dont tell them you want to go back to school immediately! They want to imagine that youll be sticking around for a long time!! Good luck!

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Thanks for the advice! I will start looking into internship opportunities. Is that pretty similar to volunteering or is it more formal/ educational?

Also a side note.

If I were to start in a different department about how long do you think it would take to work my way into the ICU? Obviously this would be dependent on many factors, but in general how long does it seem to take?

Also does anyone think that my background as a Vet Tech will help me when applying? I know animals are different, but a lot of the medicine and skills required are very similar. It seems to be helping me in school, but I'm not sure if it will help in getting a job or if it will simply be discounted since it is not experience caring for humans?

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Specializes in Anesthesia.

Keep that GPA up if you want to get into Kaiser. It's a very competitive program. The 2 folks that I know who got in had ~3.9 GPAs. USC has a solid program as well (LAC-USC has the busiest ER in California you see a lot). LLU has an okay program. Texas Wesleyan has a distance site in Colton, CA as well which is where I attend (I'm a California native). The main hospital that you do clinicals at has the second busiest ED in California, so again, you get great experience. Lots of traumas and lots cool cases, no MD residents, and lots of autonomy for the SRNAs.

My ICU in Southern CA hires new grads ALL OF THE TIME. If you can get a job as a student nurse or intern there or do whatever to get your face seen it increases your odds substantially.

Apply to ALL ICUs in your area. Whichever one has the highest acuity that hires you (either as a student or nurse), accept it. It seems like you're flexible enough to move. If that's the case, I guarantee there's an ICU out there somewhere that will take you as a new grad. Get into any ICU that you can and move up into a higher acuity ICU if you have to.

You can say your vet tech experience sparked your interest in anesthesia on your admissions essay. Aside from that, I don't think it will really help much. Just focus on getting into a high acuity ICU, getting CCRN, doing well on the GRE, and keeping your GPA as high as possible.

It sounds like you're on the right path. Just stick with it!

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