Preferred ICU exp, in your opinion

[RNthenDoc]

Hello everyone,

I am currently a pediatric surgical-trauma RN who is in in the process of switching to adult ICU. I currently have a job offer for CVICU, general ICU and STICU. I know this is subjective and relative to the school, but I have heard that CVICU is preferred for CRNA school. I have more of an interest in medical patients, something I know I would find in the general ICU (as well as cardiac, surely). My question is, would you take the job that is preferred for admissions, or the job that you know you would personally enjoy more? I love helping my patients with all of my heart, but there are still populations that I prefer. My plan after CRNA school is to return to peds as that is where my heart is (Though I do not want to do PICU).

[saveitICU, CRNA]

Hi bent,

In my opinion, work in the ICU you would enjoy the most. I think that would be conducive to you getting the most out of your experience there. The only exception I would make is if you're set on getting into a certain program and you know for a fact they like nurses from certain ICU backgrounds. If thats not the case, make sure that the medical ICU gets all of the requirements you need i.e. vents, titrating sedatives/vasoactive drugs, CRRT, arterial/central line placements, etc. (sorry if I'm being patronizing, seems like you know what you're doing). Also get as many certifications as you can (depending on where you end up): CCRN, TNCC, CMC.

Hope this helps!

[CCRN_CSC_0710]

I'd personally take the one I'm interested in more. We have many people in my program with only medical ICU backgrounds. I also feel like if you're not interested in CVICU you (no offense intended!) won't be a very good nurse. We had a nurse who switched to our CVICU just for CRNA school and it was very obvious from the beginning she was not a good fit, but when she transferred to the neuro ICU she quickly became one of the best nurses and is now in CRNA school somewhere.

[PresG33]

The one in which you have more autonomy and can articulate this in an interview. In my opinion admission committees know all applicants have set up drips, had patients on vents, had patients with Aline's; the difference is what your decision making process involved using this info. In my interview, I explained that my unit doesn't have fellows or residents and just one intensivist/surgeon covers the whole unit, therefore nurses take an active role in interpreting data and making treatment decisions. If one unit has more "oversight" and one is more autonomous I would make the decision that way. I don't think admissions care if you had an ECMO patient everyday that was run by a perfusionist and had a fellow nearby day and night; I think it is more valuable to have an ECMO pt once a month in which the nurse ran the ECMO (which is what we did in my unit). If they are the same, I think CVICU is the best match for CRNA school but that is debatable and I don't think it will matter regarding admissions. Obviously I'm biased but that is my humble opinion; just make sure to stress the autonomy and decision making at your interview. (Again, not to start a teaching vs. non-teaching hospital argument; this is just my biased opinion and one that was confirmed by my PD once I was accepted). Take my n=1 for what it's worth.