Atheris

I'm a new graduate who is looking for my first RN position in an ICU. I have given my resume to various ICU managers and applied for many different ICU jobs. All of the Level 1 SICU/ CVICU managers have turned me down because I am a new grad, but I have been offered a job in a few different ICU's after interviewing and have narrowed it down to two. I would like your feedback on which would be better experience for myself and for a resume for CRNA schools in the future. 1) Level 1 trauma MICU. Strictly MICU patients. The manager said it is not the norm for her to hire new grads (especially since I did not work on this unit prior), but based on my academic performance, work experience, and clinical experience (precepting in a level 1 trauma CVICU), she is willing to take me on. 2) Level 2 trauma SICU. Has mainly SICU patients, some open heart patients, and some MICU overflow. I currently work as a nurse extern at this hospital on a different unit. The ICU manager said she doesn't normally take new grads, but after reviewing my resume and talking to my current manager, she is willing to take me on. Both are in the same healthcare system and I may be able to transfer to the level 1's SICU or CVICU after a year (or a little more than a year) experience. I was told by multiple people that CRNA schools prefer CVICU and SICU over MICU, PICU, NICU, Neuro ICU, and Coronary Care Units. I was also told by multiple people that CRNA schools prefer level 1 trauma hospitals over level 2. Based on these assumptions, I am between a rock and a hard place deciding which position will allow me to be admitted into a CRNA program in the shortest amount of time with an adequate amount of experience. Could you please input your thoughts to help me decide?

What were all of your credentials for applying?

Thanks!

For those who applied for and got into CRNA school, I'm just curious about: 1) What was your Nursing (undergrad) GPA? 2) How many years of ICU experience did you have, what type of ICU unit, what type of hospital? 3) How many schools did you apply to and how many accepted you? 4) How many times it took you to apply before you got in? 5) Any extra credentials/ tips before applying? I'm just quite curious as to other's and how they did!

I think I only feel reluctance not to take the ICU position because there was more compassion in the way the managers at the CT extern hospital treated me. They seemed more relatable to me during the interview process and brought down their extern manager to talk to me as to why I should stay at their hospital and not take the ICU position at the other hospital (again, these are both hospitals within the same health system and I'm sure the managers from both hospitals know each other). The drive difference also comes into play (CT=20min, ICU = 35min) but the longer drive does not turn me off completely to the job by any means. I was also told by both the ICU and CT managers that a job offer would be given after the externship was done if my performance was good. Both hospital's managers said they've each only not hired one extern ever after the extern was done. My friend who is an ICU nurse didn't even have a healthcare job before graduating and he got right into and ICU as a graduate nurse before he even took his NCLEX. I've also looked at nurse ICU position hiring requirements and recommendations for a few hospitals and they say that "One year telemetry experience preferred." and nothing is said about ICU experience. Obviously ICU experience would also be preferred, but telemetry is also preferred - just throwing that out there. I don't think it will be hard to get an ICU nurse job with either, but if the ICU extern job will really give me much more experience, will help me get an ICU job once I graduate, and will help me be a better CRNA and get into a program faster, I think I will take that job.

Ironically, everyone I've asked in person says Cardiac Telemetry and you all say Medical ICU. I'll also add that some CRNA schools I've looked at are looking for the acuity level of the ICU you've worked in (and of course some are not, but I want to open as many doors as possible). If I were to take the extern job, after graduating I would be offered a nurse ICU job. The nurse ICU job would be such low acuity, I'm worried the CRNA school might ask me to get more ICU experience at a bigger hospital even after working for a few years in the smaller hospital's ICU. If I took the CT extern position, I would feel more apt to leave that hospital and look for an ICU nurse position anywhere (if need be) and open up more possibilities to get an ICU job at a bigger hospital. If I took the ICU extern position, I would (obviously) feel obligated to take the position offered to me at the end of my externship, but then might regret not moving up to a bigger hospital with more acute patients. Can someone also provide a reason to take each position over the other?

Is it more important as a student to develop basic skills from the med/surg type unit or to get direct experience for what I'm planning on doing in the future (ICU)? Also, does anyone think that the ICU position being at a smaller hospital could negatively affect anything? My friend works as a nurse in an ICU and said I shouldn't have a problem getting a job in an ICU after I graduate after taking either extern position.

I think it would be more observing how the nurse operates things such as the vents and drips rather than me do anything. I am not licensed and can only do things under direct supervision of the nurse who will be with me at all times if I take the ICU position, whereas I will be more independent and hands on if I take the CT position.

I am currently a Junior in nursing school (BSN) and have applied for two nurse extern positions. I've already had my interviews for both jobs and been offered a job in both positions. I do not know which position to chose that would best enhance my ability to become an ICU nurse and later a CRNA in a few years. I inquired about a third extern position at a main (level 1 trauma) hospital in their medical ICU, but they are only hiring one extern and required the extern to have at least 1 year of hospital NA experience before considering them (I don't have this experience yet). All of these extern positions are within the same health system, but at different hospitals. I'm not allowed to do meds as an extern and I cannot work with blood as an extern in this healthcare system. First extern position: Nurse Extern on a Cardiac Telemetry Stepdown unit. Contingent position at a level 2 trauma hospital with ~400 beds and ~35 on the unit. I would be assigned roughly 5 or 6 patients at full load (after being trained and feel comfortable). I would be doing lots of hands on stuff and was told by the manager that this would be excellent experience on a busy med/surg floor and I would learn the basics I would need to allow me to be an ICU nurse later down the road. This hospital does a lot of stuff and does not like to send their patients to the level 1 trauma (main) hospital unless they absolutely have to. The nurse manager also said once a month she could get me down in their ICU as an extern as long as it's okay with the ICU manager. Second extern position: Nurse Extern on a Medical ICU unit. Contingent position at a much smaller level 3 trauma hospital with ~200 beds and 12 beds on the unit. I would be working directly with the same nurse preceptor each day. The type of patients they receive (according to the manager) is CHF, GI bleeds, resp, CAD, kidney, post CA, etc. Nothing too crazy, otherwise the patients get sent to main. People also know this hospital is level 3 trauma, so they don't get a lot of super high acuity patients. They get a lot of people with falls and fractures and also people with things like severe influenza at their ICU. The nurse manager also said she could get me into their Neuro/Surgical ICU if I wanted which get patients with Stroke, brain hemorrhages, surgery complications, aneurysms, etc. but thought I would like the medical ICU later as I want to be a CRNA. I know the ICU extern position would look better on paper when I'm applying for an ICU position as a nurse, but it's at a much smaller hospital. The patients they receive aren't as intense as even a level 2 trauma hospital. I don't want to be in an interview for an ICU nurse after I graduate and have them ask me what I did as an ICU extern at a level 3 trauma hospital. The list of things I could say I did or learned would not be very extensive... I have to let both managers know which job I will take within four days as that's their last day for hiring externs. Can anyone please give me any advice on which position to accept and why?