Dbb82

Hey everyone. Got an offer for a full time position at a busy urgent care center. I will always have a physician with me, but I hear that a normal day consist of 30-40 pts a day with little to no downtime. Now has anyone experienced a place like this right out of graduation? Some people are telling me to stay away since it's difficult to learn because it gets overwhelming, but then some people telling me to take it because I will learn a lot by seeing a lot of patients. What does everyone think?

Hard scenarios? My icu experience isnt all that great because we barely get any real acute pts anymore for some reason. And thats the reason that im scared of the interview lol.

Any pointers on the interview? What do they ask etc. any advice will help! And congrats!!

any luck? Im waiting for them to give me the phase 2 review. Just awaiting my BSN transcripts to come in.

I've been in my MICU for over 8 months now. Other experiences are PACU for 2 years and ER for 4.5 years. As I have said in the other thread, the acuity level of my unit is not that great. It's merely nothing but stable vented nursing home patients that you turn Q2. I feel like I have hit a brick wall in learning what I need to learn while being up here. I want to go to a busier and more acute hospitals, however can't leave right now due to them reimbursing my tuition, as well as me needing enough vacation time for my wedding out of the country this June. I have an interview coming up in May and I am a wreck. Former grads told me not to worry since they only ask personal stuff, not anything clinical, but I am not too confident about this. The good thing is, the director is a very "word of mouth" type of guy, and it only took a phone call from a former grad for him to personally contact me to send in my application. I understand that I need to be fulltime critical care by the time I start, but would it hurt to go per diem at a different and more acuite cticu/cvicu's? My plan A is to stay here until there's an opening to the cardiac care unit or the cticu (not a busy kind)... Plan B is to just take the reimbursement hit and seek a job elsewhere. The only thing is... there aren't that many open positions at the more acute hospitals. Most are part-time's or per diems. Would it hurt to just take 2 per diem jobs at a more acute unit? Plus it's not like i'll just work 3 times a month there since I need to pay my bills. advice?

Yup. I am close to 1 year in ICU experience from 5 years in the ER and I still think im not ready. The acuity of the patients in my ICU are not the best to learn from. Been looking elsewhere, but my hands are tied due to needing vacation time for my wedding out of the country, as well as needing to stay due to the hospital reimbursing me my tuition for my BSN classes.

it all depends on which PACU you go to. The good thing about ours is that the pt's are already on their own bed when they get to PACU. The only physical thing we do is to just push their beds to their assigned rooms. I work both places and I would take PACU any day. My back is killing me! My ICU is small and we have no techs at night.. which means we turn our patients on our own more often than not.

Honestly, sometimes 2:1 is hard enough, these patients are unpredictable, but 2:1 is appropriate. However, 3:1 is unsafe IMO. Even if you have a pt that is a q4 hour vs, he or she can be a "dinger' or very needy. Sometimes I find myself in that pt's room than in my critical patients. A pt like that can take up your whole time, and next thing you know... your other patients are tanking. And who is going to get blamed if something happens to your other patients? Yep... You... and only you... I understand that there are a lot of staffing shortages and budget cuts going around, but it is unsafe for our patients and is a disaster looming against us and our licenses. On top of that, in our hospital, we have no techs or secretaries at night.

Either or would help. The trauma ICU will have more critical patients and you will see more. There are times in my med/surge ICU that we dont have one patient that is on a critical care drip of somes ort, whereas you will always have one at the trauma ICU with an A-line, pressors, critical meds, etc. Can't go wrong with a MICU, but you'll see more stuff at trauma. Also, try to get into a CV/CT ICU.

Jkr thanks for the insight. I think i'll be fine with the drips since im familiar with that aspect. Vent settings im not as good with as well as A-lines. The other issue I have is the skin breakdown, bed ulcer prevention, since we usually dont turn patients in the ER. I might forget to do that up there Lol.

sorry for bumping an old thread, but saw that you guys have good insight about the transition in here. I'm an ER nurse and in need of ICU experience to expand my knowledge, and as a req for CRNA school :-(

Hello Folks, I am an ER RN for 4 years, with 8 months PACU experience. My ultimate goal is to become a CRNA, and in order to do that, I will need ICU experience. Anyone here have any experience with the transition? Any tips, etc?

sheesh, what a burden off my shoulder, passed! yayyyy.

good luck mine shut off at 116, i find out tomorrow morning if i passed.

Mine stopped at a very odd number, 116 give or take. My friend said if you remember your last question, and know you got it right, it is more than likely that you have passed,but maybe she's just saying that to make me feel better. Anyone here ever pass around 100-150 questions?