I agree with Dreamweaver, your approach does depend on the politics of your hospital, what worked for me may not work for you. Also - be loving being in the CVICU it's the greatest job in Nursing as far as I know (am a CRNA student presently), and hope to one day say it's the greatest job. As for advice - In my CVICU we work very closely with Anesthesia - my letters of reference (after 3 years there) came from a CRNA, an Anesthesiologist, and the CV surgeon I had the best relationship with. My reference letters came up during my interview, so I do think they helped. Also my CVICU colleagues are dancing jigs they are so happy for me, as is my Director.:balloons: Hope my 2 cents worth helps.