Sand_Dollar

Hi ivyleaf, I am currently a CDI in a level 2 trauma hospital. I have been looking at other positions and haven't found one that doesn't require at least 1 year of acute care nursing. The big hospitals want you to have at least 3 years in an ICU or ER for background. It's not just coding, which in itself is a challenge, but the clinical part of it. I had a patient who was found down and had a STEMI. They were so focused on the STEMI they overlooked the very high CK-MB. I sent a query for Rhabdo which the physician agreed with. Without the clinical experience you won't know what to look for in critically ill patients. CDI is horribly hard to get into even with the preferred clinical background, most jobs want experience. It took me months to find a job and when I did I took a pay cut and now commute an hour each way just because they were willing to train someone. I have never heard of anyone going from UR to CDI, but every hospital is different and one may accept that as background. I wish you luck! I adore CDI; it's everything I love about ICU (critical thinking, multiple co-morbidities and putting the puzzle pieces together), but it's a ton less stress than ICU. My back is still intact, my knees don't hurt and when a code blue is called I just put my headphones back in and get back to reading through another chart.

We work 3-12s for full time status. We can schedule anything above that at 1.5 pay, which are called incentive shifts. No mandatory OT.

Normally it's about 12 weeks in my hospital for the critical care units (8 for adult care). I was hired as a critical care float, so did 11 weeks on my 'home' unit of CVCU and got a week or two on the other critical care units (IMCU, NTCU, ICU). Because I may have to float to general adult care, I got a day or two on all the other floors (ONC, Med-Surg, Ortho, etc), so in total mine was about 16 weeks. I will also get a couple weeks in the ED when it's time for me to float there. These are regular 36 hour weeks at full pay. It was first days, then nights where I will be working. After orientation, we get a meeting once a month as a group until we have been there a full year. And, for those in critical care, we take the ECCO class (Essentials of Critical Care Orientation) by AACN after we have been there for 6 months. No other classes but those.

Take a look at Salem Hospital, south of Portland. It has the busiest ED in Oregon. It's where I work and I absolutely LOVE it. There are many people who have been there 20+ years, the people and culture there are fabulous.

Look for residency programs. They vary as far as experience goes. For example, in Colorado you can't have any work as an RN, while in Oregon you could have up to one year of experience. If you can, I'd look at moving. I took a clinic job for about 6 months then got into a residency program in critical care (my dream job!). I am in Oregon and it took me over 200 applications to land my residency spot. Don't get too discouraged, look at it like a numbers game.

A few months ago I got my first acute care job and was hired as a critical care float through my hospital's new grad residency program. My end goal is to be a traveler in critical care. Here is the situation; My 'home' unit where most of my training has taken place is CVCU. I will also be orienting and working in ICU and Neuro-trauma ICU in the next month. I will be floating to all CC units, the ED and general floors when I'm done the orientations. I must work IMCU level for one year then can move up into ICU level care if I so choose. I have great support and have received excellent training, which will continue to be provided as my level of competency progresses. My plans include obtaining my CCRN when I have met the hourly requirements. My questions is this, should I keep with the float position, or take a specialized ICU position if one becomes available? My concern is that when it comes time to travel, will other hospitals look at my work history as 'diluted'? I want to be as marketable as possible, but worry that I might actually be doing myself a disservice by not picking a specific unit to settle into. Thoughts on this?

1) Oregon 2) 33.00 +shift diffs 3) New grad 4) Critical Care (starting $ applies to any dept)

I am in the most recent Salem residency cohort, as an adult critical care float. I applied through their careers section when I saw a listing up on the page. Don't forget about Legacy and Adventist new grad residencies. I am not sure about pediatric spots at any of them because it wasn't where I was looking, sorry. Good luck, the market for new grads here is brutal, but many in my cohort were newly graduated.

I just stared in a residency program in Oregon. On the west coast you can have up to a year experience and still be accepted into a program (in CO, you have to be fresh from school). You have to sign an agreement to work for them for 2 years after the residency is over. I was hired as a Critical Care Float on days with my 'home' unit as CVCU. I can't believe how lucky I am in that not only do I get to work in one ICU, but all of them...and on days!! I think I'll start playing the powerball next.

I graduated in May of 2013 as well. It took me until Sept to get my job at a clinic. Barely anyone would look at me. And acute care, forget it. So, I took what I could get because student loans were coming due! Here in the PNW you can work for up to 1 year and still be eligible for new grad residencies. I kept applying to them (and other jobs) and while I kept getting residency interviews, for some reason I wasn't hired. I have applied to 200 positions that said were eligible for new grads....but nothing. I was starting to wonder what was wrong with me (BSN, summa cum laude, 225 hrs in an ICU, worked at a U hospital, ACLS, TNCC). But....don't give up! I just got accepted into a new grad residency as a critical care float. This is my absolute dream job. When asked what critical care unit I wanted I said I loved it all and it really did not matter. I will be training in the CVCU but also get to work in MICU as well as the Neuro/trauma ICU. I can't be happier!! I would leave the experience on your resume, afterall you are working as a NURSE. And, even if it is slow, you are ticking away the one year clock to when some hospitals will accept you regardless of the experience. Good luck on the search, I know how disheartening it can be. Don't give up and keep applying. I looked at it like a numbers game and eventually either I would get a position, or the one year countdown would be over.

I would make handwritten notes next to the lecture powerpoints which I had printed out. Once I got home I then made a set of study notes on my computer. This was the best thing for me... I would often reorganize the lecture notes into something that made more sense to me. And, this is the funny part...pinterest became my #1 study tool! Because I'm a visual learner, I would find pictures/graphics that would represent what was talked about (ie blood flow in the heart). I would add different fonts and arrows to my study notes and by the time I was totally done, I would often not even have to study them again. Working, and I mean really WORKING with the lecture info worked great for me.

I am working in a clinic right now. I want acute care, but in this market I'm just happy to have a job. I have to admit the 8-4:30 M-F is nice but the work is not challenging for me...at all. Much of my time is spent refilling meds (have to make sure protocols are followed, if not they are denied), but I also run the anticoagulation clinic. I do DM education now and phone triage. To fill my time, and keep from being bored, I have started looking at target numbers (such as FOBT's for pt's over 50) and doing what I can to improve them. It's great hours, OK pay (beats 0 per hour as a student!) and fabulous coworkers, but I actually prefer 12hr shift and direct patient care. 95% of my time is on the phone and computer and except for DM education, I see a pt for maybe 5 min. I will be gone as soon as I can get a position in acute care. As a note, there are a couple other nurses who love this job. They have new babies and it works great for them. So, it all depends on your own situation.

I am a new grad and got my first job in a non-profit clinic in WA. I do med refills, manage the anticoagulation patients, do DM education, phone triage...stuff like that. I work 8-4:30 M-F and I have to say, it's a snap. I make about as much as a new grad was making in a hospital back in CO. The only stress I have is figuring out how to get into acute care (market here is brutal for new grads)!!

On the first day of my ICU Sr Practicum I got to participate in my first code. The patient came into the ED as a code and I got to go because my preceptor was the ICU charge. Not only did I get to assist throughout (it went on for 3.5 hours!) but because the patient ended up in our ICU and under my preceptors care, I was also part of the team in the ICU. The patient did not make it and because my preceptor had to take care of the business side of things, I took care of most of the post mortem care. I felt heartbroken for this family and did everything I could to treat my patient with respect and reverence, just as I would want for my own family member. I felt it was an honor to take care of her and to be part of trying to save her life. Another nurse took the pt to the morgue but once it quieted down, it hit me hard too. I had tears rolling down my cheeks, not for the patient, but for sudden, devastating loss for her family. As a student, it's easy to have a romantic idea of being part of a code. Adrenaline pumping, orders given, bringing a patient back from the brink. But a code is far from romantic, it's tragic. I was thankful for being included in that whole experience and will always regard it as a special memory; a personal reminder for me to never take those I love for granted because they might be taken away unexpectedly.

Critical care for me too. :) Good luck everyone!