hockeynpolo

TNhome - I have 4 years of ICU and 4 years of flight nursing experience. I believe UTC publishes their GRE score requirements on the website so as long as you meet or beat those requirements, you'll be qualified to apply. Some applicants get in with 2 years ICU, some get in with 10 years; it all depends on what you've done to set yourself up to succeed in grad school, how critical the patients you've taken care of are, and how much you want it. CCRN is a must for CRNA school really anywhere you go, even if it isn't posted. And I did fine on the HRSA. I'm not sure how much the HRSA score is weighted, but keep in mind they look at a variety of different data points (including the strength of your personal statement and essay) when determining who gets an interview. Everyone as strengths and weaknesses. Hope this helps.

I got in as well. Very excited!

I'm a flight nurse and my company requires all their nurses to be paramedics as well so I attended a bridge program. It was a very fast program, relying heavily on my past experiences as an ICU nurse for pathophysiology and pharmacology. My 8 weeks of ride outs with the fire department was an interesting experience since living in a fire house with 5 other guys was something new, but as stated earlier, pre hospital (medic) medicine is a different thought process. Nurses can assess but we can't order drugs. Medics can assess and refer to a protocol book to administer drugs. I'd recommend getting familiar with EKGs (you'll get a lot of chest pain calls), COPD and asthma (lots of respiratory distress calls), stroke assessments, how to treat hypoglycemia, and become proficient in starting IVs. Car accidents are also something new for nurses as even a trauma/ER nurse only receives patients; they're not on the front lines extricating them. So don't be shy if you get toned out for an MVA. Stick to your ABCs, get ready to provide ACLS at a moment's notice (no doctor around to lead a code) and remember that pedi patients aren't little adults.

an interesting potential side effect of Neo is reflex bradycardia so this patient could have had the alpha 1 agonist of neo for Bp support and count on some reflex bradycardia for rate control. I work in the transport world so when we pick up AAAs, they are usually hypertensive so pain meds and esmolol is usually all we need to bring the HR and BP down. If they are hypotensive, we give fluids and blood and fly quickly. Interesting case you had needing to keep the rate down to decrease the shearing effect of the HR, but then also need a little extra SVR support for the kidneys.

I would assume they do since it's required prior to interviewing. As far as how much that score is weighted in the acceptance process, that I don't know.

I'm from Texas but wanting to relocate to Tennesse. You?

I applied. Still waiting for a call back

Such a great book. Gave it to some other flight nurses and even though they've been flying for a few years now, they loved the book too

@ butterfly journey - I'm still at Parkland. It wouldn't hurt to mention you plan on staying at Parkland for the long run; especially when the new hospital opens. You are right in that many of the ICU interns and residents leave after their contract to go to CRNA school. In fact, 2 of my charge nurses are leaving this summer to go to school. I can't say that it will put you above others, but mentioning that you plan on staying at Parkland past your contract may help. Like I said earlier, the internship is hard but you get out of it what you put into it. Barbara and Laura are not out to get you. They have been educators for years and years and love to see their graduate nurses succeed and do well. If you are having trouble in a subject, they will stay late after class and go over it with you. If you feel uncomfortable in the clinical setting at the bedside, there are 3 other nurse internship instructors helping you through your 7 months rotation. It's not a sink or swim environment, but working in the ICU at Parkland is challenging and you do need to study up and know your pathophysiology and pharmacology.

Laura and Barbara have been doing this for more than 20 years. They already have an idea of the type of nurses they want in the internship. This probably sounds cliche, but be yourself. They aren't looking for the person who has a 4.0 GPA and is going to invent the cure to cancer. Going into the interview, I had no ICU experience and only 4 weeks of nursing school rotation worth of ER experience in a small 16 bed ER (Parkland's ER is 70 beds). They are looking for someone who will be eager to learn, as Parkland is a huge teaching hospital, willing to help others, and most of all, will fit into the Parkland Family. You can be a hotshot in the ICU, but if you don't work well with others, you're no good to Parkland's staff of doctors, nurses, respiratory therapists, or any other personnel at Parkland. The internship is a great experience. You'll definitely work hard, as the test are quite long and extensive, but the knowledge and experience you get is great.

You can still be a critical care nurse at Parkland with an ADN. Instead of doing the internship, where you rotate through all the different ICUs, you can do their Residency. The residency is different in that you interview for one of the ICUs (burn, medical, cardiac, or surgical) and you spend 4 months orienting to just that unit. For people with ADNs and who know that they want to do surgical ICU or medical over the others, the residency is a great way to get your ICU teaching. I did the internship last year but all the other nurses I work with did the residency. Let me know if you want more info about the program.

HD is never done on unstable patients in my MICU. We have pts on CRRT and if they can tolerate it, we will increase the fluid removal rate per hour on the CRRT machine to pull more fluid off. HD pulls too much fluid off too quickly. I was taught that a good rule of thumb is to titrate your medication off first before you pull fluid off. If you're pulling 100ml/h of fluid off, but having to go up on your levo or have to add vaso, the pt isn't benefiting much because you're having to give more meds that are tough on the blood vessels in order to keep your MAP in the 60s. Every nephrologist I've worked with was fine with me taking as low as 5 to 10 ml/h off due to the pt's unstable condition instead of going up on my vasoactive gtts to compensate. Remember, even if you're not able to pull much fluid off, the filter in the CRRT machine is still pulling out all the "bad" stuff floating around in the blood.

I was a new grad last year and interviewed for 2 critical care new grad programs. I was accepted to both. Now I'm 1 year out of nursing school with 1 year of medicine and cardiac ICU experience under my belt. It most certainly is possible!

I started looking at hospitals in February of last year and was contacted within 2 months, asking for me to fly out to Dallas and interview (parkland)

I grew up in California, went to college in Oregon, and applied to two ICU residencies (one in Texas and one in Tennessee). I got into both. Also there are 22 residents in my class, 10 of them came from out of state. So it is possible. If you're enthusiastic and willing to move to Texas, there shouldn't be any reservations about hiring an out-of-state new grad

haha yea usually levo does fix the issue :)

Being ridiculed for emptying things 30 minutes early is ridiculous. At my hospital, we have a 30 minutes window before and after the designated time for assessments, meds, clearing pumps, and fluid I/O. In the ICU there is no way you can do everything at the exact time, especially when something unexpected happens. I too am in a new grad ICU program and we get about 12 shifts in the 4 different ICUs. It is expected that after doing 12 shifts x 4 units (48 shifts) we have a good understanding of typical ICU procedures (safety checks, assessments, iv meds, pumps, vasopressors, vents, etc) based on the fact that if you're in the MICU or SICU, a vent is a vent and a vasopressor is a vasopressor. So for a lot of the overlapping ICU knowledge requirements, we are expected to be competent by our 3rd rotation. But regardless of the unit, time management, prioritizing care, and clustering care are my 3 biggest struggles. I understand pathophys well and know why I'm giving the drugs and what I'm looking for in my assessments, but clustering all that care, troubleshooting a lines, cvps, occluded IVs, titrating drips, traveling to CT or MRI, contacting the docs for critical value labs, changes in my patient's status, etc can really put me behind schedule and make me feel like I'm barely keeping my head above water. I've been in this program since August and I still don't feel 100% in being able to handle 2 pts on my own. But every ICU nurse and instructor I've talked to has said that this is a "normal" feeling until 6 months out working on your own. Best of luck to you (and me lol)

I recently graduated from Portland and am from the bay area so you're in luck! I recommend Kasier Walnut Creek ICU. I've heard they are hiring ICU nurses, but only with experience due to the cost of training new grads in this economy. So, with your prior experience, this may work out for you. Also, UCSF is a big teaching hospital down there and I have a nursing school buddy who got a job down there and loves it (med/surg neuro). John Muir in Concord also has an ICU and a helipad. Another big hospital in the bay area-ish would be Stanford.

Hi highlandlass1592, Thanks for your recommendations. I'll definitely be working a few years ICU and possibly ER too to get the experience I need before I apply to fly. Before nursing school, I flew with a number of air ambulances as a 3rd rider (ride along) but I never really asked them about what ICUs they worked in. I'll definitely ask around and see what flight RNs suggest.

Hi guys! I'm in a new grad program at a level 1 trauma center for ICU nurses that takes me through the MICU, SICU, BICU, C/PICU, and ER over a 7 month period. After the 7 months (and successful completion of the academic and clinical requirements and evaluations), I have the option of choosing to interview and work in one of these clinical areas. I know I plan on being a flight nurse in the next 4-7 years, so I'm wondering if there is a specific ICU that I should really shoot for? Most of the patients that are flighted into the hospital I work for go straight to the SICU (car crashed, GSW, etc) so does that mean I should be set on working in the SICU after my residency? Or is an ICU nurse an ICU nurse, with skills that can be brought to the table regardless of what unit I find myself working in? I guess I'm trying to say, that if a nurse with MICU, CPICU or BICU experience is running up against a nurse with equal SICU experience for a flight RN position, would the SICU nurse be favored (or have the upper hand) since a high volume of flighted patients are traumatic injuries? Thanks for your help!

Nurses make judgments everyday we work. I work in the ICU and with every medication I give, I need to make sure A) it's the right medication for the patient problem B) the patient is stable enough to get the medication (i.e. holding a beta blocker or ACE inhibitor if the systolic BP is below 100, titrating levo to a MAP of 65, etc), and C) the med it compatible with all the other drips that are going (in addition the the 5 rights of medication administration). Also, nurses are with their patients 8-12 hours a day, while the doc round on their patients for 15 minutes and then leave. We have that extra sense and know when our patients aren't doing well. It is then our JUDGMENT to assess the situation, assess the patient, get as much information as possible to figure out the problem, and if we can't resolve it on our own, then we call the docs. Nurses making judgments is a vital role of what we do as nurses. Nurses who don't make judgments aren't good nurses, aren't safe nurses, and aren't performing the duties of what a nurse should be doing. Keep on making judgments, assessments, and be keen on your patients' conditions and status.

use the FLACC score

Hello shoecrazynurse. You're in luck because I just moved from the Bay Area to Dallas! I'm a new grad and working at Parkland in the ICU. Parkland is the big teaching hospital in Dallas and it is closely affiliated with the University of Texas, Southwestern Medical school (it's literally right next door). Parkland is a county hospital but pays the highest wages (at least for a new grad). I'm making $24 an hour but I only have 3 weeks of experience as a nurse. The other big hospital around here is Baylor, and they pay less than Parkland by a couple bucks ($21/hour). Because Baylor isn't a community hospital, it's patients have deeper pockets and come from a different social and economic class, but I've heard from a couple nurses that there is a social disparity between the MDs and RNs. Just from what I've heard, the docs run the show and it's expected that the nurses to give up their seat for the docs. At Parkland, not so much. The docs and nurses work well together and because it's a teaching hospital, everyone is willing to teach each other something new. Experienced nurses on the floor teach new grad nurses in residency programs, and experienced docs work along side them to teach the MD residents. Plus, Parkland has a level I trauma ER (as does Baylor) but Parkland gets most of the calls. And in 2014, Parkland will have a brand new, $1.2 billion dollar hospital with 17 floors, 3 helipads, and close to 2 million new square feet! I may be a little bias towards Parkland (because I work there) but in all honesty, I've only been in Dallas for 3 weeks and it has really made an impression on me. Lastly, Texas does not have any income tax. From living in California for 18 years, I know how expensive living is out there. California will tax you whenever they can. If I stayed in California, I'd be making about $39 an hour, but the cost of living and the taxes would suck all that extra bank right out of my pocket. With that said, I like Dallas. At first, I thought it would be very cowboy and country, but that's not the case in Dallas - outside of Dallas, yes, but not the city. And living near downtown really isn't that horrible, especially since I'm used to the HUGE amount of people that live in San Fran and the surrounding Bay Area. Dallas is a big city, but it's spread out and not congested like San Fran. My favorite place to spend time is in Uptown (conveniently located outside of downtown). Uptown has lots of shopping, bars, and restaurants. And if you like football, Texans love their Dallas Cowboys. The weather is hot, and there aren't any mountains for miles, but there are a good number of fun places to go, things to do, and I've already started saying "y'all" instead of you guys :) Lakes are near by to go boating and it actually snows in the winter time. Hope this helps

Although it's a little late to post this, always double and triple check your meds. ICU pts have many drugs on pumps. Need to make sure the right pump is going at the right rate

1:2 is pretty standard for me too (Texas).