SICU_Murse

To all the CTICU nurses -- How did you end up breaking into CTICU? I know the job market is pretty tight right now but jeesh! I am having a really hard time even scoring an interview for a CTICU. Example -- I applied for a FT nights position that was posted for external applicants at an inner city hospital not far from my home. A week went by and I didnt hear anything so I contacted the recruiter...she simply stated that I was not selected. I, in my opinion, have a pretty impressive resume for a "young" nurse. I have two years of SICU experience, my BSN, CCRN, and CMC certs. you would think that I would have at least gotten to interview??

The per diem pay rates in Southern NJ are pretty competitive. Most hospitals down here are unionized, which helps. You can view local contracts for various hospitals at Health Professionals & Allied Employees |

Lynn -- I think its a great idea for the SON to have someone on these boards to help answer questions, as many pre-NP students turn to these boards when looking for information from their fellow nurses. I will be starting the acute / critical care NP program this fall and will begin my clinical / specialty courses next fall. I believe that a clinical placement coordinator will help alleviate alot of unnecessary stress on us students! What is the timeframe for when this position will be filled? neuronRN -- I am less than 5 minutes from the Stratford campus and know several people who have graduated from their acute / critical care NP program. All of which spoke very highly about the program. Location, cost, and reputation made UMDNJ my school of choice.

I forgot one of the most important parts -- We need to know that basic information so we can adequately care for the patient while he/she is critically ill. Knowing baseline information vs. current information will help us decide if the intervetions that are being done for the patient are adequate or need to be changed.

Let me begin by telling you -- I began my career on a tele unit where I routinely cared for 5-6 patients a night. I currently work FT in the SICU at a large community hospital and I also work per deim in the critical care float pool for a large university hospital. When I recieve report on a patient coming from the floor I expect the M/S RN to know some basic information about their patient for example -- PMHX, Reason for current admission, events leading up to deterioration / ICU transfer, baseline vitals, current vitals, baseline physical assessment, current physical assessment, current IV lines, current medications that could have contributed to the transfer, and lab results from the day of transfer. These are basic things that ALL nurses should know about their patients -- ESPECIALLY if they are working on transferring them to a higher level of care. You guys on the floor are very task oriented. I am not discrediting this type of nursing, but most of you do not understand the pathophysiology behind many of the disease processes for which you care for. Many times you do not know what to do for your patients when there is a devation in their vital signs from baseline. Many of you are not proficent in basic nursing procedures such as establishing adequate IV access (no that #24G you just put in is not considered adequate). Many of you do not understand the physiological effects of the medications that you administer. -- It would be my best guess that these are some of the many reasons ICU nurses get irritated with you when you transfer a patient to thier unit. Just my

Thanks Ms. B! And yes! I did my celebrating last night!

A suggestion that I will give you is that, knowing you dont routinely work in the ICU, you'll really need to brush up on your hemodynamic values and how to interpret them (CVP, RAP, PAS, PAD, PAOP, SVR, CO, CI, ScvO2, etc.)

Warfarin pretty much interacts with EVERYTHING. Two drugs that come to mind are levoquin and amiodarone.

I PASSED!! I did notice on my score report that they DID increase the cut score from 51 to 52. And the exam was DIFFICULT. Moreso in my opinion than CCRN just because it's SO focused and in depth. Best of luck!

Ms. B -- thank you for all of the wonderful information! It helped me guide my studying nicely along with the review course I took at my hospital! I'm on my way to take the exam now! Will let everyone know how it goes!

NC -- I actually moved my test date up to this Monday! I'll let you know how it goes.

Wow -- You thought it was harder then CCRN?! I might have to start taking this a little more seriously!

Thats what I was thinking, lol.

SEWRN -- Congrats on the job offer! In todays job market I would tell you to take any job you are offered, just to get your foot in the door! It seems, from reading your post, your torn between a community ICU and university step-down unit. Let me tell you a little about my experience...as a new grad I worked for ~8 months on a tele floor in a community hospital before moving into the SICU at that same hospital. While the time I spend on the tele floor was HELL (mainly because I knew I wanted to be in the ICU post graduation) I do have to say I gained the time management skills and basic assessment skills needed to flourish in the ICU. When you start out on the floor you dont have the technology and invasive hemodynamic monitoring to rely on so you need to depend more heavily on your basic physical assessment skills. I feel as though the time I spent working tele made me a better ICU nurse. I feel this way because I see so many ICU nurses looking at the numbers on the monitors and forgetting about utilizing their basic assessment skills. People tend to forget that when people go downhill the patient will display changes (in mentation, changes in physical assessment, urine output, etc.) before the monitor will display those critical changes. After a year in the SICU I was offered a per deim position working in the critical care float pool at a large university teaching hospital. In my opinion, working in a community ICU is more difficult than working in a univirsity ICU...mainly because the community hospitals simply dont have the "resources" -- mostly at night (I work 7pm-7am). I feel like community ICU RNs gain invaluable experience because they need to function with a higher level of autonomy, you dont have all the interns, residents, and fellows walking around to rely on. If you dont think you will get the experience you need to for CRNA school in a community ICU you are wrong. And you could use the points made above to argue that community ICU experience is just as valuable, if not more valuable than university ICU experience. Sure we dont have as many Swans, we dont do open heart, we dont have CVVHD, we may not prone patients, and we may not ambulate our mech. vents, etc. but there is so much that we do do that there is to learn when your a new grad. I hope this post gives you some insight! TAKE THE ICU JOB!

Hey NCcardiacNurse -- What type of ICU do you work in? I researched on the boards a bit and it seems as though the general consensus is that the CMC subspec exam is a little easier than the CCRN, but just becase its a focused exam. There arent many RNs talking about the exam on here so I get the feeling that the exam is "unpopular" if you will. I am taking this exam to strengthen my credentials becasue someday I would LOVE to work in a CTICU recovering hearts...Here are some facts about the CMC exam that I have found on the AACN website... Total number of CMC certificants: 1,134 (WOW, compared to the CCRNs 59,392) Total number of CMC certificants in NJ (Where I live): 53 Total number of CMC certificants in NC (Im assuming thats where you live): 56 Pass rate (Im assuming this is based on exams PRIOR to June 20th): 73.6% (exactly the same as CCRN) Total number of items on CMC exam: 90 Total number of SCORED items on CMC exam: 75 Passing score (total number of SCORED items that have to be answered correctly in order to pass): 51 ^^I am assuming that the above is true for exams PRIOR to June 20th, I am unsure as to wether they changed the number of items on the exam or the cut score for the new version. Hope this information helps! Alot of the CV stuff is still fresh in my head from when I took the CCRN in April so I dont plan on studying AS hardcore as I did for that...I am however taking a CV review course offered through my hospital -- It follows the test plan for the ANCCs RN-BC (CV cert)...I figure something is better than nothing! Best of luck!