Quality of ICU experience - Hospital size

[utewbrn]

I am currently a nursing student scheduled to graduate this summer. My goal in the next few years is to gain the experience and knowledge that will allow me to be a competitive CRNA program applicant/student. Here are my concerns: In the area where I live, it is very difficult for new grads to get into ICU positions. There are a couple of large, level 1 trauma centers that would offer the ideal situation, but alas these jobs are hard to come by. These facilities do sometimes offer internships, but slots are very sought after. Additionally there are several smaller (100-150 bed) hosp's in the area, which might offer an easier route into ICU.

My question is, is it possible to gain the experience I need in a smaller hospital or must I get into one of the level 1's at any cost? Is there anyone out there who's been accepted with experience only from smaller facilities?

[heartICU]

I am currently a nursing student scheduled to graduate this summer. My goal in the next few years is to gain the experience and knowledge that will allow me to be a competitive CRNA program applicant/student. Here are my concerns: In the area where I live, it is very difficult for new grads to get into ICU positions. There are a couple of large, level 1 trauma centers that would offer the ideal situation, but alas these jobs are hard to come by. These facilities do sometimes offer internships, but slots are very sought after. Additionally there are several smaller (100-150 bed) hosp's in the area, which might offer an easier route into ICU.

My question is, is it possible to gain the experience I need in a smaller hospital or must I get into one of the level 1's at any cost? Is there anyone out there who's been accepted with experience only from smaller facilities?

I would apply to both, and if you only get into the smaller ICU, take that job and work there for a few years. Then make an attempt to get into the bigger ICUs. As a general rule of thumb, sicker patients go to bigger hospitals - academic centers tend to attract specialty cases, interesting cases, etc. Many small communities will turn down patients with multiple comorbidities or refer them to larger academic institutions. You will need the experience with vasocactive drips, swans, complex vent settings, etc for anesthesia school, and many community hospital ICU patients simply won't have these things. Now before anyone flames me about "my patients are sick as dogs and I work in a 2 bed ICU in the middle on nowhere" please remember that I said "in general."