Specifics about the required ICU experience

[jordiRN]

Hi! Like many of you, I went to nursing school with the end-goal of becoming a CRNA. I just graduated with my BSN, passed boards, and got a job! All good things! But my somewhat silly question is this: what "counts" as ICU experience that is required before going to anesthesia school?

The hospital I will be working at has a weird naming system for their units, so I guess I'm not sure if my unit is considered critical enough to qualify. The job title was "RN - critical care," but the unit was called a "Stepdown Intermediate Care Unit." However, I do know that the ratio is 2:1, and they take patients with vents, critical drips, etc...just no swans or A lines. I do want to continue on to school as quickly as possible, probably after 2 years of experience in the ICU...I just want to make sure it's the right ICU!

I also know it might depend on the program I eventually apply for, but what has been your experience with this whole process? What kind of experience did you have before going on to anesthesia school?

Thanks!

[vegnurse21]

From my limited googling on this subject, step-down in any form does NOT count and they want you to have experience with invasive lines and swans. Stepdown, ER, PACU, none of those count. It has to be cut and dried ICU.

[commonsense]

Sounds fishy man. 2:1 is a typical ratio in the critical care setting, but having the ability to take critical drips but not a-lines doesn't sound right. My gut feel is that this job is a typical step-down unit position, meaning they're considering critical drips a nitro drip for chest pain or a consistent dobutamine drip. You might try starting here for a year then trying to transfer to the more critical unit in the hospital.

[wtbcrna, MSN, DNP, CRNA]

The experience requirement is actually for 1 year of "critical care" experience. The COA defines critical care experience as: "Critical Care Experience - Critical care experience must be obtained in a critical care areawithin the United States, its territories or a U.S. military hospital outside of the United States.During this experience, the registered professional nurse has developed critical decision makingand psychomotor skills, competency in patient assessment, and the ability to use and interpretadvanced monitoring techniques. A critical care area is defined as one where, on a routinebasis, the registered professional nurse manages one or more of the following: invasivehemodynamic monitors (such as pulmonary artery catheter, CVP, arterial); cardiac assistdevices; mechanical ventilation; and vasoactive infusions. Examples of critical care units mayinclude but are not limited to: Surgical Intensive Care, Cardiothoracic Intensive care, CoronaryIntensive Care, Medical Intensive Care, Pediatric Intensive Care, and Neonatal Intensive Care.Those who have experiences in other areas may be considered provided they can demonstratecompetence with managing unstable patients, invasive monitoring, ventilators, and critical carepharmacology."

http://home.coa.us.com/accreditation/Documents/Standards%20for%20Accreditation%20of%20Nurse%20Anesthesia%20Education%20Programs_January%202014.pdf

[chemokine]

In short, any unit with the words "step-down" or "intermediate" doesn't count. That's not an ICU.

If you aren't using a-lines then you can't be doing the right drips.

[jordiRN]

My thoughts exactly. The ratio is what was throwing me off, because I know of lots of typical step downs that have 3:1 or even 4:1 when really busy. However, I think you're right...this will be a good starting place for me to learn the basics, and I'll pursue transferring to a more critical unit after a year or so. Thanks everyone!