Hi y'all! Wondering if I can get some input as to which type of SICU would be better experience for CRNA school. Small community hospital or large teaching hospital? A SICU who also serves CV patients and do ECMO, or a level 1 trauma SICU?
Any info would help!
Last edit by crnagoals1 on Dec 4, '17
Dec 4, '17
The bigger the better, my background was a large trauma unit but I wished that I had had more CV experience.
Dec 4, '17
Large teaching hospital...get the more sick patients. Doesn't matter which ICU tbh, I was in Neurosurgical ICU (got a lot of trauma and MICU pt's as well) and I'm doing fine. I have classmates with PICU and NICU backgrounds as well...although many schools don't accept these, they're doing fine in school! Pick what you're interested in.
Dec 4, '17
I woyld say the large level 1 trauma center as well. If the community hospital has a high enough acuity for you to get CV cases as well as ECMO then that would be a good choice as well. I'm in a Neuro/Med-Surg ICU and I fell like I'll be well prepared for CRNA school.
Dec 5, '17
My opinion differs a bit. Large teaching facilities MAY focus their teaching more on residents/fellows and less on autonomous nursing. In some units, this means nurses must constantly check with Dr. before starting drips, etc. and I have heard (rare) units where the nurse must check before titrating vasopressors. I came from a smaller hospital, no residents, that did sick open hearts, ECMO, etc. Nursing was given a lot of independence and we would start drips, hang blood, etc. on our hearts if we thought it was what they needed (after the surgeons trusted you to make good decisions). Bottom line is that size and acuity don't matter if you're not making decisions. A unit that "does ECMO" sounds cool but it is very different if there is a perfusionist sitting on pump as opposed to nurse-run ECMO (we did this in my unit. Very cool!). The best unit is the one that teaches you to think like a provider and make autonomous treatment decisions, because that's what being a CRNA is all about. Try to talk to some nurses that work in the units you are interested in and try to learn about how they make treatment decisions.
Dec 5, '17
Bigger the better. And definitely CVICU. I worked in a cardiac ICU in a large city university hospital and it paid dividends on my interviews. At least for getting into school, I would try to get into a large cardiac ICU with swans, echo, vads, etc.
Dec 8, '17
Thanks everyone! I'm leaning towards the large teaching facility sicu with cv patients where nurses run ecmo. I really feel that I'm going to grow as a nurse there. Excited for this new chapter! Thanks again!
Dec 17, '17
CVICU or MICU in a large teaching hospital. With MICU, you will learn a lot of patho and learn about a lot of the disease processes that your patients may have.
Dec 18, '17
Any ICU that gets a wide variety of cases. All the systems. Generally, this would be a Surgical/Trauma ICU. Nothing wrong with hearts and CVICU, but most of anesthesia does not look like that. It is far, far different.
As far as which type of hospital, there is no right answer. The big teaching hospital certainly gets the acuity, but most nurses miss out on the thinking part of the game. There are attendings and residents there, doing most everything. The smaller hospital has less acuity, but the nurses at the bedside get to do far, far more management of the patient. The both have their advantages.
Lastly, ECMO is completely worthless, from an anesthesia point of view. It is neat, and dramatic, and tense, and there is very little learned or carried over into anesthesia practice. Please, I urge you to NOT make your decision based on whether or not you get to do ECMO.
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