CICU Step down or Operating Room?

[OURN83]

I am an aspiring nurse anesthetist. I will be an RN in December of this year. I currently have a dilemma. I have two job offers for a nurse extern position at two different hospitals and in two very different specialties. One is a cardiac ICU step down/telemetry unit and the other is in the Operating Room. I know, very different floors. I know that for most anesthesia schools they require ICU experience and I figure that the telemetry floor is a step in the right direction. However, I have talked to an Anesthetist in the OR during my clinical experience who said he went straight to the OR after nursing school. He said he would recommend OR experience because he was very familliar with all the drugs and that was an advantage for anesthesia school. I don't know what to do, what do you all think?

[MethaneMan]

We might want to avoid the use of "wasting time" as describing any nursing experience.

I don't have a problem with "wasting time" being used to describe a clinical experience other than ICU for an aspiring crna student. It is the man's or woman's opinion. If time is of the essence for the individual then, in fact, time is being lost if application prerequisites are not being actively pursued.

Look, ICU work is not brain surgery or rocket science (as the saying goes). It is demanding, requires attention to detail, and (here we go again) in my opinion usually attracts nursings best and brightest. If you want to be a crna, then you damn-well better be among the best and brightest. So, if that is certainly one's future, then the ICU should be no problem.

As well, if you are pursuing an ICU gig for the hopes of landing a coveted crna school seat, you should be looking for a high profile trauma center/teaching center gig. As most of us know these places are usually into gaining Magnet nursing status if they don't already have it. That being the case, the inexperienced ICU new hire will be going through a comprehensive orientation process. Again, for the sharp individual, this should suffice in preparing a nurse to be at least average starting out. I have worked with many ICU nurses that have made a career of being average and there is nothing wrong with that. I say all of this with the background of a six year ICU veteran and will be starting crna school myself this fall. Here it is...my final opinion...go find an ICU job if you are sharp, motivated, and focused on becoming a crna in a timely fashion!

[Summitk2]

We might want to avoid the use of "wasting time" as describing any nursing experience, however. It may be a beneficial stepping stone for your particular situation, and who knows? Something may come down the pipeline sooner than you think.

I think most people would agree that there can be great value in gaining tele/step-down experience before moving to the ICU... it gives you skills/knowledge that will be useful (ecgs & drugs). At the same time, it's a very different skill set--on tele, you'll learn about time management, but often more centered around patient load and tasks, rather than patient acuity. You'll learn about some drugs, but popping a routine beta blocker in the pt's mouth is a lot different than pushing adenosine or diltiazem.

I would be concerned that going down this path could lead to becoming STUCK in step-down. It's easy to get comfortable, or argue that maybe you need a little more experience before moving to the ICU. Make sure you maintain your clear direction and sequential steps towards CRNA school.

Hanging out in the OR would be fun, but if you're trying to make yourself marketable to ICU nursing, step-down would be the way to go.

[japaho41]

Really, come on now, if you want to go on to CRNA school, cut to the chase don't waste your time on the step down's. I am saying don't settle if you want to stick to a timetable when you want to go back to school. I don't buy the fact that you will get time management experience. When you get in the ICU you will be performing at entire different level of nursing that requires both critical thinking and time management.