Need some advice...

  1. So I started out in an ICU at a smaller hospital. Finished my GN internship and worked there for about 10 months. I had an opportunity to transfer to the ER and took it because I had so much fun in the ER in school and thought I would love working there...I went back and forth on doing CRNA school (which was my original plan and the reason I went into ICU to begin with) mainly because I didn't know if I wanted to put my life on pause again for school after I had just busted my butt in nursing school for years! Well, I stayed in that small ER for about 6 months and I transferred to a level 1 trauma county hospital and I've been in the ER here now for another 6 months. My problem is now I'm really thinking I made a mistake and I should have stuck to ICU and gotten that experience because I could have been applying and/or starting CRNA school by now. Now that I'm positive that CRNA is what I'm going to do, I'm not sure what my next step should be. I hate to just hop jobs so frequently and I would like to find a unit and stay in it for a while but I feel like being in the ER just isn't going to get me the experience I need to do anything for the future. I know that TCU accepts ER experience from what I hear...but I'm not entirely convinced that I would be successful in the program since I haven't worked with vasoactive gtts or vents etc. in a year. I contacted one of our ICU team leaders who directed me to HR and reminded me that there's new grads wanting the positions too (which I'm not taking as a good sign) and I can also apply for a level 2 hospital ICU that is nearby. I just feel like I need a solid year of experience in ANY unit (but especially good at a level 1 trauma ER) before I make any more career moves!! Can anyone give me any advice? What would you do?
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    About criticalRN10

    Joined: May '09; Posts: 197; Likes: 117


  3. by   missnurse01
    I would not be worried about the trauma designation. Find a busy unit, transplant, or open heart and get your experience. Apply at every hosp that has an opening in those units in driving distance to you. Work for a few years and apply when you feel ready.

    I was an ER to cvicu transplant for many reasons but mostly for experience for flight and crna school. Now that I got in I am more in the ER than ICU and very happy.

    good luck
  4. by   jrkingRN
    If you're happy in your trauma ER and your local CRNA program will accept that as the critical care requirement, I suggest staying put. If you want to become more familiar with vasoactive gtts and vents try finding a PRN position in a critical care unit. That way you can have the best of both worlds.
  5. by   missnurse01
    the only thing with going prn only is that you do not get the sick pt's. They know you did not have much orientation or experience so you will not get the sickies. I would find people that only had trauma er experience that became crna's and ask how well they felt it prepared them. I have heard more often than not that they had to learn a lot on the fly that they would have had experience with in the ICU. I worked trauma ER, held ICU pt's in the ER, etc. It is a different beast having them day in and day out.

    good luck!

    also, you can also talk to the pd (program director) at the school and ask how the applicants that have only er experience fair in the program. if they struggle, etc.
  6. by   criticalRN10
    That's a great idea!! I actually got a call today from my HR rep and scheduled an interview with ICU in May...I'm so torn though I've heard horrible things about working at this particular ICU (especially coming from ER..they don't like us lol) but it would be an awesome place for experience. I'm happy where I'm working now (most days) and like most of the people I work with. I would hate to switch and be miserable in ICU just for the experience I don't even need to get into school. I sent my manager an email with a heads up in case the ICU manager contacts him b/c I don't want to burn any bridges...I'll probably just transfer to ICU just to be "safe" with the application process and continue to work PRN in the ER if he'll let me. I think I'll contact the school like you said and see what they say. I'm mad at myself for not taking GRE and CCRN sooner though because if I had it right now I would be able to apply for the January 2014 CRNA school which the deadline is July 1st. Even if I don't get in, worth a shot since they only take apps yearly.
  7. by   criticalRN10
    Well it turns out that was the best thing I could do was call! She said I definitely should go to ICU because they very rarely accept ER experience. Thanks for your input everyone!
  8. by   missnurse01
    great!! icu is very very different. Just be the best new-to-icu person you can be. Lots to learn, be a sponge. Very good luck to you. I would not tell anyone in the ICU, even during an interview, that you are planning on getting experience in order to go to crna school.

    good luck and let us know how it goes!
  9. by   criticalRN10
    I'm hoping that they don't make me do a full on internship since I do have 10 months of ICU experience already... but I will definitely soak up all of the experience I can there for sure. The problem is...when my team leader called the lady I'm interviewing with to try to get me in, he said "she wants to do CRNA and all that so she wants to come to ICU..." so she already knows :-/ lol at least I still got an interview though!! he told her I'm a really strong nurse and he hates to lose me but I would be great up there so hopefully he can help me get in.
  10. by   RhinoRocketRN
    Don't worry about the interviewer knowing... It shows you have goals and you are open and honest about it. It'll pay off in the end
  11. by   justinlsu
    Hey so before I got into CRNA school I read this site daily to try to get information. Because I have been so busy with school I haven't been back on here, but just thought about it and need to repay for the advice i got. Your question is one that I had, and struggled with. I actually started in ER and made transition to ICU, but it was only for school. Honestly I love Emergency and am still not a big fan of the ICU. In my application and interview process I found out that yes the schools want you to have a year, some two of experience by the time you start the program. While working at a level one might be a feather in your cap, it in not necessary to get an interview, get into school, or be successful in school. I went to 4 different interviews, and every single one of the programs told me that everyone that they were interviewing they would be successful in the program. The thing to realize is that you will be working daily with these people for the next three years. They want people that will be easy to work with and be around. I do not think that people that had "better" experience with me had any advantage once the program started. While you can get the basics in the ICU it is in no way the amount of information that you will learn in just your first month of school alone. That being said, I am glad that I spent my time in the ICU. In the ER we do things that we know are important and will save a persons life. In the ICU, you will have twelve hours to delve into every disease process and pharmacological effect of every drug given. It is a different way of thinking, not better but different.
    In your time before you apply for school this is what I recommend. Transfer to the ICU where you're at if you can. If not transfer to wherever you can get in the quickest, preferably one that does hearts and neuro. When youre in the ICU take the sickest most unstable patients every night. While its nice to cruise on an insulin drip all night, you will not be learning. Take any opportunity you can to learn any device/procedure/disease process. If you dont know ask. Be conscious of all the drugs you are hanging, how they effect the patient, and each other. Specifically know which receptors each drug act on, the receptor effect, and the specific organ effect of the receptor. This will be huge in your interview. As soon as you get into ICU take your ccrn, start studying now. If you're smart enough to get through crna, you are smart enough to learn corn review without ever seeing 90% of the patients it test on. I recommend Laura Gasparis review. Finally if you like the ER stay on prn, I was able to never get sent home in 2 years of my icu work because I could do it all. Census can drop in ICU, it doesnt in ER. Also even though most schools don't consider ER for requirements, I believe it will make you better in the OR. If you are able to stay calm, think, and treat a multiple gsw that rolls up pov, you will be better suited to take care of a crashing pt on the OR. Oh last thing I know you want to be honest which I commend, but not a whole lot of ICU managers are going to invest time training you if you tell them you are trying to fast track to CRNA school so maybe keep that to yourself until you have been working there a few months. Kinda long winded and all over the place but feel free to email me with any questions that you or anyone reading this have. A few people helped me and I would like to pay it back. Put something in subject line so I make sure to see it. Good luck with everything.
  12. by   missnurse01

    I agree with a lot of what you have said. I was ER first before ICU and can definitely love it more, but it all depends on the night, lol. I also highlighted my ER experience on my application for school as teaching me the calm in the face of the storm mentality. ICU newer nurses were always asking why I was calm, but hey, as long as you know how to fix a problem, then it isn't as big of a deal if a problem does happen that you didn't anticipate.