Switching units

[DirkFromDallas]

Currently 2yrs on a Neuro&Trauma ICU and feel that varied ICU experience will make me a better candidate and more prepared for CRNA school when I apply in a year. I really do enjoy my unit, the coworkers, teamwork. I have recently been doing charge and there is ample opportunity for leadership, research, precepting, but I feel that another unit that is CVICU&SICU combined would lead to clinical growth.

The only problems are that I won't have this leadership, precepting, etc. opportunity if I switch units. Also I will be retaking classes to improve GPA, limiting my availability, along with prior Anesthesia tech experience and it's clear that my goal is to go back to school. So my questions really are:

Does clinical experience trump leadership/charge/precepting, etc.? How do admissions view this?

How can I can I be honest in an interview without sounding like it's a stepping stone?

I really have wanted to work open hearts ever since I was a tech transferring pts to this unit but after nursing school and stepdown exp. my current unit was the only one open. I hate to leave coworkers but I think the move will help me grow. Thanks

[Defibn', RN, EMT-P]

I don't know that I would switch units. How often are you getting sick patients? Vasoactive medications, vents, and the like?

[DirkFromDallas]

It depends really. Generally I'll have at least 1 vented pt, sometimes 2. There aren't a ton of really sick pts at one time imo but sometimes I will get one of them. Drips include neo, levo, propofol, fent, cleviprex, cardene, precedex, sometimes versed, and occasionally paralytics, rarely epi. With the paralyzed pts we do train of four/ bis monitoring. We see alot of central and art. lines, but cvp's are occasionally used but not as important as a cardiac unit. The last time I saw a swan I was an anesthesia tech, but I know they are used less often and in open hearts?

I think it's kinda shotty to get hired and then less than a yr later turn around and ask for references, but I am under the impression that there is more hemodyamic monitoring on cvicu's. I have known people to go to crna school from my unit but many more went from the cvicu/sicu.

Thoughts?

[Defibn', RN, EMT-P]

Yeah I see where you're coming from. I worked in weird ICU. We were a "heart recovery" unit but also had a ton of sepsis and resp failure. Toward the end of my time there we pretty much stopped using SWANs. IMO you are probably in a good spot, and I don't recommend switching at this point. I would try to apply and see what happens. You are right that moving units would make it more difficult to get recommendations. The big benefit to recovering hearts is the immediate post op period where they sometimes have pretty labile hemodynamics. Depending on the unit culture it may take a while before they even give you those. If I were you, I probably stay where you're at and make sure I knew everything about the unit, the drugs, and the conditions that you routinely treat.

[SuziQ1978]

Oh Gosh. The CVICU, my worst nightmare. Not because of the patients as much as because of the surgeons. Talk about Egos.

Good luck. I work in the Neuro ICU and love it. Would consider the MICU to learn more pathology. Never the CVICU.