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Transferring ICUs for better experience?

SRNA   (1,149 Views | 6 Replies)

571 Profile Views; 12 Posts

Hello, I eventually want to apply to CRNA programs and I’m looking for some advice about if/when I should transfer ICUs.

As a new grad I started in a medical progressive care unit, where I worked for 14 months. After that I transferred to a neuroscience ICU in April 2019 and I’ve been there since. I’ve had lots of experience with pre-op/post-op craniotomies, EVDs, seizures, and medical/surgical overflow. We currently don’t have anyone who can do clot retrievals, so we have to send out all strokes who need thrombectomies. We are also not a trauma center so unfortunately I have not had experience with traumatic neurological issues either.

I enjoy my current job, however I’m concerned I’m not getting the experience I need to prepare for CRNA school. The majority of my patients are stable, extubated, not on any drips, and just require frequent neuro assessments. Most shifts, I honestly feel like I’m in a step-down unit with extra charting. This has been an awesome first ICU job, especially because all the intensivists, mid-levels, and senior nurses are super helpful and willing to teach, but I’m starting to worry that I’m just not getting sick enough patients to learn from. 

Are my concerns/reasons for wanting to leave valid? I feel terrible for wanting to leave this unit because I love the management and my coworkers. My unit director is super approachable and supportive, but that somehow makes me feel even guiltier.

And when would be the most appropriate time to start applying to other ICUs? I’m definitely not going to start looking before the 1 year mark at my current job, but I’d really like to start applying to CRNA schools sometime between the next 1-3 years (depending on how ready I feel) so I don’t want to piddle around too long either. I just started studying for CCRN, so I’m thinking about applying to new jobs after I take the test.

And finally, what sorts of ICUs would give me the experience I’m looking for? I’m thinking about SICU, MSICU, and trauma. I’m also curious about trauma-burn and transplant, but I’d have to learn more about those. And I’ve also been back and forth about cardiac because I’ve heard some bad things about the demeanor of CTICUs, but I feel like I would get invaluable experience there. Ideally, I’d like to be in a high-acuity ICU where I’m getting exposure to complex assignments and high-stress situations.

Thanks for reading! Any and all advice is much appreciated!

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TPN1986 is a RN and specializes in SRNA CEN CCRN-CMC.

79 Posts; 999 Profile Views

Normally I wouldn't jump to telling someone to quitting their job and seeking new experiences, but honestly everything you outline in your post is exactly why you need another job. If I were you I would start looking yesterday, this isnt to say that you couldnt get into a school from your current job. But unless your stats are stellar you're setting yourself up for some difficult interviews. Panels want to know what kind of patient's you take care of, what an average day on your unit looks like. They place a high emphasis on having patients with drips and vents at a bare minimum. If the majority of your patients are just on a neuro ICU because they have an EVD then it's going to be difficult to articulate why you're ready to start school. As for job seeking, I'd look for a job where your local CRNA school recruits from because that's where you're gonna find the best experience. 

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9 Posts; 613 Profile Views

I’d say it’s worth it from personal experience. You want the best ICU experience possible to prepare you for school. I left my community  ICU after one year for a level 1 SICU at a brand name hospital and my program director was thrilled to see the newer, more critical experience on my resume. I also feel way more prepared to start school than if I were coming from my first job! 

Edited by Nursesky94

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HappyCCRN1 is a BSN and specializes in Burn and Surgical/Trauma ICU.

44 Posts; 635 Profile Views

You’re not getting the experience that you need and want and you’ve come to this realization at less than a year. The feelings of guilt about leaving are completely understandable, but this is your career and your future. 
I’m not sure what your options are as far as hospitals in your area, but if CRNA is your goal, I would start looking now. It seems like you’ve done the research you need to know where you should apply: high acuity ICU’s.

Most programs like surgical, med-surg, or CV ICU. I worked in a huge burn ICU and gained incredible experience there. But I learned so much more when I transferred over to surgical/trauma ICU because of the case variety. I feel that really rounded out my resume when I was submitting applications. My one regret was not having CV experience, but it didn’t come up as an issue for me. 
 

Good luck!

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ProgressiveThinking has 7 years experience as a MSN, CRNA and specializes in Anesthesia.

429 Posts; 13,500 Profile Views

After you hit the one year mark transfer into the largest and most generalized ICU that you can get into. You could also try picking up shifts in other ICUs at your current hospital on your days off, or ask to be floated there. If cross training is required, find the ICU that is shortest staffed and ask the unit manager if you could come in and cross train on your days off. They would likely be thrilled to have a current ICU nurse come in and help out. 

This will do 1 of 2 things: 1)It will expose you to a different patient population, and 2) On your resume you can put that you are cross trained in those ICUs and frequently floated to them. It will look good on applications for both your next ICU and CRNA school. It would show that you are flexible and have varied experience. My PD actually liked that I had an ICU float pool job on the side (in addition to a very busy, broad, and generalized county MICU with traumas and surgery patients as well) because it showed flexibility. 

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ptier_MNMurse has 4 years experience as a BSN, RN and specializes in CVICU.

67 Posts; 933 Profile Views

You sound like you are definitely on the right track! I agree with what everyone else is saying on here: seek out the ICU that is going to give you the best experience to get into school, transfer at the 1 year mark, and until then make sure all of your grades are excellent (take additional classes/graduate classes if necessary), get your CCRN, volunteer on committees or your local AACN board, eventually precept, and get involved in and educated about the ICU and anesthesia communities! I think it will go a long way to be educated on current practice issues and current and anticipated changes in the years to come! It is all very exciting and promising! (Look at the AACN and AANA websites).

I know how you feel about leaving a good, solid community of people, but you must remember that this is YOUR future, and if you have your sights set on moving forward into nurse anesthesia, then you must take the necessary steps to do so. People will understand that and there will be others behind you to support the unit when you leave as well!

My only other advice would be to see about shadowing in the ICU you are seeking out to ensure it is what you are looking for! You want to see lots of vents, gtts, lines, drains, devices, some would say with a surgical focus (SICU or CVICU) though there are many MICU's that provide great experiences as well and can sometimes have a surgical component to them! Lastly, as a CVICU nurse myself, I can say that while we generally carry a strong demeanor, it is not much different than other ICU personas in my experience. Generally, ICU nurses become more and more particular with time, and that's good for our patient population! No need to fear CV!

Best of luck!

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Defibn' has 6 years experience and specializes in SRNA.

134 Posts; 2,137 Profile Views

On 1/8/2020 at 5:34 PM, mph53953 said:

Hello, I eventually want to apply to CRNA programs and I’m looking for some advice about if/when I should transfer ICUs.

As a new grad I started in a medical progressive care unit, where I worked for 14 months. After that I transferred to a neuroscience ICU in April 2019 and I’ve been there since. I’ve had lots of experience with pre-op/post-op craniotomies, EVDs, seizures, and medical/surgical overflow. We currently don’t have anyone who can do clot retrievals, so we have to send out all strokes who need thrombectomies. We are also not a trauma center so unfortunately I have not had experience with traumatic neurological issues either.

I enjoy my current job, however I’m concerned I’m not getting the experience I need to prepare for CRNA school. The majority of my patients are stable, extubated, not on any drips, and just require frequent neuro assessments. Most shifts, I honestly feel like I’m in a step-down unit with extra charting. This has been an awesome first ICU job, especially because all the intensivists, mid-levels, and senior nurses are super helpful and willing to teach, but I’m starting to worry that I’m just not getting sick enough patients to learn from. 

Are my concerns/reasons for wanting to leave valid? I feel terrible for wanting to leave this unit because I love the management and my coworkers. My unit director is super approachable and supportive, but that somehow makes me feel even guiltier.

And when would be the most appropriate time to start applying to other ICUs? I’m definitely not going to start looking before the 1 year mark at my current job, but I’d really like to start applying to CRNA schools sometime between the next 1-3 years (depending on how ready I feel) so I don’t want to piddle around too long either. I just started studying for CCRN, so I’m thinking about applying to new jobs after I take the test.

And finally, what sorts of ICUs would give me the experience I’m looking for? I’m thinking about SICU, MSICU, and trauma. I’m also curious about trauma-burn and transplant, but I’d have to learn more about those. And I’ve also been back and forth about cardiac because I’ve heard some bad things about the demeanor of CTICUs, but I feel like I would get invaluable experience there. Ideally, I’d like to be in a high-acuity ICU where I’m getting exposure to complex assignments and high-stress situations.

Thanks for reading! Any and all advice is much appreciated!

Don’t feel bad for looking out for yourself. Your ICU will be fine without you. You have the right mindset and I respect that you want to do the right thing. I know it’s hard to leave a comfortable place with friends and a great manager. But, you need to leave to help you get into school. If your manager is as great as they seem, then they will be supportive. Just do it the right way and give them a heads up. I think a year is a good time period to give a unit a shot. They have made a lot of money on your back. Don’t feel bad. 

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