Transitioning from post acute to ICU-- - Tips Appreciated.

beekee · May 21, 2019

With being away from the bedside for three years and having no acute care experience, I suspect that jumping into the ICU will be difficult (but that depends somewhat on where you are located). I would try getting into a med surg or step down unit, if you can’t get into an ICU.

bsntocrna · May 24, 2019

Hey Beekee,

Thanks for the insight.. You're right I'm going to focus on getting in and then try for an in-house transfer. Applied for a Med Surg position and was called 1 day later, I have an in person interview next week. Wish me luck.

Thanks!

JBMmom, MSN, NP · May 24, 2019

Good luck with your transition back into acute care. I agree that jumping from your current position to ICU could be a daunting challenge, but that's not to say it couldn't be done. However, getting your feet under you in med surg would be a great place to start. They are very different skill sets, though. I transitioned from med surg to critical care and I think my time in med surg served me well. You have a little more of a time management component with higher patient loads, and critical care really requires a bit more critical thinking on a regular basis with titrating drips and monitoring a more acute patient. I hope you find what you're looking for!

bsntocrna · May 24, 2019

19 minutes ago, JBMmom said:
Good luck with your transition back into acute care. I agree that jumping from your current position to ICU could be a daunting challenge, but that's not to say it couldn't be done. However, getting your feet under you in med surg would be a great place to start. They are very different skill sets, though. I transitioned from med surg to critical care and I think my time in med surg served me well. You have a little more of a time management component with higher patient loads, and critical care really requires a bit more critical thinking on a regular basis with titrating drips and monitoring a more acute patient. I hope you find what you're looking for!

Thanks, I certainly appreciate your insights! Since your path is basically the one I've laid out, I got a couple of questions if you don't mind.

1. How long were you in Med Surg before the transition?

2. Was it difficult to transition into ICU from Med Surg?

3. Any particular reason you transitioned to ICU?

As I mentioned, my end-goal is CRNA but I got long ways to go. Med Surge (1 year?)>>GRE, Org Chem, Statistics (Need to take that apparently)>> ICU (1-2 years)>> Apply for the program

Ruby Vee, BSN · May 24, 2019

Plan to stay in Med/Surg for at least a year; two would be better. It takes at least a year to learn the things you need to learn there. I know you said you were in “post acute care” before your three year hiatus from the bedside. Is that long term care? Rehab? Would Med/Surg be a refresher for you, or are you going to be covering a lot of new ground?

Most CRNA programs require at least a whole year of ICU before applying, and many of them won’t consider less than two years. You’ll be gathering recommendations for anesthesia school as you go, but consider that you might actually LIKE Med/Surg or ICU and want to stay.

bsntocrna · May 24, 2019

14 minutes ago, Ruby Vee said:
Plan to stay in Med/Surg for at least a year; two would be better. It takes at least a year to learn the things you need to learn there. I know you said you were in “post acute care” before your three year hiatus from the bedside. Is that long term care? Rehab? Would Med/Surg be a refresher for you, or are you going to be covering a lot of new ground?
Most CRNA programs require at least a whole year of ICU before applying, and many of them won’t consider less than two years. You’ll be gathering recommendations for anesthesia school as you go, but consider that you might actually LIKE Med/Surg or ICU and want to stay.

It's rehab.. IVs, wound vacs, complicated wounds, trachs, etc...

You're certainly right about the ICU requirements in those CRNA programs. Fortunately, the 3 programs I'm looking at let me apply with 1 year of exp but obviously the more ICU exp the better my application would look. I hadn't considered the gathering of recommendations while in Med Surg and/or ICU, definitely takes time to build those relationships.

JBMmom, MSN, NP · May 25, 2019

18 hours ago, bsntocrna said:
Thanks, I certainly appreciate your insights! Since your path is basically the one I've laid out, I got a couple of questions if you don't mind.
1. How long were you in Med Surg before the transition?
2. Was it difficult to transition into ICU from Med Surg?
3. Any particular reason you transitioned to ICU?
As I mentioned, my end-goal is CRNA but I got long ways to go. Med Surge (1 year?)>>GRE, Org Chem, Statistics (Need to take that apparently)>> ICU (1-2 years)>> Apply for the program

I was in med-surg just about a year. I hadn't considered transitioning to ICU, but the position sort of fell in my lap. (not necessarily a good thing, unit is very understaffed and short on experience, so learning has been a challenge when I was senior staff on my shift some nights after six months). I still pick up on the med-surg unit because I like both work environments. I don't know that the transition was any harder than any new jobs I've started before, nursing or non-nursing. The learning curve is always steep, this just seems a bit steeper because lives could literally be on the line. I enjoy learning and I used lots of on-line and book resources, I still do. Good luck!

Nurse8988 · Jun 2, 2019

Hi there! I would recommend applying to MS or step down ICU positions if you are unable to land an ICU job. I know some facilities that allow a nurse to transfer in house from med surg after 9 months of being on med surg. Anyhow, I did subacute nursing for a year prior to ICU and the transition was challenging for me but certainly doable. I went into ICU nursing because I feel that I would learn a great deal and the challenge of caring for the sickest of the sick enticed me. Tips for success in ICU would be...

1) Be safe. Triple check everything when administering meds

2) Pay attention to detail.

3) Review/study ICU concepts on time off. Doesn't have to be every day but enough to familiarize yourself to ICU(this time varies from person to person). Some people don't study at home but I recommend it to increase your ability to pick up on ICU concepts.

4) Work hard and don't give up. If anyone can be an excellent ICU nurse, why can't you. Reflect on things you feel that you need work on, address them, and keep pushing. You may have days that you feel like are so draining and difficult but when you leave and come back to work remember that it is a new day and that you are a great nurse. All the best!