Types of ICU.

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Specializes in Critical Care.

I'm highly considering traveling as an RN whilst enrolled in an online NP program. I currently have a little over a year and half of postoperative experience and I'm currently training on a heart transplant VAD floors that does manage drips such as (milrinone, dobutamine, dopamine, nitro, cardz). It has a 1 nurse to 3 patients ratio.

This floor is a stepping stone for me. I am planning on SICU by possibly March.

My question: What are the most needed ICU nurses in travel.

What ICUs are the most broad in ICU skills?

I'm told SICU is very broad.

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MICU, Neuro ICU, SICU, CVICU all have can have unique patient populations. If I had to provide an educated guess, I'd say that SICU provides the broadest entry for travelers as I would think most such experienced SICU nurses will have enough medical experience to thrive in that setting as well (some may find it a bit dull).

You didn't ask, but CVICU is likely to pay the most. Cardiac cath requires CVICU skills and certainly pays more currently. Flight nurse (I don't think there would be many travelers) is also an ICU subset that would pay more.

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Specializes in Critical Care.
MICU, Neuro ICU, SICU, CVICU all have can have unique patient populations. If I had to provide an educated guess, I'd say that SICU provides the broadest entry for travelers as I would think most such experienced SICU nurses will have enough medical experience to thrive in that setting as well (some may find it a bit dull).

You didn't ask, but CVICU is likely to pay the most. Cardiac cath requires CVICU skills and certainly pays more currently. Flight nurse (I don't think there would be many travelers) is also an ICU subset that would pay more.

I would be interested in CCU and we do have CCU, at my facility CCU is a subset of MICU. However CCU does not receive VADs or transplants as those go to either SICU or the floor I'm currently training on (which is a step down ICU).

I would also be interested in cross training in CCU. From my understanding at my facility SICU nurses can float anywhere in the ICUs.

I was also asking because I was wondering how travel agencies decide how to match you and/or what hospitals typically ask for in terms of experience. For example will being a SICU nurse give me edge over a Burns or Med ICU nurse for a Neuro ICU position?

I want to make myself marketable.

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It is not just your title or positions held. Fit is also determined by a skills checklist you will have to fill out as a traveler. You are submitted to specific travel assignments, such as a particular type of ICU, that you choose. You can't necessarily tell about patient population from a job posting or title of the unit. Final fit can be decided by you and the manager in an interview before you accept.

I'm not sure your question about what ICU jobs are in demand by hospitals can be answered definitively by a traveler. I might suggest calling agencies and see if they are willing to tell you about which ICU specialty is your best choice to focus training. You are eventually going to have to talk to agencies anyway, right?

As far as being marketable, collect as many certifications as possible, get rave written references, and get lots of experience.

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Specializes in Critical Care.
It is not just your title or positions held. Fit is also determined by a skills checklist you will have to fill out as a traveler. You are submitted to specific travel assignments, such as a particular type of ICU, that you choose. You can't necessarily tell about patient population from a job posting or title of the unit. Final fit can be decided by you and the manager in an interview before you accept.

I'm not sure your question about what ICU jobs are in demand by hospitals can be answered definitively by a traveler. I might suggest calling agencies and see if they are willing to tell you about which ICU specialty is your best choice to focus training. You are eventually going to have to talk to agencies anyway, right?

As far as being marketable, collect as many certifications as possible, get rave written references, and get lots of experience.

Thanks!

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Specializes in ICU/PACU.

Try a trauma surgical ICU in a level 1 trauma center. That will include neuro patients most likely, which is very marketable.

Or you could go a different route and do CVICU and stick with that.

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As some have said, your travel agency will give you a skills checklist that will include just about any ICU skill or machine imaginable and they'll ask you to accurately describe how skilled and comfortable you are with that disease process management or machine. Usually with a scale of 1 to 5, 1 being no experience with it to 5 being you could teach a class on it.

The title of a certain ICU greatly varies based off the hospital and the state. I've worked some hospitals that titled themselves an advanced Trauma ICU and wanted everyone to be TNCC certified (a certification created and aimed at ED RN's) and they thought they were something special. The patient population there was what I would consider mostly typical Med/Surg ICU patients with a couple neuro cases with basic ICP monitoring. Although those nurses who had never worked in any other ICU thought they were highly skilled and "badass", I laughed realizing that they would have drowned at a really high acuity MICU I worked at in Atlanta last year where the patients acuity level was much higher and difficult to keep alive. Those nurses in that MICU almost all had their CCRN and these Trauma ICU nurses barely knew what a CCRN was!

Then another hospital I traveled to felt comfortable with my background in Cardiac, CV, Neuro, Medical/Surgical, Pulmonary ICU's that they threw me into the highest acuity patients I've ever taken. I enjoyed the challenge but I honestly had to tell them on a few cases that I didn't totally feel comfortable pulling three chest tubes out of the chest and cardiac space on my own, manipulating the Milliamps and Sensitivity of the external pacer to see if there was an intrinsic rate, cap the pacer wires, pull the Swann-Ganz Catheter and Cordis out, titrate off about 8 vasoactive drips, extubate the patient, monitor for resp distress or cardiac tamponade then transfer the patient out to receive another fresh heart coming. They wanted all this done within about 6 hours and I had another critical cardiac patient I was caring for.

You definitely want to be completely honest on your skills checklist. If you've seen one patient with ICP monitoring before don't put comfortable or competent on your checklist because the hospital will expect you to hit the ground running with little to no orientation.

You ask which type of ICU is most marketable and that's a tricky question. If I had to pick one type it would be a medium sized (300 to 400 bed) regional community hospital that no other major medical hospital is within an hour circumference. It seems that's your golden spot for ICU's to be big enough to handle some serious stuff but not so big that they've split themselves up into multiple ICU's. Once they become big enough to split into multiple ICU's you sadly get limited on your scope of practice and knowledge base, unless you manage to float between them all. If you can work at a trauma level 2 community hospital that does CABG and interventional cardiac caths, uses CRRT, IABP's, DKA protocols, Drug Overdoses, Severe Sepsis, Mild to Moderate Trauma's, Ischemic CVA's and possibly hemorrhagic CVA's, Whipples gone bad, Surgical related wound Vac's, complex vents with ARDS, you get to be a part of the RRT etc, that would be your best bet to prepare you for travel.

That's the background I had when I went traveling and it's just about prepared me for any ICU that's been thrown my way. Of course every day as a nurse you learn new things, new drugs, new techniques but I had a solid and safe foundation to practice in a wide scope out in the world. Good luck to you!

Up Vote Up Vote ×
Specializes in Critical Care.
As some have said, your travel agency will give you a skills checklist that will include just about any ICU skill or machine imaginable and they'll ask you to accurately describe how skilled and comfortable you are with that disease process management or machine. Usually with a scale of 1 to 5, 1 being no experience with it to 5 being you could teach a class on it.

The title of a certain ICU greatly varies based off the hospital and the state. I've worked some hospitals that titled themselves an advanced Trauma ICU and wanted everyone to be TNCC certified (a certification created and aimed at ED RN's) and they thought they were something special. The patient population there was what I would consider mostly typical Med/Surg ICU patients with a couple neuro cases with basic ICP monitoring. Although those nurses who had never worked in any other ICU thought they were highly skilled and "badass", I laughed realizing that they would have drowned at a really high acuity MICU I worked at in Atlanta last year where the patients acuity level was much higher and difficult to keep alive. Those nurses in that MICU almost all had their CCRN and these Trauma ICU nurses barely knew what a CCRN was!

Then another hospital I traveled to felt comfortable with my background in Cardiac, CV, Neuro, Medical/Surgical, Pulmonary ICU's that they threw me into the highest acuity patients I've ever taken. I enjoyed the challenge but I honestly had to tell them on a few cases that I didn't totally feel comfortable pulling three chest tubes out of the chest and cardiac space on my own, manipulating the Milliamps and Sensitivity of the external pacer to see if there was an intrinsic rate, cap the pacer wires, pull the Swann-Ganz Catheter and Cordis out, titrate off about 8 vasoactive drips, extubate the patient, monitor for resp distress or cardiac tamponade then transfer the patient out to receive another fresh heart coming. They wanted all this done within about 6 hours and I had another critical cardiac patient I was caring for.

You definitely want to be completely honest on your skills checklist. If you've seen one patient with ICP monitoring before don't put comfortable or competent on your checklist because the hospital will expect you to hit the ground running with little to no orientation.

You ask which type of ICU is most marketable and that's a tricky question. If I had to pick one type it would be a medium sized (300 to 400 bed) regional community hospital that no other major medical hospital is within an hour circumference. It seems that's your golden spot for ICU's to be big enough to handle some serious stuff but not so big that they've split themselves up into multiple ICU's. Once they become big enough to split into multiple ICU's you sadly get limited on your scope of practice and knowledge base, unless you manage to float between them all. If you can work at a trauma level 2 community hospital that does CABG and interventional cardiac caths, uses CRRT, IABP's, DKA protocols, Drug Overdoses, Severe Sepsis, Mild to Moderate Trauma's, Ischemic CVA's and possibly hemorrhagic CVA's, Whipples gone bad, Surgical related wound Vac's, complex vents with ARDS, you get to be a part of the RRT etc, that would be your best bet to prepare you for travel.

That's the background I had when I went traveling and it's just about prepared me for any ICU that's been thrown my way. Of course every day as a nurse you learn new things, new drugs, new techniques but I had a solid and safe foundation to practice in a wide scope out in the world. Good luck to you!

Wow, your reply was absolutely amazing! Thank you so much! = )

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