Which ICU is BEST for Nurse Anesthesia???

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Specializes in Cardiac & Medical ICU.

So now that I've passed the NCLEX and am an official RN (:rolleyes:), I am looking to apply to ICU units starting this week. I've heard cardio, thoracic, and trauma units are great ICU units to enroll into to satisfy the ICU requirement for nurse anesthesia but am not entirely sure. So I just had 2 questions:

1. Which ICU unit is best and most liked by admission committees when you apply to nurse anesthesia programs?

2. After looking at different ICU units in hospitals that I am applying to, I think I would love cardio-thoracic and trauma ICU's the most. Out of these 2, is there a better one to gain experience in?

Thanks a million in advance for all your thoughts and advice everyone!! :bow:

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They usually looked most highly upon a cardio-thoracic (CVICU) icu. But I know people who gotten into CRNA school w/ MICU, SICU, CCU and NEURO/TRAUMA ICU. The important thing is to get into a unit that has lots of vents and uses lots of vaso-active gtts. Good luck and Congrats on passing boards!

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I think either CVICU or Trauma ICU are strong areas. CVICU would be a great area b/c you have the cardiovascular issues. Most of the trauma patients are pre/post surgical but have good hearts. Their only issue is the immediate trauma. Trauma ICU is good for the fact that you are trying to stabilize the patient and it is fast-paced. The CVICU is good because you will get experience in the EKG interpretation, as well as various drugs (more than Trauma ICU). I worked in both. Both have their strengths, but I think CVICU would be the way to go (if it is a large CVICU with IABPs/ PAs/CABGs,etc). Good luck and you're looking in the right direction!

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I'm about to start my first critical care job, and I haven't decided what unit to request yet (we get to rank our top few choices, then they assign based on need for newbies in critical care). I'm really interested in neuro/trauma, and it's where I precepted, but I feel like I should try the CVICU and get the experience for CRNA if I don't hate it. I think I'm going to put CV as my first choice, and see how it plays out - every new hire might want to be there, so I may well not get in anyways.

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You need to think of what will make you successful in a program, not just "what will get you in".

CVICU by far gives the most advanced preparation for anesthesia school: you have more automomy, do more titrating of pressors, and learn how to manage major fluid shifts. You also will have more experience with invasive lines, and getting patients extubated post-op.

However, CV has its disadvantages for you:

#1) a true CVICU will not employ you until you already have strong ICU experience.

#2) you really need to see a wider range of patient issues, since anesthesia is not all about hearts. You would never pass CCRN without other experiences also.

SICU/Trauma offers the widest range of ICU nursing: ventriculostomies, unstable trauma, some invasive lines, vent management, etc.

Your best bet is to get into a surgical ICU at a Level2 Trauma or higher. Since you're a new RN (congrats), how quickly you learn will really depend on your previous medical experience. I was a Paramedic for 8 yrs before getting my RN...and was still overwhelmed in my SICU (like everyone else).

After becoming competent in a surgical ICU, progress into other areas of nursing. Be willing to float, or pick up extra shifts. Get some floor nursing under your belt (time management) and ER experience (procedure skills). If you're a strong ICU nurse, then you should be able to move into a CVICU.

That's my take on it. Worked for me. Don't limit yourself to 1 area of nursing, and good luck!

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You need to think of what will make you successful in a program, not just "what will get you in".

CVICU by far gives the most advanced preparation for anesthesia school: you have more automomy, do more titrating of pressors, and learn how to manage major fluid shifts. You also will have more experience with invasive lines, and getting patients extubated post-op.

However, CV has its disadvantages for you:

#1) a true CVICU will not employ you until you already have strong ICU experience.

#2) you really need to see a wider range of patient issues, since anesthesia is not all about hearts. You would never pass CCRN without other experiences also.

SICU/Trauma offers the widest range of ICU nursing: ventriculostomies, unstable trauma, some invasive lines, vent management, etc.

Your best bet is to get into a surgical ICU at a Level2 Trauma or higher. Since you're a new RN (congrats), how quickly you learn will really depend on your previous medical experience. I was a Paramedic for 8 yrs before getting my RN...and was still overwhelmed in my SICU (like everyone else).

After becoming competent in a surgical ICU, progress into other areas of nursing. Be willing to float, or pick up extra shifts. Get some floor nursing under your belt (time management) and ER experience (procedure skills). If you're a strong ICU nurse, then you should be able to move into a CVICU.

That's my take on it. Worked for me. Don't limit yourself to 1 area of nursing, and good luck!

While I usually agree that broad ICU experience will help you, I have to take offense when you say "you will never pass the CCRN with only CVICU experience". Absolutely not true. I have only worked Cardiac Surgery ICU, and passed the CCRN within 9 months of being off orientation.

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Obviously there was no intention to "offend". To me, CCRN implies a strong nurse, able to handle just about any patient thrown at them. "Critical Care" is not just limited to ICU or CCU. If a nurse started on a step-down cardiac floor, worked up to easy CVICU pts, then moved into CVICU full-time...thats great. But you can't deny that experience would be lacking in other critical areas.

The whole point isn't what makes a CCRN nurse....the point is what will give you a solid background to be successful in nurse anesthesia. If all you've done is cardiac, then you'll be struggling when it comes to all the other facets of anesthesia. Most nurse anesthesia programs/clinical facilities won't offer you much autonomy with vascular cases: you'll rarely be on your own...maybe never with CPB cases.

The learning curve for student nurse anesthetists is very steep. If you get behind, its really hard to catch up. Your best bet is to be well-rounded going into a program. When it comes to it, the only thing that teaches anesthesia is living anesthesia (school) The concepts are highly specialized, and foreign for most entry students.

Sorry to offend you bunny. Happy.

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Specializes in Anesthesia.

Prior to anesthesia school I worked in a Burn ICU. What I liked about this patient population was that though it is "trauma" ICU many of these patients (the big devastating burns) ended up with multi-organ system failure to include cardiovascular. So I got fairly good cardiac experience too, while obviously not to the extent of the CVICU, but more than the average trauma or medical ICU (just my opinion). As Happy mentioned, managing fluid shifts, you haven't seen MAJOR fluid shifts until you've treated a burn patient. But the point is you learn what shifts are treated with crystalloids vs. colloids vs. pressors vs. any combination of the three.

No matter which ICU you end up in, getting into a Level I center is your best bet, as you will see the sickest of the sick and become familiar with the high acuity patient population.

Good Luck and congrats on finishing RN school!!

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Specializes in CVICU, ICU, RRT, CVPACU.

The thing with my CVICU is that we deal with a lot of unstable patients, fast paced codes and all sorts of situations that dont just relate to hearts. When I initially started I wanted to go to ICU and due to my background in other areas they wanted me to go to CVICU. I ended up there and dont regret a bit of it. It is excellent experience and due to the type of patient population we have, we end up with a lot sicker patients in our unit them many hospitals due. The bonus in CVICU is that we also take traumas. We dont take bolts, but we to take traumas, lumbar drains, ICP's, ect. If I had the time I would actually love to go back and get more experience with it, however Im getting ready to apply. Most of the CRNAs that I work with who have been on admission boards have told me CVICU is their first choice.

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Specializes in Pediatric critical care.
Prior to anesthesia school I worked in a Burn ICU. What I liked about this patient population was that though it is "trauma" ICU many of these patients (the big devastating burns) ended up with multi-organ system failure to include cardiovascular. So I got fairly good cardiac experience too, while obviously not to the extent of the CVICU, but more than the average trauma or medical ICU (just my opinion). As Happy mentioned, managing fluid shifts, you haven't seen MAJOR fluid shifts until you've treated a burn patient. But the point is you learn what shifts are treated with crystalloids vs. colloids vs. pressors vs. any combination of the three.

No matter which ICU you end up in, getting into a Level I center is your best bet, as you will see the sickest of the sick and become familiar with the high acuity patient population.

Good Luck and congrats on finishing RN school!!

I just started working in a Burn ICU, and I was wondering if it was going to be good experience for entering into an anesthesia program. Any advice of what I should keep an eye out for and pay close attention to? Of course, I will learn as much as I can anyway, but is there anything particular to CRNA school that I should pay the most attention to?

Thanks

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Ok, I have to add in a comment here about the ICU experience. I believe that a CVICU is good or a SICU. CVICU is good in that you have the patients with the cardiothoracic surgeries but that is limited. A SICU gives you a well rounded opportunity to have all surgical specialities. A SICU that has cardiac surgical patients would be the best.

Also, there are many ICU's, we all know that, but they are not all the same. As a CRNA, you work with patients who are either healthy or ill, you pre-op them, provide their anesthesia and deliver them to the PACU. You then move on to your next patient. The best experience to prepare you for that is in a high turn around surgical unit. Those patients come in and are out quickly. MICU, CCU etc, Burn ICU's etc, your patients are there longer and become long termers. It is the same thing day in and day out.

Yes, all programs look at experience differently but those who take the PACU, NICU, ER, MICU and CCU applicants do so because they do not have enough SICU or CVICU applicants.

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I have a different perspective on this issue since starting anesthesia school. I worked in a large level 1 SICU (UCLA), several of my friends in my program worked in the CTICU at the same hospital...both awesome units...Swans, drips, IABPs, ECMO, .....you get the picture..."good units for anesthesia school" right??

I agree it is good to know how to titrate drips, manage fliud shifts, etc...but when you when you start anesthesia school they are going to completely change your knowledge base, thought, and reasoning..They will teach you to think differently and unlearn most of what you know. Some of the most experienced nurses in my program are struggling the most. Their paradigm of thought has been turned upside down. I'm not saying ICU experience isn't important..I'm just saying there's no need to get hung up on one type of unit as "being the best training for anesthesia school." ICU nursing IS NOT anesthesia nursing. Get on a unit with sick patients where you learn to work efficiently and make priority decisions under stress....that will help you more than anything when you start school. Good luck.

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