Why no NICU?

merlee · Jan 31, 2011

Since most of your schooling as a CRNA will involve adults, probably better to work in an adult ICU.

Shimano0606 · Jan 31, 2011

It probably depends on the level of NICU care. If you're doing routine ECMO, High Frequency Ventilation, drips, etc...then that should totally count. Lower acuity NICUs can be like a newborn nursery. Most likely, if the school accepts NICU, then they will really be interested the acuity of your patients since it varies so much.

I'm in a PICU, and the CRNA interviewer was mostly curious about the bigger kids I've taken care of. The bigger kids were more likely to get some of the heavier drips and adult-like respiratory management.

PICU can be the best of both worlds. My youngest patient was a few days old and my oldest was 26 yrs old.

Hope that helps. Good luck.

rockabye · Jan 31, 2011

I have also heard some schools don't accept NICU experience for CRNA. I don't know of any NICU nurses going on to CRNA school either. I think it is because NICU is a whole lot different than other ICUs and basically most specialties as well. There are no CRNAs that deal exclusively with newborns so having a broader range of patient ages is more helpful. Plus, compared to other ICUs, NICU can sometimes be less intensive than what is considered critical in other ICUs. Don't get me wrong, because there definitely can be really sick babies in the NICU, but there are also many easy "feeder grower" babies in the NICU too that don't need as much medical attention.

PICU on the other hand is very good experience for CRNA application. I know of a few PICU nurses who are going for there CRNA right now.

merlee · Jan 31, 2011

Since most of your education will be about adults, then you should seek experience in an adult ICU. Or a year of each.

stanman1968 · Jan 31, 2011

It is so specialized that the work is not applicable to the greater population.

umcRN, BSN, RN · Jan 31, 2011

I work in a NICU and people do have to leave to get experience elsewhere if they want to go CRNA. The reason being mostly is that we do not sedate and use anesthesia in the NICU as it is used in other patient populations, neonates are a very different population, the drugs we use are different, the amounts we use is different. PICU will likely get you the experience you need.

goldens1 · Feb 1, 2011

thanks a lot everyone. all your points make perfect sense ;-). just good to hear it from people that actually know what they're talking about. I really love this site!

BabyLady, BSN, RN · Mar 2, 2011

Just curious if anyone has any idea why some CRNA schools wont accept NICU as critical care experience, yet some do? I'm in my 2nd semester of getting my BSN (this is my 2nd degree, 3 semesters to go, woohoo!) and our last semester will encompass just working with a preceptor, ideally in a field you want to work in and can hopefully get hired on in after graduation. I am heavily considering CRNA school, so I will probably try to spend my last semester in an ICU setting. Should I avoid PICU or NICU?
Thanks for any advice.

The NICU is not going to give you the critical care experience you need as a CRNA...our patient population is highly specialized, the number of medications we use is somewhat narrow.

I have co-workers that have gone to FNP school and they all said it was one of their biggest challenges..learning about "adult stuff".

Working with adults will give you the best experience..especially with disease process...infants in the NICU are not really sick..they usually have "conditions" rather than infectious illnesses.

USMC2CRNA · Mar 23, 2011

I work in a NICU and people do have to leave to get experience elsewhere if they want to go CRNA. The reason being mostly is that we do not sedate and use anesthesia in the NICU as it is used in other patient populations, neonates are a very different population, the drugs we use are different, the amounts we use is different. PICU will likely get you the experience you need.

I disagree, the sedation etc you do in the ICU is probably the least important experience you take with you to CRNA school. It's more the knowledge of managing multiple disease processes, hemodynamic monitoring, pharmacology of pressors etc. I had only PICU experience and did fine in school though I wish I had done some adult ICU first. For example I had never evenb seen a phenylephrine gtt until I started clinical. Where I did clinical there was one CRNA who had NICU only before school and she admitted it was really a struggle. She is extremely smart and hard working though. IMO adult SICU oir CTICU is the best prep though if you like peds you can get by with PICU. The PICU experience will help you if you want to do pedi anesthesia which is a small niche that seems to be growing in demand.

Goose Xx, MSN, RN, EMT-P, CRNA · Apr 1, 2011

I was acceppted and recently just started classes(5 weeks ago). I spkoke with several applicants while in the interview phase. Most worked in small CICU's. They each had several years of expeirince.

During the interview process, we were given a written test that dealt with a post-surgical patient and the managment of the patient while in an adult SICU.

I was the only applicant from my interview day to get a spot in the class. My GRE scores weren't that great, I had not taken the CCRN, but my undergraduate GPA was 3.9. The intervier, also the program director, stated the typically nurses do not score high on the GRE.

My work experince in a high acuity Surgical ICU helped make the difference. The focus on the interview dealt with current work experinces. From what I can tell from the first 5 weeks of school, my work eperince in the SICU was what gave me an additional edge. I also have 16 years of CC Paramedic experince.

After the first 5 weeks in class, I can see why they want Adult ICU experince. All lectures thus far (14 credits - all in anesthesia) have focused on adults. We will have pediatric experinces, but once the core course are done. I feel they are looking for adult experince because that is the largest patient population requiring surgery.

Be prepared, Getting into CRNA school it self is a huge accomplishment. It is very competative. Our class had 100 applicants, I am in a class of 25.

Good luck on your endevors,

BCRNA · Apr 14, 2011

I worked in the NICU before getting into anesthesia. The reason is that the experienc you get does not include vasoactive drugs or adult populations. I learned to intubate there though, where I worked it was the NICU nurses that did all intubations of newborns. You do virtually no cardiac drugs, it is almost all respiratory related. The exception would be NICU's that do hearts. But even then it is much different from adults. The list of drugs you use in adult ICU is much broader, as is the advanced treatment modalities (pacing, ballon pumps, swans, etc.) NICU is great experience, but few NICU's could prepare you as well as an adult ICU.

Of course that is just opinion, that is why every program has there own criteria of what is acceptable. But as a whole newborns have a much limited and focused list of problems you care for. It is almost always resp distress d/t immature lungs. There are congenital anomalies and cardiac issues, but not enough to prepare you to care for adults. They dont have COPD (similiar to an adults, though I bet you have a much better grasp of BPD--which I am betting most CRNA's couldnt explain) or CAD. They havent lived long enought to have PVD, DM, or many other disorders acquired from a life of bad genetics and poor lifestyle. Which you will need to be familiar with to care for adults.

I personally think NICU is a great place to get experience as long as it takes care of actual ICU patients and is not a step down unit with and ICU name. Especially if you want to specialize in neonatal anesthesia. Which this is an extremely small job market. Most neonatal CRNA's still do more pediatric than neonatal. Unless you work at a large hospital that does neonatal hearts, they do just less than one or two year age group.

Very few programs take NICU, I would recommend some adult ICU experience to be more competitive. Unless you just happen to live close to a school that accepts it and you don't plan to apply to any other school.