Why no NICU?

[goldens1]

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.

[misscece]

The majority of my nursing experience (which was all critical care) was in a Level III NICU where I took care of the sickest of the sick neonates. When I made the move towards pursuing my CRNA, I made the choice to change gears and start working with adults. I went on to do about four years of CVICU, SICU, and MICU.

I agree whole-heartedly with BCRNA regarding the cardiac aspect of neonates vs. adults - they are two different animals. While NICU experience serves you well in the sense that most people are scared to death to handle a baby weighing less than 1000 grams, a background in handling those preemies will definitely give you a leg up when it comes to the hands on. Also, I believe that NICU nurses tend to be far more precise in minute drug doses as this is the norm. HOWEVER, with adults you are usually dealing with complex coexisting CHRONIC disease processes whereas with babies you are usually dealing with some sort of genetic issue, anoxic insult, or problem associated with lack of development. Pediatrics is a subspecialty of anesthesia, which means you will spend very little time on this and more on adults as a whole. And, even within the pediatric specialty, neonates are but only a small fraction.

With that being said, one of my classmates came in with only NICU experience. He worked in a Level III NICU for over ten years and graduated at the top of our class. While he did struggle with the "new animal", he excelled and is one of the smartest guys I know. I would let him do my anesthetic, or the anesthetic of any of my loved ones, without hesitation.

Bottom line - don't limit yourself to the schools that will take just the NICU experience. Get the NICU experience if that is what you are interested in, but follow up with solid adult experience as well.

[ICUAZRN]

I am a NICU nurse AND an SRNA heading into my senior year. A lot of schools don't take NICU experience but some do. My class has 9 pediatric nurses and 5 of them have only NICU experience. Everyone in my class is doing extremely well. I have found that the transition to adults was easy for me and some of my classmates took a little longer to adapt but you can definitely cut it in anesthesia school. I did work in a level 3 NICU and was a travel nurse for 5 years before school and I think that definitely helped. Bottom line is some people can cut it and some can't. Adult experience is good but isn't absolutely necessary. Whatever you think you know about nursing, no one knows anything about anesthesia starting school and the playing field is pretty level at that point so if you find a school that allows you to go with NICU experience dont worry about Adult ICU experience, you'll be fine :)

[LNeonurse]

Well, I have been working in the NICU (level III) for the past 7 years and I will say that I agree with the general concensus on this topic. The NICU is a very specialized area and I feel that the exposure is just not enough for anesthesia school. I have heard of nurses getting into CRNA with only NICU experience, but personally, I would not be comfortable doing that. I am in the process of looking for an adult ICU position.

[NICU_SRNA]

I am about 6 months into the CRNA program and I feel like I am doing well. I only have 2 1/2 years of level III NICU experience. However, I do have 9 months of medical surgical experience and I have my CCRN-NIC and had relatively high marks in undergrad (3.7). I also had good marks on my GRE.

I do not think the NICU experience has given me too much of a disadvantage because I am not that far out of nursing school and I do remember a lot from undergrad. I have noticed that the people that are in my class that have been out of school for a really long time are having an even harder time. There is so much to learn and it seems that a lot of the other ICU nurses that I am in class with did have a lot of experiences that I did not have. However, they have never really understood all the mechanisms behind all the things that they were doing. If I had a nickel for everytime I heard one of my classmates come out of lecture and say "Wow, I never knew those things! It is amazing I did not kill my patient." As a CRNA they are basically teaching you to practice medicine while maintaining your nursing vigilance (vigilance is the foundation of what it means to be a CRNA). The fact that I was a NICU RN has made me ever more vigilant to small changes in vital sign that my classmates often do not pick up on. I DID feel like I had to work a lot harder for many of my classmates for the first semester of classes. However, it seems as if after that they have move beyond ICU knowledge and they have moved into a deeper realm of knowledge. CRNA school is hard. You will need lots and lots of coffee and a good support network. If you have a will to do it, do not let the fact that you only have NICU experience dishearten you. A NICU RN can definitely do it!

Also... As a NICU nurse you will not only have the advantage of knowing about babies, you also know a little about OB. This knowledge really comes in handy too. So I would say if you are a NICU nurse who wants to go to CRNA school you should also try to float to OB once in a while in order to learn that area. Believe me, this can be really helpful! I know it has been for me because I am one of the only ones in my class with this type of experience and it has been tremendously helpful.

[dreamMUSC]

It depends on the level of thi NICU because our NICU doesn't have feeder/growers those would be sent to a different unit.

[offlabel]

It's just a matter of "well rounded-ness". Patients in the NICU compared with adult critical care have nearly an insignificant number of working diagnoses. There are some general principles that cross over pretty well, but the vast difference in the number of medical and surgical problems just can't come close.

Are there outliers that do OK? In areas where there is a steady stream of high stakes, pretty sick surgical patients, even some students with strong adult CC back rounds really have to hustle to keep up.

Not the end of the world, but as someone who has been involved in clinical anesthesia training of folks with all kinds of back rounds, I'd encourage not to do it.

edit...ughhh, bit on a major necro-bump...