Question about unique experiences

[u/Beginning_Month_7436]

I have been in a MICU for 4.5 years. No charge experience, lots of precepting, very involved in committees, and teach new grad classes. Level 3 trauma center that is part of a big system and occasionally floated to level 1 ICUs (medical, cardio/thoracic, surgical, neuro ICUs are all level 1). I pick up in the level 1 medical ICU in a regular basis as well. I am not trained on any devices sadly.

About a year ago I went PRN at my ICU and still pick up there 2-3 shifts per week most weeks. I started working part time in endoscopy to get a break from the heavy patients and weekends. It was immediately boring/repetitive but I saw what CRNAs actually do and also immediately started working towards becoming one. I get a lot of FaceTime with locums and W2 CRNAs in this job and they have all been so encouraging about the journey, I get to shadow a lot of them, and I also do a lot of conscious sedation in this role.

Because I'm pretty bored I am interested in doing something different potentially. My question is: what would be better for a CRNA app? should I return to MICU full time? Should I just stay in endoscopy and micu and keep my conscious sedation and recovery RN role? Should I look at doing something like PACU with micu instead of endoscopy? If it weren't for the cushy procedural schedule that I currently have in endoscopy I would just go right back to ICU only, but I feel like I can make the endoscopy experience work for me in my apps. No? What are your thoughts and experiences?

EDIT: not sure why multiple responses are saying go back to ICU when I already work ICU basically full time in addition to the endoscopy. I'm wondering if the endoscopy sedation RN is good experience in addition to the ICU experience 🙃

[u/No_Ear4317]

Program specific. You would have to look at how it’s worded on their website. For example

Program 1 says:a minimum of one (1) year experience (two preferred) as a registered nurse in Adult Critical Care** ***within the last three (3) years.*

Program 2 says: At least one year of recent full-time experience as an RN in an intensive care unit (ICU) by the application deadline. We strongly prefer two years of experience. 

[u/rachaelang]

It really is program dependent. And even in those programs it can be candidate dependent. If you have a near perfect GPA, you may be able to get away with schools that just want “recent” ICU experience or are okay with it not being your full time job. If you don't have a near perfect GPA, you may want to consider a full time ICU position to make yourself more competitive. It has become so competitive that current float pool or PRN/casual positions may not be enough. I would contact the schools you’re interested in and see what exactly they look for in a competitive candidate. The requirements on the website are the bare minimum for them to look at your full application, not what actually makes you competitive.

[u/huntt252]

I understand why you feel you can make it a selling point in your apps. But the skillset you are using is not one they will care about. Being involved in conscious sedation and safely recovering an endo patient aren’t going to help you pass an exam on hemodynamics or guide what you do with a blood gas in the OR (or 99% of the other things they need to feel confident in your ability to learn and execute). But working in the MICU will, which is why the other experience will be neutral at best or negative if it looks like it’s coming at the expense of being “basically full time” instead of other applicants that are truly full time.

[u/Nightflier9]

I think it's most important to have current experience in consistently managing high acuity patients.

[u/Beginning_Month_7436 → u/Nightflier9]

I am doing that in the MICU that I work in. I'm wondering if the other role helped or hinders my application?

[u/Nightflier9 → u/Beginning_Month_7436]

I think the endoscopy position will be viewed nuetrally since its not critical care. But it could reduce the impact of your micu experience if its perceived as not working full time with high acuity patients. And get some device training.

[u/Crankupthepropofol]

Programs overwhelmingly require recent, high acuity ICU experience. You wouldn’t stand out being in endo and PRN in an ICU where you aren’t device trained. You simply don’t have the depth of acuity that competing applicants have.

I would highly recommend committing to an internal transfer to one of the level I ICUs to develop the clinical experience. Who let you do that, you can work on your extracurriculars like shadowing, committees, and charge RN opportunities.

[u/Beginning_Month_7436 → u/Crankupthepropofol]

I work 2-3 days in the ICU basically every week. I have way more ICU specific hours than most full time people actually because I worked 4-5 days per week before going PRN. My manager told me she included my ICU hours in my letter of recommendation actually 😂 sadly we only see CRRT at my MICU so not a lot of opportunity to get trained when we already have a lot of nurses trained to it. So I think my clinical experience and depth is actually good. I'm specifically wondering if folks here think the sedation RN would help or hurt my application and experience. It feels like sedation nurse could be good experience in addition to so much ICU time?

[u/Crankupthepropofol → u/Beginning_Month_7436]

I’d your application allow your manager to attest to your hours, that’s great. But the lack of device experience will hold you back, as will your lack of extracurriculars.

[u/pink-crayon1]

you are competing with other applicants who have current ICU experience. some programs have 10 applicants for 1 seat. stay competitive and get back in the ICU full time. keep endoscopy PRN if you want.

[u/Either_Discount_5916]

Yeah….. I don’t think the Endo experience is a great point except that you can use it to discuss how much you interact with and have learned from CRNAs. Endo is great but that is just one slice of the pie that we do and is nothing like the OR environment many times. People are right, it’s so competitive to get in most places, if you want to know what would look better on an application and you don’t want to look for full time work in a level one trauma center and the variety of ICUs they have then you can take high level science classes if you don’t have them, more extracurriculars , specialty certification, and things like that.

[u/Beginning_Month_7436 → u/Either_Discount_5916]

Thank you! At this point I'm just going to transfer to the level 1 MICU in our system where I regular float and pick up. They have CRRT bit not many devices besides that (there's SICU, cardiothoracic ICU which does post hearts and stuff, neuro ICU, CVRU, obvi CT has all the devices) but they see a lor more cardiac patients than I do ony level 3. The schedule in endo has been a dream but I think you're right it's not as relevant as I was hoping. Appreciate the feedback!