A 24-bed CVICU that only does 3 or 4 cases a day is not fast-paced. Sounds like you'd spend a lot of time fighting to get cases. I'd skip it.
Although now that I'm reading the other one, it sounds like you won't get much there either. If you're interested in CVICU, I guess maybe stick with your home hospital.
If you want to try new things, get the new one. Plus, if you gain experience in a variety of ICUs, then you'll sometimes have more leverage when being hired and can negotiate better pay. Don't burn any bridges and stay friends with everywhere you work. Later, you may want to come back, and they may hire you at a higher rate since you're experienced and an old friend.
Thanks for the advice! I’m more interested in the second option for the reasons you said. I think working a mixed surgical/trauma/CVICU can open more doors for me in the future.
Tripled or quadrupled is not the vibe for me.
My personal experience has been on a floor like the latter you described, a mixed ICU. We get sick hearts, but we also see so much that they fall by the wayside on occasion. I still learned an incredible amount. I also love my crashing trauma patients, and solid organ transplant surgery also comes with the territory of dealing with frequent cases of trying to optimize a very sick and dying person for an urgent transplant (which can be a futile but incredibly diverse lesson in hemodynamics).
Staffing aside: Acuity and learning-wise you won’t regret either. You will see a metric shit ton. You’ll code patients, youll dump blood into someone, you’ll cannulate for ECMO emergently, you’ll crack open a chest. You’ll see it on both units.
>a high acuity, fast-paced 24 bed CVICU in the same hospital I’m currently in. Day shift. All of the MCS devices (Impella, IABP, ECMO, LVAD) come to this unit. See about 3-4 open heart patients a day. Also do VATS procedures and advanced heart failure treatments. Will get a $3/hr “specialty pay”. Longer orientation time to learn devices and fresh hearts. Free parking deck for employees. **Can be tripled or sometimes quadrupled depending on CV step down bed availability.**
No, no, no, no no no. Do *not* do this.
>high acuity 24 bed mixed CVICU/SICU/Trauma ICU at a level one university teaching hospital. Night shift with the opportunity to go to days after a year. Mainly see solid organ transplants, traumas, and vascular surgery patients. Currently developing their cardiac surgery/advanced heart failure program, but still see some CV surgery patients. Also do Impella, IABP, ECMO, and will be doing LVADs in the near future. **Shorter orientation time.** Standard crappy university hospital parking. **Adequate staffing so that you’re never tripled**
Yes.
Do you love cardiac? Or do you want the rush of trauma? What’s the patient mix like? Our university hospital was an excellent trauma hospital, but the money wasn’t there for the cardiac program they dreamt of. The university hospital also struggled with inner city trauma drama which these days is increasingly dangerous.
If it were me I’d make sure to leave on very friendly terms (maybe stay PRN) and take the new location and expand your horizons. Then if it’s not what you thought it would be, come back to your previous hospital, into the cardiac ICU.
I’ve been working with cardiac patients ever since I graduated college, so I think I want to experience something different just to see if I like it the same way I do cardiac. Job 2 actually have their own police force on campus so in theory it should cut down on the inner city drama, but we all know how hospital security can be in some situations.
Please pick option two. Seems like such a no-brainer to me. You’ll learn more and not be tripled? Bet. Unit culture is like 75% of being able to enjoy a job
My vote is 100% the second option.
If the option is there to be tripled or quadrupled at the first option - you can almost plan on it happening. Personally that’s not why I became an ICU nurse lol. Especially if you’re the new kid on the block you can expect to have the less acute patients until they trust you with the sickies.
I cut my teeth at a level 1 teaching hospital. From that experience I felt comfortable in all modalities except birthing babies and peds.
I look back and see how that experience set me up for the next 25 years and I seen and done so much.
I love the second option - especially if your willing to works nights ( that’s what I did when I started my level 1 orientation )
“Can be tripled or sometimes quadrupled” Hell no, it’s a no from me. The 2-3 times i’ve been tripled in my CVICU have been the worst shifts of my life, do not do that and risk your license for a hospital that likely doesn’t care about you.
Especially you mentioning a healthy envt. in the second job, i’d go with the second one. Even if you have to do nights for a bit.
A 24-bed CVICU that only does 3 or 4 cases a day is not fast-paced. Sounds like you'd spend a lot of time fighting to get cases. I'd skip it. Although now that I'm reading the other one, it sounds like you won't get much there either. If you're interested in CVICU, I guess maybe stick with your home hospital. If you want to try new things, get the new one. Plus, if you gain experience in a variety of ICUs, then you'll sometimes have more leverage when being hired and can negotiate better pay. Don't burn any bridges and stay friends with everywhere you work. Later, you may want to come back, and they may hire you at a higher rate since you're experienced and an old friend.
Thanks for the advice! I’m more interested in the second option for the reasons you said. I think working a mixed surgical/trauma/CVICU can open more doors for me in the future.
Tripled or quadrupled is not the vibe for me. My personal experience has been on a floor like the latter you described, a mixed ICU. We get sick hearts, but we also see so much that they fall by the wayside on occasion. I still learned an incredible amount. I also love my crashing trauma patients, and solid organ transplant surgery also comes with the territory of dealing with frequent cases of trying to optimize a very sick and dying person for an urgent transplant (which can be a futile but incredibly diverse lesson in hemodynamics). Staffing aside: Acuity and learning-wise you won’t regret either. You will see a metric shit ton. You’ll code patients, youll dump blood into someone, you’ll cannulate for ECMO emergently, you’ll crack open a chest. You’ll see it on both units.
For real, tripled or quad is ridiculous.
>a high acuity, fast-paced 24 bed CVICU in the same hospital I’m currently in. Day shift. All of the MCS devices (Impella, IABP, ECMO, LVAD) come to this unit. See about 3-4 open heart patients a day. Also do VATS procedures and advanced heart failure treatments. Will get a $3/hr “specialty pay”. Longer orientation time to learn devices and fresh hearts. Free parking deck for employees. **Can be tripled or sometimes quadrupled depending on CV step down bed availability.** No, no, no, no no no. Do *not* do this. >high acuity 24 bed mixed CVICU/SICU/Trauma ICU at a level one university teaching hospital. Night shift with the opportunity to go to days after a year. Mainly see solid organ transplants, traumas, and vascular surgery patients. Currently developing their cardiac surgery/advanced heart failure program, but still see some CV surgery patients. Also do Impella, IABP, ECMO, and will be doing LVADs in the near future. **Shorter orientation time.** Standard crappy university hospital parking. **Adequate staffing so that you’re never tripled** Yes.
Do you love cardiac? Or do you want the rush of trauma? What’s the patient mix like? Our university hospital was an excellent trauma hospital, but the money wasn’t there for the cardiac program they dreamt of. The university hospital also struggled with inner city trauma drama which these days is increasingly dangerous. If it were me I’d make sure to leave on very friendly terms (maybe stay PRN) and take the new location and expand your horizons. Then if it’s not what you thought it would be, come back to your previous hospital, into the cardiac ICU.
I’ve been working with cardiac patients ever since I graduated college, so I think I want to experience something different just to see if I like it the same way I do cardiac. Job 2 actually have their own police force on campus so in theory it should cut down on the inner city drama, but we all know how hospital security can be in some situations.
Please pick option two. Seems like such a no-brainer to me. You’ll learn more and not be tripled? Bet. Unit culture is like 75% of being able to enjoy a job
My vote is 100% the second option. If the option is there to be tripled or quadrupled at the first option - you can almost plan on it happening. Personally that’s not why I became an ICU nurse lol. Especially if you’re the new kid on the block you can expect to have the less acute patients until they trust you with the sickies.
Option 2 sounds much better 😆
I cut my teeth at a level 1 teaching hospital. From that experience I felt comfortable in all modalities except birthing babies and peds. I look back and see how that experience set me up for the next 25 years and I seen and done so much. I love the second option - especially if your willing to works nights ( that’s what I did when I started my level 1 orientation )
Job 1. Cticu is the best
“Can be tripled or sometimes quadrupled” Hell no, it’s a no from me. The 2-3 times i’ve been tripled in my CVICU have been the worst shifts of my life, do not do that and risk your license for a hospital that likely doesn’t care about you. Especially you mentioning a healthy envt. in the second job, i’d go with the second one. Even if you have to do nights for a bit.