You're ready to retire from the bedside and go back to school to become a CRNA?
ICU experience is a prerequisite for CRNA school for specific reasons. Honing in on your skills during your time in the ICU will make you all the more prepared for starting clinical residency in CRNA school.
- Mastering Difficult IV Access
Prior to CRNA school I was on the Difficult IV Access (DIVA) team at a large teaching hospital. This allowed me to use an ultrasound to get IV access in patients with a history of difficulty such as dialysis patients, cancer patients etc. Familiarity with an ultrasound and gaining venous access in challenging situations are two skills you will use often in CRNA school clinical residency. So if you can get that exposure during your ICU training that would be awesome!
- Ventilator and Airway Management
As anesthesia we are regarded as the “airway experts.” This means understanding deeply how to best ventilate and oxygenate a patient, the foundation of which starts with ICU exposure. The ventilators you use in the operating room will not be the same ones you saw in your ICU but certain ventilatory modes and features will. What’s the difference between pressure support and pressure control? – this you will see in the operating room and have to differentiate. As an ICU nurse, your respiratory therapist (RT) can be a wealth of knowledge in this area. My time in the ICU, after I knew I wanted to become a CRNA, was spent talking to my favorite RTs and understanding airway management better. Tracheostomies, CPAP, BiPAP all these things will reappear in the operating room, make sure you have a thorough understanding of why we make these kinds of airway management interventions and it will put you ahead of the curve.
- EKG Interpretation
Surgery is regarded as your body’s stress test. This provides a significant strain on the heart, but healthy individuals usually have uneventful experiences in the operating room. As providers we aim to optimize our patients before surgery, but the reality is that most of the anesthetic drugs we use do impact the heart’s normal functioning. So being able to read, interpet and determine differences in an EKG is a skill that can be first developed in the ICU. As a CRNA, monitoring and noticing the changes in your patient’s EKG is a part of what we do in the OR. Understanding these changes, when to call for help and how to best treat them is part of your scope of practice as a CRNA. Get familiar with EKG interpretation at the bedside because its a skill you will further build on through your training.
- Interdisciplinary Communication
There are so many soft skills in anesthesia that the textbooks could never teach you. It’s not until you are in the clinical environment that you realize that effective interdisciplinary communication can make all the difference. As ICU nurses, we know that we spend most days paging for interventions, getting different teams to talk to one another and coordinating care for our patients. During a high stakes code situation the leaders in the room facilitate the closed loop communication and provide a productive environment for providing patient care. Anesthesia is a constant high stakes game, when dealing with a patient's health in a service focused field time is of the essence most days. Learning how to best communicate using closed loop communication, open-ended questions and even the SBAR (situation, background, assessment, recommendation) techniques during your time in the ICU, will strengthen your skills for when you reach the OR.
Final Thoughts
Wherever you may be in your CRNA school journey – if you are just getting exposed to the career field now, preparing for interviews or getting ready for clinical residency. Thinking back on these skills of obtaining difficult IV access, ventilator management, EKG interpretation and interdisciplinary communication will help prepare you for the next step. CRNA’s utilize these skills everyday so be prepared to show the strength of your ICU experience.
Ready to take the next step? Check out our 30-Minute Masterclass on "Becoming a Competitive CRNA School Applicant" and start your journey today!
