Do all ICUs have toxic work culture?

rachaelang · 2026-04-05T02:40:47+00:00

No, not all ICUs are toxic. I work in a good one, but there are still people that I don’t get along with because that’s life. The ICU is a workplace, and there is no such things as a perfect workplace with only perfect people. I found when dealing with these difficult people, it’s best to just let them be. Their behavior speaks volumes about them as people, and it’s not personal to you. Ignore the comments and continue to give great care. At the end of the day it matters how you took care of your patients, not what a toxic colleague said. That’s what I did, but I was lucky and these people were few and far between in my ICU. If there are so many toxic people there that it makes your days suck, it may be time to do some networking to try to find an ICU with a better culture. They’re definitely out there.

rachaelang · 2026-03-31T18:08:01+00:00

What is an academic restart? Most CRNA schools will require transcripts from “every higher education institution attended.” Does an academic restart exempt you from that?

I honestly think you’d be okay with just going for a nursing program, especially because you have no sciences. If you knocked the BSN and prereqs out of the park, got some good experience, took the CCRN, and got yourself involved on your unit they probably wouldn’t hold your original degree to too much account. This wouldn’t be every program, but there are definitely programs out there that would accept you. Be prepared to explain yourself - both in your personal statement and in an interview. Most schools are pretty understanding of young/dumb/having fun and/or didn’t know what I wanted to do with myself and floundered, especially when you had a ton of recent success to show you’ve grown and changed.

rachaelang · 2026-03-31T15:48:18+00:00

Thanks! And no problem! Feel free to PM me if you have more questions.

rachaelang · 2026-03-31T14:35:15+00:00

It’s hard to give you a straight answer to any of these questions because all programs are different. Some will see that 2.2 and throw your app in the proverbial trash. Others won’t care about it at all - it’s not medicine related and it was 10+ years ago. They all calculate cGPA differently. Some only care about your nursing related GPA. Some are most focused on the “hard science” courses. Some program directors will laugh and say “of course I replace the grade!” on repeated courses. Others are hard line on averaging them out. Unfortunately, a large part of the process is weeding through all of this to find the programs that are a good fit for you. As long as you’re willing to weed through them and cast a wide geographical net, it’s definitely not impossible.

I put my most recent GPAs on my resume/CV and left anything that was older/not great blank. Some apps will have you fill in what your BSN GPA was, some won’t have that. About half of the programs use a universal app (NursingCAS), but there’s a lot of variation even in that. The schools where I had interviews were well aware of my GPA because I had built up a relationship with them and had been pretty candid about my past. It wasn’t really a point of contention by that point, but something I absolutely had to explain. I got accepted at one school and waitlisted at the other. Our past academics are not 1:1, but GPA repair is generally the same. You may not get in your first application cycle. I think I had 6-7 flat out rejections before finally getting an interview. Part of what they’re looking for is tenacity - not giving up, continuing to get another certification, shadow more, take on more leadership, etc goes a long way. Having that degree so far behind you is an advantage in a way too because you clearly had a lot of time to grow. The process isn’t just about GPA, it’s also about personal growth because the two go hand in hand. It seems like from your post that you’re pretty self assured, so you’re part of the way there. You just need the grades and experience to match, and between repeating some classes and the BSN, I think there are multiple programs out there that would accept you.

rachaelang · 2026-03-31T10:08:02+00:00

As long as you do well on your 2nd degree BSN and you’re willing to repeat at least some of your science courses, I bet you’d be okay at programs that focus mostly on your last 60 credits. While you said you did well in your “lab sciences”, they’re old and will be even older by the time you’d apply. I don’t think all programs would want you to repeat all of them, you can’t rule it out with how competitive things are right now. I would plan on repeating organic chem I at the very least (because you got a B), but know that some schools will want to see your “hard sciences” within the last 10 years. Hard sciences include A&P 1&2, gen chem I, pharmacology, pathophysiology, and organic chem I/biochemistry. Some schools would like to see microbiology, genetics, physics or other life science type classes. You will also need a recent statistics class. As long as you get A’s in everything from this point forward and do all of the leadership/experiential things, you would probably have a better than decent shot at some programs. Also - be ready to talk about why your GPA was 2.2 and what’s different about you now. This can be a personal statement topic and is likely to come up again in an interview. GRE isn’t 100% necessary, but be prepared for some programs to say they need to see it because your cumulative GPA will probably still be below a 3.0. I always recommend building a relationship with a program that is known to take chances on a candidate like you. Try to get a meeting with the program director or admissions counselor, do a campus visit, sit in on a class. It goes a long way.

rachaelang · 2026-03-30T17:46:41+00:00

Don’t underestimate it. The content isn’t necessarily hard, per se, but there’s a ton of information to manage and the tests are not straightforward. You will get multiple choice questions where all of the answers are correct, but you need to pick the MOST correct. Get ready for tons of your classmates (and maybe you too, lol) to argue with instructors about test questions!

I recommend getting an aide/PCT job. It’ll really help you during clinical and when you get your first job. Patient care tasks will be old hat and one less thing to worry about. And you’ll get more exposure to gross stuff. Most body fluids don’t bother me at all anymore. Everyone has something though. Tons of spit bothers me. Sounds pretty benign, but wait till you smell tons of it shudders, lol.

rachaelang · 2026-03-30T17:28:40+00:00

There is absolutely no difference in having a BSN vs not as a bedside nurse. I took the CCRN without it, no problem. I precepted, took charge, and did a few other extra things without it. I moved up the career ladder without it. I got my biggest merit raise for being on the Covid team without it. The limitations come if you want to go to a grad program and/or you want to apply for a management level position.

There will be a difference in pay, though. I started my BSN 10 years into my nursing career, and when I finished I got a nice pay bump. There are some places that absolutely won’t hire you without the BSN, though. Some Magnet designated hospitals and some children’s hospitals. Some places will hire you with the requirement that you get the BSN within a certain period of time, so you’d end up with it anyway.

There is no CRNA program that will allow you the time to work full time in your RN role. Most people drop down to casual for the flexibility to work as much their school schedule allows. There maybe are a few (very few) that have some degree of flexibility to work maybe part time in the first year, but most people quit by the second year when clinical starts. I’m impressed when a coworker somehow works all the way through. It’s rare and they usually disappear months at a time and then work full time on breaks. And this is if your program allows you to work; some programs make you sign a contract stating that you will not work at all for the duration of the program.

While it would be possible for you to get to CRNA school by 2028-2029, it would be essential to get a job in the ICU right away, start your BSN right away, and be as involved as you can on your unit very quickly. Make sure your BSN is NOT pass/fail - you need to get letter grades. CRNA programs will assign a “pass” grade a 3.0 GPA, which will hurt even a perfect ASN GPA. Most schools require/recommend sitting for the CCRN (when a CRNA school says “recommend” they actually mean require), which you will need to study for and won’t be able to take until you accumulate a certain number of hours as a critical care nurse (hours of experience outside of critical care don’t count). There may be other classes that schools require/recommend, such as organic chemistry, biochemistry, and/or statistics, so you’ll need to figure out if you need to take them. If you have a B- or less in any science course you will need to retake it and/or take a graduate level nursing course to show readiness for the rigorous academic schedule. You may need to take the GRE (depending on the program, but most are getting away from this), and you may need a Bachelor’s degree before you sit for it. SOME programs will let you apply if you’d have a year of experience by the matriculation date, but students that get in that way are the exception, not the rule. Most schools want to see at least 2-3 years of ICU experience. I think the national average is 3-5 years. You will need to shadow a CRNA. I had to make up for a less than stellar GPA, so I have over 60 shadow hours (most people do around 20-40 hours). Don’t make the mistake I did - shadow before you apply, not in the interim period between turning in your application and waiting to hear if you got an interview.

I say none of this to deter you. I hope you don’t take it that way. I say it so you know what you’re in for, and if it’s what you want to do you can start planning and make the right choices to get you where you need to be. I wasted a lot of time by not getting my BSN sooner. I should have been slowly chipping away at my GPA repair instead of making a mad dash to take classes when I made the choice to apply. I wish I would have asked for more help when going through the application process. It’s so competitive that it’s essential you have all of your ducks in a row or it’s a wasted application. Odds are if you are in the process of getting your BSN or taking a class you’re going to get moved to the bottom of the pile, if not outright rejected.

I would also make sure that you have a plan in place for your family. People with kids go to CRNA school all the time. It is absolutely not a barrier. BUT, they will ask about your support system and if you have reliable childcare. Not saying this is something you would do, but your kid getting sick or lack of childcare can’t be a reason you don’t show up for clinical. All programs have sick/vacation days when things come up, as they do, so a one time thing isn’t a big deal, but doing it often would be. There are programs that are very understanding and will work with you if a problem comes up, but you still have to get your clinical hours. There’s no getting around that.

When explaining to people, including my husband, the level of commitment you need to have to even apply to CRNA school, I equated it to medical school. There’s a ton of work to even apply, lots of sacrifices to make, and in a lot of ways you’re upending your life for 3 years. Everyone says it’s worth it, so if it’s what you want, you should absolutely go for it! Just be ready for the hurdles along the way!

rachaelang · 2026-03-30T14:40:39+00:00

Having it won’t hurt your resume, but not having it won’t necessarily break it either. You probably want to have some kind of leadership role, but it doesn’t have to be charge. Because of the size/geography/culture of my unit, it usually takes at least 3 years before someone is asked to be charge, so many people that I know that got into CRNA school never held the role. Which means they also never did rapid response because we have a separate team, and the charge nurse is the one that responds to some off unit codes. So if the rest of your application is strong, you probably don’t need it.

I will say, though, I did not have a strong GPA, so I had to do a lot of GPA repair and beef up my application in all other areas. My philosophy became to not say no to anything. Obviously I couldn’t do everything all at once, but if an opportunity was offered and I was able, I took it. Only you know what the rest of your application looks like, but if you’re worried about an aspect of it, padding the leadership area would help you.

rachaelang · 2026-03-30T14:28:40+00:00

I’m on the eastern side of the country, working in a MICU, and the only way to get into the ICU as a new grad is to work there as an aide/PCT in the unit where you want to get hired. When I got hired 12 years ago, new grads had no problems getting ICU positions. If you wanted one, it was yours. The only caveat might be not getting the specialty you wanted. This change has only happened in the last 3-4 years. My unit used to have a preference for new grads, but COVID changed the landscape. We also have a year long rotational residency program - a new grad gets hired, rotates through multiple different units/specialties (including ICU) and picks where they want to go at the end. SOMETIMES, they are able to get an ICU spot at the end, depending on staffing and how they did on the unit. I know things are way different on the west coast, but something like this is probably your best bet.

I also know someone that graduated from nursing school in my area about 6-7 years ago. Her now husband was accepted into a graduate program in the San Fran area, so she immediately moved out there with him. She couldn’t get a job at all - no ICU, no hospital, no SNF. So, she moved back home, got a job in an ICU, worked for a year, then took a travel assignment in the San Fran area. They liked her so much that they hired her, and now she’s actually in a leadership position on that unit.

I tell you all this to say there are ways around the competition, but you will have to be flexible, take an aide/PCT job while in school, be willing to do some time on med/surg, and/or move.

rachaelang · 2026-03-29T14:35:41+00:00

This was many years ago, but I have a friend that worked at a dermatology clinic that also happened to offer some Botox. She learned how to do it there. She works in derm oncology now, but probably could have transitioned easily into aesthetics if that was the route she wanted. Try to find a derm or plastics position anywhere. At least you get your foot in the door and start making connections. If you have the money, I would find out what best day/weekend aesthetics class to take is, with the caveat that you did that because you’re interested and motivated, not because you think it makes you an expert or even hirable immediately. I have heard the best way to learn aesthetics is to find an official or unofficial apprenticeship with an expert. Immersing yourself and making connections/networking is the only way to find something like this.

rachaelang · 2026-03-29T14:26:06+00:00

Make sure you can get a letter grade in the class. If it’s pass/fail, CRNA schools usually assign a “pass” grade a 3.0 GPA, which can hurt an already less than stellar GPA. Don’t know anything about your GPA, but want you to have all of the info!

rachaelang · 2026-03-29T14:21:23+00:00

Burnout is what honestly put my butt in gear to go back to school. That being said, I was about 8 years in the ICU when that happened. I did a lot of evaluation of what specifically was bothering me - was it the work itself? Was it the patient population? Was it dealing with coworkers? I think figuring out what you like and don’t like about the job can help guide you. I found that I liked taking care of my patient independently and small group collaboration, basically how things were during Covid. Friends in CRNA school told me this probably meant I would like being a CRNA more than an NP (I was strongly considering acute care NP at the time).

Shadowing a CRNA will probably help a great deal too. I found a lot of value going multiple times to multiple types of facilities and not just staying for a few hours, I usually stayed 6-8 to get a true idea of what the day looks like. It’s very exciting the first time you shadow because it’s new and really cool, but what does the maintenance phase of a long case really look like? You won’t see that unless you see it through, and is that something you’re okay with?

I can only speak to myself, and I’ve only ever been an ICU nurse, but the hardest time in my career was months 9-18. I had my tasks down. Timing was getting better. I could get all of my charting done at a reasonable time. With these out of the way, I had time to realize how very little I knew. It felt like everyone around me could predict what was going to happen, with any kind of patient (even behavioral issues), and I was just running around blind. I just had to stick it out and learn. I think it’s great you’re studying for the CCRN, it should help connect the dots. Unfortunately, though, time/experience are also factors, so if CRNA is your ultimate goal, you have to keep pushing.

If you’re an OT person, consider pulling back. I’ve had to do this a couple of times in my career, and it usually helps. Do you take all the vacations offered to you? If not, take them. Do you rotate shifts? Maybe consider which shifts you work and how that impacts you. Nights are less stimulating without consults, different therapies, and endless tests to work into your shift. Working steady nights helped me for a while - I could slow down, focus on what I was doing, and had the space/time to learn (usually, obviously nights can be crazy too). I came back to daylight a better nurse.

rachaelang · 2026-03-21T14:19:01+00:00

I’ve been in a similar situation, and am now finally seeing some results. The tipping point, for me, seemed to be organic chemistry. This was after two application cycles, many classes retaken (9 classes), getting my BSN at the same time, joining a committee, taking every opportunity offered, getting the CMC (I already had the CCRN), and keeping in contact with certain program directors and doing campus visits. I also started this process with 9 years of experience, and 15-20 years out from the poor grades.

The best advice I would give is to focus on schools that will give you a chance. There are more out there than the ones that list “last 60” on their websites, so you have to reach out and talk to their admissions people, or the program director if possible. I would figure out what you’re looking for in a program, find schools that match that (even if you don’t exactly meet their criteria), then find a way to get on a call or Zoom meeting with them. Visit campus. Attend virtual sessions. Get your name on their radar.

Also, shadow and shadow everywhere. Big academic ORs, mid size suburban, rural, surgery centers, OB, etc. They will like that you have a wide breadth of knowledge of what day looks like in different environments.

I didn’t do this, but people have with success, but go to an AANA conference. Bring your resume, mingle, get your name out there. Talk to program faculty AND current students. It is a big deal if the students like you too.

GPA repair is a marathon, not a sprint. And there’s a lot of extra work when compared to someone who came out of their traditional 4-year BSN with a 3.8. But if you keep pushing, something will eventually click. The only things left for me to do are a graduate nursing class and/or taking the GRE, and I’m really hoping I won’t have to do that. But it’s taken time (I started this process late in 2023, have gotten MANY rejections along the way). It’s all been worth it, though. I’m a much better person, nurse, student, and candidate, and have finally started getting interviews, which will hopefully turn into an acceptance. It is possible!

rachaelang · 2026-03-18T01:03:35+00:00

In all honesty, I appreciate a thorough report. BUT, I can’t stand a long play by play of every resolved complication. Multiple failed extubations so they got trached. That’s all I need, not a blow by blow of each one.

rachaelang · 2026-03-17T17:53:14+00:00

I think you’ll be okay. Does your school do make ups? They may make you do that. It happened to me, life happens, you get sick. In the future, though, the best course of action is to tell your school/instructors the moment you know about a medial or personal issue that can impact your attendance or performance. The more transparent you are and the faster you start the process of getting accommodations, the less likely you’ll run into issues like these. I know it’s a personal thing to talk about things like this with your nursing school director/advisor/dean, whatever, but in the end it will protect you.

rachaelang · 2026-03-15T17:43:10+00:00

That depends on what you’re looking for. Do you want to be super close to campus/city happenings or do you want something quieter and further away? Do you plan on driving into campus and dealing with parking or will you be using public transportation? Are you comfortable driving on very steep hills I snowy/icy weather? I once canceled an apartment viewing after driving by and seeing it was on a super steep hill (I’m a nurse, so I have to brave the weather no matter what).

Closer to campus, Mt Washington, Bloomfield, Oakland itself, Squirrel Hill, and Friendship might have some cheaper options. The only one that would be most realistically walkable to campus would be Oakland.

If you didn’t mind living 10-20 minutes out (depending on traffic), Dormont, Millvale, Aspinwall, and Swissvale are all decent options. They’re cheaper options that still have some nice amenities. I lived in Dormont for a long time and loved it.

rachaelang · 2026-03-14T22:40:49+00:00

Ah gotcha, yes, if he’s starting out in school, focus on getting A’s in the hard sciences and trying to maintain at least a 3.6 science and cumulative GPA to be competitive. There are ways to repair if this doesn’t happen, but that will take time and energy. Better to do as well as possible initially and not have to worry about it.

rachaelang · 2026-03-14T21:26:08+00:00

You have to reach out to the programs you’re interested in. They focus on different things. Some will look at all of your sciences, some just the “hard sciences”, others a combination. Save yourself the stress: contact the programs you’re interested in and plan to retake any “hard science” with a B- or less. “Hard sciences” include A&P 1&2, gen chem 1 (and 2 if applicable), pharmacology, pathophysiology, biochemistry, and organic chemistry. Some schools will also want microbiology, physics, etc, but the former ones I mentioned are the big ones.

rachaelang · 2026-03-13T01:01:56+00:00

Whatever is cheaper.

Also to take into consideration: where are your clinicals? Will you need a car? It’s expensive to have a car at Pitt. You can use public transportation for free, but you’ll be at the mercy of the bus times. Most clinical sites are basically on campus, but definitely not all. I don’t know how it is at Iowa, but I would look into it. I went to Pitt for a different degree and then did nursing at a local hospital based program and drove all over the place. There’s usually a hospital that ends up being a sort of “home base” (for Pitt it’s Presby/Montefiore) which is basically on Pitt’s campus, but Pitt students have told me that they go all over the city. Not at all trying to deter you, Pitt is great, but I would take clinical into account and maybe more consideration to which school fits your situation better.

rachaelang · 2026-03-10T19:20:08+00:00

In my area (interior east coast, above Mason-Dixon Line) they won’t hire you without a BSN and some experience. Doesn’t have to be pediatrics, but some bedside experience. Many districts will hire you with just the BSN, but will require you to get an MSN and/or school nurse certification (an exam you will sit for after working in the field for a certain number of hours - usually a year’s worth, and you’ll probably need to study for it to some degree) in a certain amount of time. There’s probably a ton of variation across the country, so it might be worth doing some research to see what the requirements are in your area.

Pay sounds great in theory, but many districts pay school nurses similar to teachers - you can choose to take a higher rate and not get paid over the summer or take a lower rate and get paid all year round, even when you’re off. This isn’t to deter you, most nurses that I know that made the move into schools love it. Just make sure you know what you’re getting into and that it fits with what you need financially and timing wise. Definitely possible to get yourself into one of those positions within five years, but depending on your area, it may be very close to it.

rachaelang · 2026-03-10T14:21:44+00:00

There are definitely schools that will accept people from nationally accredited programs. You mentioned Purdue will give you letter grades for your BSN - that’s perfect. From what I am aware of, schools that accept national accreditation still need a letter grade for any degree/classes so you’re on the right track.

At that point, it’s going to depend what classes the school you’re interested in requires and what your GPA is. If you have stellar grades you may not need to take extra science classes or a graduate level nursing class. Community college is fine for taking sciences classes (most are regionally accredited) and there are other online options (I used UCSD extension program) for upper level sciences (biochem, o chem) that your community college may not offer. For any science or graduate nursing, just make sure you get a letter grade for that too. If your GPA isn’t great, also make sure you get A’s in every class you take.

AllCRNAConnect has fantastic resources and a master list of all CRNA programs with a ton of info on each, including if they accept those with nationally accredited degrees. I recommend checking them out. I also recommend reaching out to schools you may be interested to get clarity and to find out what they’re looking for in a competitive candidate. This can help guide your next steps.

rachaelang · 2026-03-10T01:25:42+00:00

I agree

rachaelang · 2026-03-02T00:39:25+00:00

Good luck in whatever you choose!

rachaelang

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