[BillboSN]

I observed in the PICU a while ago and I really think that I would enjoy working there. The children's hospital in my area offers a 6 month Versant internship program for new grads. I was just wondering if I were to start out working in the PICU, would it be difficult to then work with adults. I would like to eventually work in an ER or a med/surg ICU but I do not want to pass up the opportunity for this internship. Has anyone made the switch and if so how was it?

[janfrn]

I think it might actually be easier in some ways to go from peds to adults. With adults, there's usually only one standard dose for many drugs; there's sure a lot less math involved in figuring out doses. Management of serious illness is not really all that different in terms of what's done, but will be different in terms of the order of action and the volumes involved. Fluid resus is fluid resus. Titration of vasoactive drugs is the same, only the numbers are different. There are typically fewer common diagnoses with adults. Kids can come in for literally anything, except most of the life-style related illnesses like heart disease and emphysema. You can reason with many adults easier than you can most children. They may take direction better. They can often tell you what's wrong, or at least help you figure it out.

I know several people who have done the peds-adult transition and they all say that they find it pretty straightforward.

[mark2climb]

I just made the transition myself from working six years of peds critical care (PICU,CICU,ED, and PACU) to an adult med/surg ICU that takes fresh hearts. So far, I've found that the acuity has been less than I expected, even with the fresh hearts.

I agree with the previous post. The drug calculations are a bit simpler but there are lots of meds that are completely different than for peds. I've also found that most adult pts have many, many comorbidities that make them more complicated but also more interesting medically.

Feel free to PM me with questions or thoughts.

Mark