I am also a NICU nurse who just transferred to the ER FT, but still working PRN in NICU. while in NICU I also had a desire to try PICU, so I emailed the NM of the PICU asking if I could orient and work on an as-neede basis. Since then I have worked quite a few shifts there, and it is very different from NICU. Your pts are all ages and sizes, get a whole world of meds you never use in NICU, have an entirely different assessment/code process, and you have to learn to actually interact with your patient on a developmentally appropriate level, eg a 5y/o or a 15 y/o. You depart from the typical "RDS" "Sepsis" "PPHN" etc dx of NICU and see almost anything, such as sickle cell crisis, DKA, trauma, Toxic Shock Syndrome, seizures, encephalitis/meningitis, etc. A whole new world, scary but challenging. In NICU you have to wait a while to see results, but in PICU you get to see a child go from comatose/sick as snot to awake and watching shrek with you. They have a life to go back to that NICU babies are just beginning. SO .....after all that rambling, YES it's very different, I don't necessarily like it better than NICU, but it breaks the monotony that I feel in the NICU sometimes.