Adults vs Peds/NICU career track - help with preceptorship

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    Hi Everyone,
    I will be graduating with my BSN in May and I am having a hard time figuring out what I want to do next. Growing up my areas of interest were always either NICU/OB or Trauma/Critical Care, different I know but I always want to be where the action is. In school my favorite rotations have been mother baby and to some extent peds (although I was at a hospital without a very diverse patient population). I just seem to feel more confortable with the babies and kids. My thoughts are that I want to go into either PICU or CVICU (working on getting on a shadow day in the PICU b/c I'm only assuming I'll like it right now). However, the thing is, I am commited to a hospital for 3 years and they do not have any peds patients. They do have a Level III NICU but its really just a medical NICU. Anyone requiring surgery gets sent to the local childrens hospital.

    I thought that I would use this opportunity to try adult critical care and I submitted my request to be in one of the ICU's for my senior preceptorship (also following the line that I am also interested in trauma - there are several level 1 trauma centers near me). There are limited spots available in the ICU's however and I may very well not get in. My second choice was ED. I am begining to rethink my choices and want to include NICU as one of them. I still think I want adult ICU as first choice. My problem is that I am scared of going to the NICU first because I don't want to limit my career choices in the future (even the unit manager said she thinks NICU is limiting) I am very indecisive and I love all that nursing has to offer. I feel like my instinct is probably telling me that I feel most comfortable with kids but I want to experience it all. But I also dont want to take 10 years to get to where I want to be.

    SO I have some questions....

    1. Will a preceptorship in the NICU limit you in trying to apply for an adult ICU position or any adult position for that matter?
    2. What happens if I work in the NICU for a few years and decide I want to work with adults? How difficult is that transition? Does anyone regret going straight into NICU/PICU/gen. peds? Nobody ever says they do! but someone must have switched from peds to adults at some point.
    3. Where would I get more experience that is relevant to the PICU? Adult ICU or mostly medical NICU? (I've heard so many conflicting opinions!) I was leaning toward adult ICU, now I thinking NICU. Howver, in a medical NICU I imagine I will work alot of the same diagnoses over and over, with a pretty similar patient population, as opposed to a PICU where you never know what you're going to get.


    Thanks for your help!!
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