Medical to NICU?

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Specializes in NICU.

Hello all!

I've got a little quandary here. Apply to NICU or tough it out on Medical?

I've been working for a year and five months now, at my first job as an RN on a medical/oncology with tele floor. I've really enjoyed it there, the teamwork is great, there is a wide variety of patients, and I love the patients. However, there have been a lot of changes recently at our facility making the working conditions more difficult, namely, we don't have aides anymore (RN-patient ratios staying the same) and haven't had a unit clerk on weekends. In addition, the turnover is high (or rather, people leave frequently and they drag their feet on replacing them). As it is now, I am the most experienced RN on my shift with almost a year and a half experience. I have also been...'encouraged' to get chemotherapy certified--which is great, more education and all, but there aren't ANY other chemo nurses working with me, so there is no one I can go to for help and questions. So, my stress level has been increasing and I certainly don't enjoy my floor anymore.

Along comes several NICU postings, at my same facility. I did a 90-hour internship there in my last semester of nursing school and enjoyed it (although I ran afoul of a couple of day shift nurses), but that's the extent of my pediatric and NICU experience. I liked what I did there and I enjoy every age population, but I'm afraid of being 'stuck', so to speak in NICU if I went there--would it be irritatingly difficult to transition to adult ICU if I got the bug? Should I just wait for an adult ICU posting?

And if I post to the position, I'm not sure if my manager can force me to stay, seeing as we are pretty bare-bones (although they did hire some new people) and I am the only one who has been there over a year (the next two behind me in seniority reach their one-year mark in October).

This is all assuming that they would even interview me, ect.

Sorry for the wall of text, I just needed to get this all out. Any thoughts?

Specializes in Pedi.

First thought is who is giving the chemo on this oncology floor where no one (including the most experienced nurse) is chemo certified?

Internal transfers usually need to be approved by the manager of the original floor. At least that's how it worked in my facility. So, yes, your manager could probably block the transfer. You could call HR and ask, hypothetically, what the process for internal transfers is.

Specializes in NICU.

There is one chemo certified nurse on nights--me, however, another one is going to the class in October.

Specializes in Pedi.
There is one chemo certified nurse on nights--me, however, another one is going to the class in October.

This doesn't seem safe. Who is double checking the chemo? One nurse is expected to care for all chemo patients on an oncology floor?

Specializes in Pediatric/Adolescent, Med-Surg.
There is one chemo certified nurse on nights--me, however, another one is going to the class in October.

I am not even an Onc nurse and I know at every hospital I ever worked at all the nurses on onc floors are chemo certified, even the new grads within so many months. I agree having only 1 chemo nurse when you are a floor that gives chemo sounds like a medication error waiting to happen

Specializes in Critical Care, Education.

My Spidey sense is tingling . . . sounds like the OP's hospital is in financial difficulty & trying to squeeze as much out of the labor budget as possible. The first step is always to eliminate non-nursing positions (CNA, unit clerk, telemetry tech, etc.) and then decrease staff via attrition by failing to replace nurses who quit. I guess the powers-that-be think nurses will just accept the changes rather than kick up a fuss.

If they are willing to compromise on patient safety - not having backup for chemo - this may not be a place where you want to stay in the long run. Critical Care areas may be a bit more safe because the staffing model is usually total care, so a transfer may be the best option. But keep your eyes open, as this may only be the tip of the iceberg. Prepare for your Plan B if you start seeing supply & pharmaceutical shortages or cutbacks in ancillary clinical services.

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