ER or PICU?

  1. I am looking to change specialties. I have experience in ICU and Surgery. I do not have a lot of experience working with children. But, I generally love kids and the few times I have had peds patients I really enjoyed it. I also have floated to ER a couple of times and loved it. I am debating what would be the better fit for me and am looking for any advice and/or experiences that would help me to make a decision. What are some of the cons of pediatric patients, etc?
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  2. 9 Comments

  3. by   *PICURN*
    when i first graduated, these were the two areas i was debating between as well.

    ER: I did one shift in the ER and although I loved the variety and loved the somewhat "organized chaos", I felt like we were just like a holding area until they moved the patient to a floor or sent them home. I also didn't want to deal with the drug seekers, etc.

    PEDS: Love kids, but at the same time I was scared to specialize, especially right out of school. I felt if I specialized, maybe I would lose all my "adult" knowledge since kids are so different. Whereas if you were in the ER you would treat kids and adults.

    In the end I chose PICU b/c I was interested in critical care, and pediatrics. Overall it just seemed to be a better fit for me *and I LOVE IT!!!*

    Just remember you can always switch again! If you try peds and hate it, then you can always go to the ER later, or vice versa.
  4. by   JennB03
    Thanks for replying. I have an interview in PICU in two days and I still am not 100% sure what I want to do. I too am drawn towards ER because of the variety and the "organized chaos" but I know how extremely busy and overworked the staff is in most ER's. I also have heard many stories of crazy people and drug seekers. I am drawn toward PICU because I love critical care but do not like the constant heavy lifting with my previous ICU job. I also feel that working with kids, although challenging, probably is the most rewarding. My question is how do you deal with the difficult parents? I know that with all nursing jobs working with some families can be very challenging even exhausting. Do you feel that because you are dealing with children that the families are worse then in other areas?
  5. by   suzanne4
    Be aware that you will also see "adult-sized" patients in the PICU. They actually can be over 6'5" and 132 kg............the nice thing about PEDS ICU is that you see everything...........and the drama that goes right along with it.
    It can be the most frustrating place to be working somedays and others the most rewarding.................
  6. by   *PICURN*
    Some parents/families are very difficult. You just have to not let them run you into the ground. It's hard to draw the line, but sometimes you just have to let them know that right now you need to do "x, y, and z" for their child and you will get to "1, 2, and 3" (which are less important, and what they want you to do right this second) when you are through. They are going through a really stressful time in their life and basically handing over their child for you to take care of, so you can imagine the stress...so just remember that when dealing with the parents.

    I agree with suzanne, sometimes the "kids" are adult size!

    It is a very rewarding area to work in though
  7. by   eurith
    Hey,

    After working in PICU for 14 years, I can attest to the fact that you will have to deal with families that are under a great deal of stress...so, you will have more than your assigned load of patients and for a longer period of time than you would in the ER...too bad the acuity does not reflect that...The most important issue or question is...Do you or any nurse in the PICU have the SUPPORT of management? i.e. consistent visiting policies, supportive social services etc....If you do not, then PICU is not for you or any other nurse...
  8. by   traumaRUs
    Aw come on guys. Being an ER nurse isn't all bad! Some of us love it and thrive on the organized chaos. You have a variety of patients, never know what is going to come through the door and most times you go home knowing you helped at least one person. Good luck.
  9. by   ERRN1028
    I worked ER for 3 years (absolutely loved it) I started out as a new grad there, wouldn't trade that exp for anything. About 40% of the patients are not truely ER patients-does get abused alot (I worked community and charity hosps in the ED)
    Now I work PICU 1 year now, love it way more, i know that every patient I have in PICU really needs to be there and is sick. Kids are very resilient and more challenging. Just amazing to work with kids and I think more rewarding.
    I can't tell you what to choose depends on your personality ER never stops constantly new patients, family members, some ill, some not, new IV's, procedures, Definately get lots of skills in, and you learn prioritizing and organizational skills.
    The ICU more laid back once you get your first assessments done, lots of reassessing, have more time to bond with patients and familys, a lot of medicines and titrating drips, monitors, ventilated patients, suctioning, post-op patient
  10. by   JennB03
    Thanks to for everyone's wonderful advice. I have just had my second interview in PICU and am very excited. I won't have an answer for two more weeks.

    Just out of curiousity ERRN what made you leave the ER?

    Once again, Thanks!

    Quote from ERRN1028
    I worked ER for 3 years (absolutely loved it) I started out as a new grad there, wouldn't trade that exp for anything. About 40% of the patients are not truely ER patients-does get abused alot (I worked community and charity hosps in the ED)
    Now I work PICU 1 year now, love it way more, i know that every patient I have in PICU really needs to be there and is sick. Kids are very resilient and more challenging. Just amazing to work with kids and I think more rewarding.
    I can't tell you what to choose depends on your personality ER never stops constantly new patients, family members, some ill, some not, new IV's, procedures, Definately get lots of skills in, and you learn prioritizing and organizational skills.
    The ICU more laid back once you get your first assessments done, lots of reassessing, have more time to bond with patients and familys, a lot of medicines and titrating drips, monitors, ventilated patients, suctioning, post-op patient
  11. by   ERRN1028
    Quote from JennB03
    Thanks to for everyone's wonderful advice. I have just had my second interview in PICU and am very excited. I won't have an answer for two more weeks.

    Just out of curiousity ERRN what made you leave the ER?

    Once again, Thanks!
    JennB03- I left the ER when I moved away from my home town to a big inner city ER, in Memphis TN. I started working at the chartiy hosp here. The ER was crowded with patients on crack, drugs, magets, uncompliant seizure patients, gunshot wounds after gunshot wounds, I cryed everday I left work, just horrible 12 hours shifts. I finally left when 3 nurses got beat up by patients, I didn't want to be one of those nurses, felt it was more nsafe to work, so the next job I sought was far away from crazy adults.
    I think I made a great choice, I'll never go back. I'm sticking with the kids, more challenging and I look forward to going to work.
    Thanks for asking ! p.s the ER I worked at in the community hosp was wonderful true ER patients and I actually saved lives etc. there.

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