NICU PICU/peds transition

I've worked in many children's hospitals over the years, only one has gotten this right! They had a TCU- transitional care unit- for all the NICU grads/chronic kids with trachs, home vents,ect. After the child is stable, they transfer to the TCU for "fine tuning" and TONS of teaching for the family. There were private rooms so that parents could stay overnight and be involved in all of their care as they will be at home. It was great... able to free up an ICU bed and really give the parents the time they need to learn to care for their child and really be comfortable before they went home. Seemed to work out well.

We have a very similar set up in our NICU. What you call the TCU we calll the NDU for newborn development unit. The NICU and NDU share the same nursing staff and ideally the primary nurse will following the baby from the NICU to the NDU.

For the most part, it works very well. However, there are some staff members that only want to do NICU and simply don't have the personality to do the extensive teaching that the NDU requires, or they don't care for the slower pace. There are an equal number who only want to work in the NDU and who dont' feel comfortable doing critical care. (one RN who almost exclusively works in the NDU honestly did not know how to draw a gass off of the kid's UAC).