Should I do a Transition to Practice in ICU or General Peds to climb my way to PICU?

guest769224 · Jan 14, 2018

You should probably take the ICU position. It will open more doors down the road than general pediatrics will. ICU will have many things in common with PICU.

I am an adult ICU nurse that just got hired to PICU. But then again, maybe PHX children's hospital prefers to hire internal candidates, such as from pediatrics.

You have a tough decision.

ArizonaNurseStudent · Jan 14, 2018

Thank you for the reply! As an ICU nurse, did you find it difficult to transition to a PICU at all or were employers happy you had ICU experience?

guest769224 · Jan 14, 2018

Yes, my employer prefers the ICU experience in their hiring. It is helpful because ICU uses many of the same drugs and algorithms, but just different dosing.

ICU will have arterial lines, pressors, vents, etc. All things that PICU has. Pediatrics doesn't have those.

BUT, it does get you very familiar with pediatric dosing and vital signs. Those have been a challenge for me to learn in comparison.

sugarmagnolia3 · Jan 25, 2018

1) Phoenix Children's Hospital: General Peds

Pros:

Well-known hospital nationwide ----yes

Happy nurses--they all love their job -----not true at all

Night-Shift (Easier scheduling) ----it's a good place to learn

Good chance of job offer after ----I have heard this

Explore in-depth if peds is for me! ----don't do it if you want to work in in critical care

Generally known to be competitive entry ---not really

Hone time management skills w/ multiple pts ----yes

Staff usually great teachers ----I hear really conflicting things about this

20-25 minute commute

I love working w/ kids--have three yrs paid experience with children with special need----then maybe that's for you!

Cons:

Only one hospital location

General Med-Surg floor

Night-Shift may offer less pt interaction

Restricted to pediatric skills

Add to this ---- terrible pay!

2) Osborn HonorHealth: ICU (Level 1 Trauma)

Pros:

I LOVED my adult ICU days! (though not here) ---Osborn ICU is a fun place to work

Level 1 Trauma Center: high acuity ----yes

Potentially more critical thinking ----than pediatrics? yes

Great resume builder anywhere ---100%

Good chance of job offer after ----maybe

Multiple hospital locations ----yep

Recognized as one of top specialty hospitals in Arizona ----Hmmm, not aware of that

Day-shift (no shifting sleep schedule) ----days are great, but harder to learn on, in my opinion

5-10 minute commute

add to list: better for resume

pay is much better

Cons:

Harder to coordinate with classes maybe

Controversial upper manangement ----yep

Pediatrics at another hospital location----yep peds and PICU elsewhere. Bet once you got some experience in adult ICU, you could cross-train to PICU

No peds tMiKamp6de3r+2KGP58f52ZkpBgA=

Less opportunity of learning to juggle multiple pts ----no, it's just different

Not particularly know as being competitive to get in ----it is not easy to get hired right into ICU

What do you think?? Should I start in general peds and work my way up (and make sure I want peds) or go to ICU and build my resume to a more general audience? I'm torn because Phoenix Children's might be hard to get into if I do end up deciding to want to work there--any advice appreciated!

ICU, 100%! You can go do PICU after you get a solid critical care foundation (2-3 years)

HazelLPN, LPN · Jan 29, 2018

You could do it either way. I worked in adult ICU for years and years before I started doing PICU. However, most of the nurses that I worked with in the PICU started out at other units at the Childrens' hospital.....infectious disease, hem/onc, ER, NICU, burn, pulmonary, neurosurg....even inpatient rehab. We also had our share of new grads that went through the hospital's NA program where they worked in the PICU as NAs part time before becoming RNs where they were able to learn quite a bit about critical care that they would never normally learn in school. I was in the minority starting out with adult critical care. I don't think it makes a difference as to were you start as long as you are intelligent, willing to learn, and love what you are doing.

The biggest challenge I had was getting used to everything done by weight....and that kids compensate very well before they crash vs adults will usually look like hell long before their moment of glory. It didn't long me long though. Now getting used to NICU is another story.....

PICU was my favorite kind of nursing that I did...hands down. I especially liked the great variety that you see in the PICU that you don't see in other kinds of nursing. You can take care of a burn one day and bad wheezer the next and then help admit the open heart the third. It keeps you on your toes and it keeps the mind sharp because technology is always changing, there are always new things to learn and something you've never seen. Its also much less physically demanding than adult ICU as the size of the patients are much more manageable (in general of course). I ruined my knee in adult ICU...and even after replacement it will never quite be the same.

Critical care can be learned. I've seen it. Peds can be learned. I did it. What can not be learned is inborn talent and passion...that you must possess inside of you.

Either route can send you on the path in which you desire.

Best to you in your career,

Mrs. H.