Adult PCU RN transition into Peds?

Pediatric Critical Care Columnist · Dec 18, 2013

Why don't you think about PICU? Or PCVICU?? You'd have NO trouble making the transition since you already have the critical care part. You'd need some ventilation management and pediatric specific education but it's not that steep of a ladder. I work with lots of nurses who came from an adult critical care background who are doing very well. In my experience it's easier to integrate a nurse with an ICU or HDU background into a PICU setting than it is to integrate a peds floor nurse. That's not saying that either group make better PICU nurses, just that already knowing the critical care aspects makes it easier because that's the most essential part of the job. If I don't have to teach you how Levophed works or all the elements of hemodynamic monitoring and titration of drips, teaching you how to interact with kids is a snap!

babowman3RN · Dec 18, 2013

Why don't you think about PICU? Or PCVICU?? You'd have NO trouble making the transition since you already have the critical care part. You'd need some ventilation management and pediatric specific education but it's not that steep of a ladder. I work with lots of nurses who came from an adult critical care background who are doing very well. In my experience it's easier to integrate a nurse with an ICU or HDU background into a PICU setting than it is to integrate a peds floor nurse. That's not saying that either group make better PICU nurses, just that already knowing the critical care aspects makes it easier because that's the most essential part of the job. If I don't have to teach you how Levophed works or all the elements of hemodynamic monitoring and titration of drips, teaching you how to interact with kids is a snap!

Thanks for your reply! I figured I'd need to go to a Peds floor to just get Peds experience. But I guess maybe not? Just because I know the med calculations are tedious and kids can have different signs/symptoms than adults. But, maybe I can go into PICU! I love cardiac care so maybe PCIVCU! =)

Thanks again! Looking forward to my transition in the near future.

SC_RNDude · Feb 9, 2014

Hello all,
I'm going to be brutally honest here and I don't want any negative comments. I'm here for insight.
I'm a 2yr exp PCU (more ICU just without vents) nurse. We are a high acute PCU, pulling sheaths, titrate neo, levo, nitro, cardizem, etc., also post open heart unit (usually 2 days post op) with a ration of 5:1. Oh and I do charge, with full teams...
I'm young. I'm 23. I worked as a CNA since I was almost 18 as I was going to school. Waayyy back when I was super young, I've always wanted to be a nurse and always wanted to do pediatric nursing. I acutally imagined myself working at St. Jude. But in nursing school something happened, and I didn't want to do it anymore. I think they scared me.
But now, working in this busy acute PCU with these adults, these grown adults on disability who walk and talk better than I do, loving their "di-la-la", endocarditis pts from IV drug use that we do valve replacements for, then OF COURSE aren't compliant post op and develop pneumonia, pleural effusions, DVTs, etc (oh and it's OUR fault), it's exhausting. It's frustrating. And just down right p*sses me off every single day.
Over the past year I've been thinking about peds. Now before any smarty pants pipes up and says "you have to deal with the same things in peds too! Drug addict parents, kinds trying to kill themselves, etc"...I know. But. My heart breaks for sick children. They can't help mom and dad abused drugs or drank or smoked, and now they are paying the consequences. They can't help they have cancer. They can't help a lot of these things. And I have SO MUCH compassion for the little troopers. And that they are. They are so resilient. However, I can shunt my emotions as well as not to get too emotional.
A friend of a friend is a peds nurse. She told me a story of how a little boy she was taking care of came out of surgery and she asked him if he wanted pain medicine. He said so cute "Um no ma'am. I think all I need is just some chocolate pudding." OMG how darling!
So what do you think? How difficult would it be for me to get into Peds? I'm working on my BSN now and PCCN certification. I'll need PALS too, I know.
But can anyone share a similar experience? Were any one of you an adult nurse, then go into Peds? Or vice versa?
Just looking for info and conversation.
Thanks!

Go for it! My nursing background was similar to yours. I worked in an adult PCU and an adult med/surg tele. I also got burned out on the same things you speak of. I interviewed for a peds cvicu but didn't get it.

That was a blessing. I ended up in a peds med surg unit, and I love it. The job is very challenging, but is easier in a few ways. Mom or dad is usually around to feed,bath,change diapers, etc. You won't be chasing bed alarms worrying about your ETOHer or dementia patient breaking a hip or cracking a skull. Your back won't be sore from moving big people around, and you won't be passing out dozens of pills a day.

I always heard that the parents are hard to deal with in peds. There are exceptions, but for the most part they are much more pleasant and easier to work with then in the adult population. For one thing, you almost always working with one or two parents. Not an adult patient and their spouse, sons,daughters, etc.

Eventually I may want to go to a different unit. But in the meantime I am learning everyday, and I feel my options will be more open then if I had gone to the cvicu.

jrt4 · Feb 14, 2014

I would agree that you would probably be more suited for a PICU and may be an easier transition. General pediatrics is a whole different game and may be a harder transition due to having 4-5 patients and trying to coordinate care. With that said I couldn't imagine doing anything else. You will really want to think about that decision though because dealing with kids can be just as frustrating as dealing with adults. After 13 years or so some patients are just as bad as adults with their attitudes and substance abuse. It is sad to think about but kids tend to take after their parents.