Best training ground for PICU wannabe

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  1. Best training ground for PICU wannabe?

    • 2
      NICU
    • 7
      PICU
    • 0
      Other: (Please specify)

9 members have participated

Hello everyone. I would like some advice please. I am aware of the current new grad job market so I realize my question is potentially purely hypothetical. However, I am a strong candidate among my new grad peers and I firmly believe that having faith and believing that positive things will come into your life makes a difference and I like to prepare as such. Okay, with that little caveat addressed, in the future, I want to be a PICU nurse. I definitely know that pediatrics is where I belong and I have a strong desire to work specifically in critical care. I have spent some time in the NICU and I like it a lot, but I am the type of person that always needs new challenges. I need to be learning new things consistently and I don't like to feel stagnant. I know I would love the challenge of the NICU early on, but in my heart, I think a few years down the road, I would be bored. I'm drawn to the variety and complexity of the PICU.

IF I had a choice between accepting a position on a general peds med-surg floor or starting in the NICU (level 3 I believe, but ECMO and cardiac babies go to PICU), which position would better prepare me for a PICU position in the future? My hospital does not hire new grads in the PICU, but the NICU and peds floors do. I'm not sure if the ICU experience is an advantage or if the wider range of ages and conditions, albeit much less acute, is better.... or if it's 50/50. Any advice is appreciated. Thanks!

EDIT: UGHHHH.... I wanted the poll to say Peds not PICU. Sorry, going on little sleep!

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Specializes in NICU, PICU, PCVICU and peds oncology.

Well, obviously the PICU would be the best choice, but NICU wouldn't be a bad second. Although there are differences between the two specialties there are really a lot more similarities. The differences are generally pretty superficial. And let's face it... PICU gets a LOT of infants, due to the high incidence of respiratory illnesses in that population. In the hospitals where I've worked, pretty much any baby that had been discharged from hospital and needed readmission was considered not eligible for NICU. Of course the peds med-surg floor would see a nice variety of illnesses and issues, and you'd learn a lot about growth and development beyond the content of most nursing school peds courses, but the critical care part of it might be your ace in the hole down the road. I started in neonatal intermediate care then made the jump to PICU. Totally doable.

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Specializes in Pediatrics, Emergency, Trauma.

I say the Peds floor... or is there a way for you to seek out a Children's Hospital? I was hired as a new grad in a PICU and under their residency program. You get a TON of variety ECMO, CRRT, trauma, vents, wounds, transplant and even chemo patients. I don't know what area you are in or your situation is, but if you plan to stay in your area, then by all means go for the Peds floor...you will get a lot of patients from the PICU, just stabilized.

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Well, obviously the PICU would be the best choice,

LOL... yes. I was posting with three hours of sleep over two days. I meant for the poll to say "Peds" :facepalm: or NICU and I couldn't get back to the poll to fix it and also couldn't figure out how to delete the whole post and start over. Thanks so much for the input.

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I say the Peds floor... or is there a way for you to seek out a Children's Hospital? I was hired as a new grad in a PICU and under their residency program. You get a TON of variety ECMO, CRRT, trauma, vents, wounds, transplant and even chemo patients. I don't know what area you are in or your situation is, but if you plan to stay in your area, then by all means go for the Peds floor...you will get a lot of patients from the PICU, just stabilized.

Unfortunately, this is the Children's hospital. They don't hire new grads in PICU. My family situation (and the housing market debacle :devil:) will not permit me to relocate. I have to position myself using the opportunities I have available to my locally. Thank you for your input.

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Specializes in NICU, ICU, PICU, Academia.

Peds is the better choice. Think of inpatient peds as the 'med-surg' of the world of children. It will be a great training ground for developmental issues and the types of diagnoses you would typically see in a PICU. A year or two of general peds, some aggressive involvement in continuing ed and certs, and you'll be a good candidate for a PICU position.

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I worked NICU for two years then transferred to the peds CICU at my hospital. It was a very smooth transition. I already knew ICU stuff (and there is so much ICU stuff), how to think critically and how to prioritize tasks when you're given around ten orders at once (all STAT of course as you're also trying to keep your kid from coding). Also since it was in the same hospital I had already cross trained and floated to the unit I was transferring to so I knew my way around a little bit. As someone who started as a new grad in an ICU I think it's much easier to train a newbie to the ICU than someone whose been trained to the acute care side of it first.

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Specializes in PICU.

Between gen peds and NICU, I would say NICU. The experience of dealing with critically ill neonates will translate well to taking care of critically ill children. Many vasopressors will be the same, the general ideas of vent management will be very helpful, etc. Not to say that gen peds wouldn't be helpful as well, but my vote between the two is NICU.

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Can you check with the hospital about cross training opportunities? I was hired as a new grad PICU RN but I know that my hospital allows for the peds nurses to train for PICU after two years experience. And then the NICU nurses can float to PICU, but they usually get our stable babies. From my experience NICU is a lot different than PICU in that nurses are constantly touching their patients in PICU while the NICU babies can't have that much stimulation. I suggest you pick the one you WANT more since you will have to work there until you get transferred out. If you have any preference, go with that one.

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I would definitely say NICU. NICU will obviously give you the critical care knowledge, you will have similar patient to nurse ratios, you will know vents, sedation drips, pressors, central lines, chest tubes, on and on. All of that knowledge will easily transfer to the PICU. We have had multiple peds floor nurses transfer to PICU and it was extremely challenging for them even though they were fabulous peds nurses. Maybe you could even meet with the PICU manager and ask for feedback as to what she thinks the best avenue would be. Good luck!

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Specializes in Pediatrics.

Given that your goal is PICU I would start in Peds, which is what I did. After two years I moved and got a job in the PICU at CHOP, I worked there for a year and it was a great experience but I believe my peds background was very helpful. I now float at a different hospital between NICU, PICU and general pediatrics. While the some critical care skills are similar in NICU the mindset is very different and I had a hard time learning the NICU ways after being a PICU nurse. NICU is much more wait and see and less reactive. For example in the NICU if my pt desaturated to 70% I wait to see if they will recover without help for 10-30seconds. However in PICU I would turn up the oxygen and suction the patient almost immediately 9times out of 10. Do Peds if you can get PALS, chemo certification, IV placement skills whatever you can pick up along the way. I enjoy working in NICU but it is not the best training ground for PICU, personally I believe a trauma adult ICU would be a better preparation.

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Thanks for all the advice. And even though I truly, deep down didn't think it would happen to me for a handful of reasons, the new grad market claimed me too. I had big dreams, but my eyes are wide open. Neither opportunity (peds or nicu) presented itself to me and I accepted a position I was offered in adult med-surg. The one thing I did NOT want to do with my nursing degree. But I am giving it 100% and, surprisingly, I enjoy it even though it's in a speciality I have zero interest in. I just enjoy being a nurse at this point. No experience is wasted (especially as a new grad). My new plan (I always have a plan lol) is to begin looking for a peds med-surg spot in a year. My road to PICU will have to have an extra stop or two (if an adult cardiac opportunity arises, I would jump on that too), but the dream remains! Again, thank you all for helping me!

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