Can't Decide - NeonatalICU or Stay in Trauma

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Specializes in Trauma ICU, MICU/SICU.

I'm currently a tech on the transitional trauma unit graduating in December. I LOVE where I'm at.

I also want to work with neonates and have accepted a position in the NICU for January. I just don't know if I want to go right into critical care.

Also, I want to be on the weekend program (premium pay 3 out of 4 weekends/month).

Here are my pros and cons... Please tell me what y'all think! :uhoh3:

TTU

Pros

Love what I do

Bonus ($4000-13,000)

Short Orientation

Incentive pay

Great base knowledge

Like population

Time to figure out what areas of nursing I enjoy/hate

Sets up well for TNICU, ER, ICU, NICU

Weekend program in 6 months

Already know staff

Good at this population

NICU

Pros

High Tech

Low impact on my body

Specialized

No residents

Safer population

Don't know if I'll be good with parents

TTU

Cons

High impact on my body

Tech to RN transition may be difficult

Lack of exp nurses at night

More dangerous population

May not get into NICU when I want

Adult poop :chuckle

Cons

Don't know if want right away

No bonus

Specialized

Limited OT

Long orientation

May not like population

Won't have nursing base knowledge

Lack of exp nurses at night

No weekend for at least 1.5 years

Don't know staff

As you can see I'm leaning toward staying where I'm at. But this is the toughest most well thought out decision I've ever made. I am DRIVING MYSELF CRAZY!!!

Specializes in Critical Care / Psychiatry.

I always thought a long orientation was preferred against a shorter one.

At least that's what my instructors and colleagues seem to make me think!

Specializes in critical care; community health; psych.

eenie, meenie, minie moe... LOVE IT is heavily weighted. It's a rare opportunity to get paid for working at what you love to do. Twelve hours is a loooong time. JMHO. The transition from tech to nurse isn't a piece of cake to be sure but its pain is temporary.

Whatever you choose, I wish you lots of good luck.

Specializes in Gerontology.

Always go for a longer orientation gives you more time to catch on and more support, once you are off orientation people look at you as you are ready.

From what you described, I would stay where you are for at least 6 months. You will build your confidence as a new grad in a comfortable arena that you like, and NICU will be there if you want to switch. If you love it, stick with it for a while!

Specializes in Trauma ICU, MICU/SICU.

Thank you everyone for your responses.

I decided to stay on TTU. I e-mailed the Director of NICU and she supported me 100% and told me to contact her when/if I'm ready to start in NICU. I think this is the best of both worlds!

Thanks again!!!

Specializes in Neonatal ICU (Cardiothoracic).

I know you already made your choice, but here's some advice to help you validate your choice.

I assume you haven't done any time in the NICU. Most of what you wrote as pros/cons are correct. However, the "safer population" I don't understand. You are dealing with babies here, some less than a pound, usually critically ill, sometimes their parents last shot at having children, sometimes products of drug use, alcoholism. Are you sure this is for you, as opposed to an accident/crime victim? These kids cras in seconds. SECONDS!!! I volunteered to work yesterday morning, came in to care for a set of "stable" heh heh, 29 week twins. Within 30 minutes of getting there, I coded one 4 times, pushed epi, did compressions, assisted with a pericardial tap, started dopamine, gave FFP, boluses with NS, reassessed again and again, etc, etc. I started here as a new grad 5 months ago, and nursing school taught me nothing about NICU. It is all on-the-job training. While I now feel somewhat prepared, this is never going to be a predictable job. I still love it though!:uhoh3:

Specializes in Trauma ICU, MICU/SICU.
However, the "safer population" I don't understand.

I meant safer for me not the patients. I describe patients in terms of acuity. Safer is the work environment of the population. When you work with head injuries, drunks, drug addicts, etc. It can be dangerous. I've been kicked in the chest, swung at, and between a patient and the door when a pt. decided to go nuts. I take care of shooters, shootees, etc. My life has been threatened by a patient's Significant other, etc.

Are you sure this is for you, as opposed to an accident/crime victim?
No, I'm not sure its for me. Thanks for the "advice" though. I found your post a bit condascending, I assume due to you misunderstanding what I meant by a safer population. I never assumed NICU patients were predictable nor did I ellude to that anywhere in my post. I personally believe that I would do a disservice to my patients by starting in a critical care area such as NICU which is why I ultimately decided to stay where I am and learn to be a nurse first.
Specializes in Neonatal ICU (Cardiothoracic).
No, I'm not sure its for me. Thanks for the "advice" though. I found your post a bit condascending, I assume due to you misunderstanding what I meant by a safer population.

Ok, that's fine....I didn't mean to be condescending at all. I apologize if I came across that way. It's probably due to the fact I had just gotten off working 60 hours that week. I've noticed that many non-NICU nurses come into the unit as one of these: either they are afraid to do anything, or freak out when a baby gets sick/codes, etc. If you are willing to learn like crazy and accept challenges when you start in NICU, you'll do fine, but a lot of people burn out quickly in that environment. I would have done what you did, and start out where I was comfortable, amid supportive coworkers. I'm sure you'll be ready for your transition to NICU in no time. Good Luck!

Specializes in Trauma ICU, MICU/SICU.
Ok, that's fine....I didn't mean to be condescending at all. I apologize if I came across that way. It's probably due to the fact I had just gotten off working 60 hours that week. I've noticed that many non-NICU nurses come into the unit as one of these: either they are afraid to do anything, or freak out when a baby gets sick/codes, etc. If you are willing to learn like crazy and accept challenges when you start in NICU, you'll do fine, but a lot of people burn out quickly in that environment. I would have done what you did, and start out where I was comfortable, amid supportive coworkers. I'm sure you'll be ready for your transition to NICU in no time. Good Luck!

Thanks Steve! We also get people on our unit who have NO IDEA what trauma entails and end up walking out the door rather quickly. We'll see where I end up. I'm happy I'm staying where I'm at for the moment with my crazy traumas.

Specializes in Trauma ICU, MICU/SICU.
I always thought a long orientation was preferred against a shorter one.

At least that's what my instructors and colleagues seem to make me think!

TTU is a short-er orientation, but it is still at least 12 weeks. TTU is a Trauma step-down unit. We have 4 critical care (but no vents) patients in one room with a nurse/tech team and the rest of the floor are trauma med/surg patients.

The NICU orientation is at least 6 months and is much more intense. I plan on enjoying lots of time with my four year old and husband for putting up with my FT school/FT work schedule. These were probably the most important factors in my decision.

Thanks!

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