Curious...any of you guys considering Peds/PICU/NICU?

donsterRN, ASN, BSN · Feb 2, 2007

Well, I don't think Peds is my calling. I'm not interested in it ... yet. I haven't rotated through there, so maybe I'll change my mind.

I have been on the receiving end of oncology services provided by many awesome oncology nurses. It's a field I hadn't considered previously, but I definitely have an interest.

I'm probably going to be a med/surg nurse till retirement!

Medwynn · Feb 3, 2007

Hmmm Peds, NICU, or PICU. While i've already had my rotation there and enjoyed it somewhat, it's definately not something i'd like to do. I already am loving my apprenticeship in the CIC/CSU.

Now it may be the whole thing about having to deal with children and young adults. To be honest having to deal with children/young adults kinda scares me. Although my experiences with ppl with cardiac issues can be an eye opener, i have no real interest in your side of nursing.

As for helping me decide to go into your field of nursing, just be real about it and show what real Peds/NICU/PICU experience is. Don't water it down and let us be as involved as possible. You will find guys who are into it as much as you are.

Roy Fokker, BSN, RN · Feb 3, 2007

I wanna work peds so bad but not enough good hospitals with good peds unit in the area.

Trav · Feb 5, 2007

I will graduate in May and my primary interviews have be NICU and Peds, the clinical manager seem to be looking to but more men in those departments. Is that not the same of other hospitals?

UMichSCN07 · Feb 5, 2007

I'm in a clinical on a peds acute care floor right now and it's a good experience, but not what I want to do 40 hrs/wk, 52 wks/yr. However, I love ICU environments, almost regardless of focus, and would consider Peds ICU or Neonate ICU. However, I don't think that I'm going to get any clinical experience with PICU/NICU, so something that would help me to decide is a good, in-depth review of the differences between PICU/NICU and the adult ICUs, and maybe an overview of the types of patients seen in the PICU/NICU. A description of your "typical" day would be helpful, too.

Mike in Michigan

gdean1 · Feb 5, 2007

I relish the opportunity when I graduate! I spent one day in NICU and fell in love. There is one guy who works there and he fell into that position 21 years ago and hasn't left. I never thought I'd like it but can't wait. I have an interview this week with a VP interested in getting some of us in as LPN's while we finish school to train and keep us when school is out. I'm pumped, though I wished more guys were in that area.

vamedic4, EMT-P · Feb 7, 2007

I currently work peds as a tech, and I plan to continue working as an RN when I graduate. After having worked as a field medic and taking care (primarily) of adults, I know that peds is where I need to be. I've been here long enough (12 years) to see many of my patients grow up, get better, and, sadly..I've watched some of them die. But I wouldn't trade it for the world.

vamedic4

SteveNNP, MSN, NP · Feb 7, 2007

A good, in-depth review of the differences between PICU/NICU and the adult ICUs, and maybe an overview of the types of patients seen in the PICU/NICU. A description of your "typical" day would be helpful, too.
Mike in Michigan

Well, here's a brief "day in the life" in NICU....

I get to work and get report on my assignment of 1-3 patients. These can have any number of diagnoses including cardiac anomalies, sepsis, respiratory distress, meconium aspiration syndrome, etc... Let's say I get a 24-weeker, a "feeder-grower" and 1st admit. (we rotate admissions where I work) I set up a "giraffe" bed for admission, a 30k bed that converts from a closed isolette to a radiant warmer in 15 seconds. I assess my 24 weeker, who is around 600 grams in weight, assessing VS, fontanelles, color, tone, lungs, his umbilical or peripheral arterial line, PICC/IV lines, chest tubes, ETT. I make sure his dopamine/dobut gtts, along with hyperal, lipids and fentanyl gtts are running without problems. I check out his High-frequency oscillator ventilator, which is a special vent that pulses 600-800 puffs per minute, "shaking" o2 into his lungs while holding his alveoli open at a controlled pressure. He's already gotten a few doses of surfactant down his ETT to help "ripen" his lungs. His assessment's complete, so I change his diaper and bed linen and reposition him. Doors shut, light off....on to feeder grower... Assess, especially abdomen, checking to be sure he's tolerating his feeds, IV's are intact, especially the 26ga one in his scalp we placed after 4 attempts. Bed linen's changed, NG tube's patency checked, BG fed q3hr formula. Back to bed... ok time to chart... meds due on 24 weeker: Claforan and Vanco, Bumex too... L&D calls for a 35 weeker lady partsl delivery. I go with one of our unit's 3 RT's, manage the baby in the delivery room. No resuscitation needed, just a little blowby o2. Back to nicu, more meds and an ABG to get on 24 weeker. Feeder screaming for more food. It's time to feed again. This time I attempt to PO feed with a bottle, slowly teaching the baby how to pace his sucks and breathing. He's slowly getting it...I teach mom and dad how to give him a bath and change him. We also go over discharge paperwork for later this week. ED calls, sick kid, can't get an IV. I go down with another RN. Get the IV in and come back. More VS, ABG's, feeds and meds. My 24 weeker's Hct comes back 24. I start a PRBC transfusion, right before L&D calls again. This time it's a 30 week abruptio placentae. The kid comes out blue, apneic and with a HR in the 40's. the RT intubates as I start compressions and draw up epi. 0.2ml down the ETT...cpr continues. The kid comes around, and we rush him back to nicu to admit him. So now I have 2 vents...another RN picks up my feeder....don't have to worry about that, now. I'm caught in a mad rush. the new kid goes into SVT,,,,I grab the neonatologist and some adenosine, push it. He converts. I hang his and the 24 weeker's IV fluids and chart....more meds due...labs due. Luckily we're a great team and help each other out. Finally it's 7pm. I report off to the oncoming RN before finishing my charting. I've already seen the new kid's family, oriented them to the unit and answered all their questions and gotten consents signed. IV's are in, meds given and labs sent. I'm exhausted, but done for the day.

Some other things I do in NICU:

Ambulance/flight transport

PICC line placement

Codes

Assist with surgery, central line, Chest-tube placement.

I can intubate, place PICCs.

I really enjoy the high-technology and fast pace, including delivery room resuscitations. But I also love taking time to teach and counsel parents, and even just sit for a while and feed a baby,.....It's hard to explain. I hope the above scenario wasn't too scattered, but it's pretty much what happened today at work....

You really can't even compare PICU/NICU with adult ICU. Peds diagnoses are usually not chronic. We get a lot of traumas, including gunshots, ATV accidents, DKA, Asthma, RDS, RSV, etc. You see a lot of the same drugs and treatments, such as vents, chest tubes, central/arterial lines, etc, but not stuff like COPD, Heart disease, ESRD, etc.....

Stephen

jamonit · Feb 7, 2007

i'm not a guy, but i can't wait to begin my career in the picu next week. everyone talks about how it is going to be so depressing, blah blah blah, but this is what i want to do with my life. if i wasn't there helping the kid, he/she would still be sick. since i am there, i can do my best to help save his/her life.

anyway, i think picu/nicu/peds ed, hemeonc, etc are great areas for both men and women. they're highly specialized, but so fascinating.

Janus Rising · Feb 8, 2007

I would actually love to work in Peds, but honestly the thought of losing a kid would destroy me. Even though I want to work in the ER and know that I will be more likely to lose one there, for me I see the ER as a more proactive life-or-death thing, ergo, more acceptable to me. Never said I was sane or made sense :)

nole8302 · Feb 9, 2007

My wife is a NICU RN and I have got to experience that already. It is very intersting and something I have thought about. I am very interested in becoming a neonatal NP.