can't decide between the NICU and ER

SteveNNP, MSN, NP · Sep 4, 2007

Ha! Don't worry.... if it's a level III it'll be fast paced enough.... this coming from a NICU nurse who had a brief stint in the ED. Believe you me.... NICU was fast paced enough.....

fergus51 · Sep 4, 2007

It does depend on the unit though. I've worked in units that were technically level 3s, but their acuity overall was very low. They'd have a couple of sick kids and a dozen feeder growers. Perhaps you should ask if you can do an observation day in the unit. Then you'd be able to see for yourself.

rnpilot · Sep 5, 2007

It definitely depends on the unit. Did they give you a tour of the unit before offering you a job? When I worked at a university hospital, I developed a "12 hour" bladder and could eat a hamburger in under one minute. I quit smoking because I couldn't get out to smoke, and that was when we could smoke in the next room. I also worked in a level III that had 14 beds that was much, much quieter and less crazy. We didn't keep any babies under 26 weeks, so our acuity generally wasn't that high, but I really loved it. It was still challenging without being hair-on-fire crazy.

JulieRN07 · Sep 6, 2007

I did get a tour of the unit. At the time it seemed very slow and quite, but I know that can change at any moment. This nursery is a Regional Center, so these babies are probably pretty sick-i guess I just don't see where the action would be with one or two babies?

fergus51 · Sep 7, 2007

One baby crashing is more than enough to keep you extrememly busy. It's about putting in lines, hanging new drips, intubating, doing blood gases, adjusting based on that, all the while continuing other assessments which can require different actions (insert a chest tube? Send a kid to surgery?)....

Jerico, BSN, RN · Sep 13, 2007

There was more variety in the ER.

I got thrown up on and cussed in the ER.

I felt more stress in the ER.

In the NICU it feels more autonomous.

Just as busy but more serious thinking involved IMO.

Clientele much more grateful.

JulieRN07 · Sep 13, 2007

Thank you Jerico. That puts it into a different perspective for me-

WDWpixieRN, RN · Oct 8, 2007

I did a student internship in the ER this summer and it was great exposure/experience for me as I realized I wasn't as in love with it as I thought I would be. We weren't level I, but it was constantly busy and obviously interesting with lots of new/different pts.

The downside is the not-so-new/different pts (frequent flyers), smelly people (hey, let's take grandma to the hospital because we think she's having a stroke and all 8 of us will smoke like chimneys in the van on the way there and darn, don't I wish we'd taken our Saturday shower last night?), people who expect to be waited on because they are in an ER, people who scream and yell because they're pretty sure that their cough of two weeks is MUCH more important than the guy who's having a stroke/heart attack/diabetes coma down the hall, drunks, druggies, people who don't have insurance so they use the ER when they really should be seeing a primary care physician or an urgent care for their sniffles, etc. It's not at all like you see on "Trama, Life in the ER", lol.

I'm now hoping to get a chance to shadow or spend some time with a RN at a local children's hospital to see if that's more my speed. I think the NICU sounds fascinating and always vacillate between the two myself when I get the question, "Where do you want to work?" I haven't totally eliminated the ER, but it's no longer at the top of my list.

Best wishes!!

Sweeper933 · Oct 8, 2007

There was more variety in the ER.
I got thrown up on and cussed in the ER.
I felt more stress in the ER. quote]
I love working in the NICU - but you also get thrown-up on quite frequently! Granted, getting puked on by a baby is much better than a full grown adult, but still! I've had nights where I've gotten peed on, pooped on, and puked on - all in the same 12h shift!
We've also had parents swear at the nurses - usually it's the parents who are high on who knows what...

cured · Oct 12, 2007

One baby crashing is more than enough to keep you extrememly busy. It's about putting in lines, hanging new drips, intubating, doing blood gases, adjusting based on that, all the while continuing other assessments which can require different actions (insert a chest tube? Send a kid to surgery?)....

Im in my last semester and considering the NICU. Do the nurses do all of the things you mention here---ABGs, intubating, inserting chest tubes?????!!!!

TiffyRN, BSN, PhD · Oct 13, 2007

ABG's: yes, most everywhere, doing an art stick for all kinds of labs including ABG's is common, some of our RN's know how to run the machine that analyzes the sample but mostly it's the RT's who run the machine.

Intubating: some places, but only with extra training, our unit has several RN's who intubate but they are all the most experienced.

Inserting Chest tubes: I've never heard of RN's doing this, maybe some NNP's do this?