Deciding between two NICUs

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I am graduating this spring and have a job offer and an interview in two different NICUs. Both are for 6 month internships in level III units in non-profit teaching hospitals. One is very high accuity hospital downtown that has a seperate level III and level II and the other will have me start out in transition nursery, level I, level II and then level III during the 6 month internship.( I will work level III but also have opportunities to take a shifts in the other levels after internship.) Both hospitals do surgeries but the second hospital sends cardiac pts to the first. The second hospital pays more and has better benefits than the med center hospital but has rotating shifts (2weeks days, 2 weeks nights) and 3 days on 2 off, 2 days on 3 off with me working every other weekend (fri,sat,sun) and every other week has 5 12s! I don't know if this schedule is better or worse than just 3 12s on nights. (it is more hours, so more training and overtime pay?) I am concerned with quality of life as well as getting the best start in my nursing career. I want to be in a good atmosphere but feel like both hosptials have good environments...just need a little perspective from some experienced NICU nurses. The downtown hospital would also require a move and higher rent...

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Specializes in NICU Level III.

I think the best start is the place that does cardiac surgery. Also, 5 12's is a LOT.

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Specializes in Maternal - Child Health.

5 12 hour shifts is a lot, but it will also leave you with extended periods of time off without the need to use vacation time.

I once worked rotating 12 hour shifts, 2 weeks of days and 2 weeks of nights. I was never so miserable in my life. During the winter, I went to work in the dark, came home in the dark, slept in the daylight, and went for days without seeing the sun. The constant rotation was he** on my body and mind. I never worked the same shift long enough to get acclimated, and so was constantly tired, out of sync and sick. After about 9 miserable months, I gave my manager an ultimatum: a steady shift (any steady shift) or I would quit. It just my personal experience. Others may respond better to the constant rotation, but I don't think it is good for anyone.

If you believe that the positions are essentially equal otherwise, I would encourage you to think seriously about the physical and mental effects of constant shift rotation.

Best of luck to you!

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Specializes in NICU III/Transport.

IF it were me... I'd work for the higher acuity, less pay hospital. You are going to learn skills there that you may not learn in the other hospital. Cardiac experience is always a bonus. Those skills will benefit you in the long run in your career.

Also, like Jolie said... that shift rotation is horrible. I'm sure that's why they pay more, to try and entice you to put up with that. It may or may not work for you, but I couldn't do it.

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Thanks so much for your input! Is it also good though to have experience in level II and transition nursery? I want to have as many skills as possible during my first two years. Both are level III and high accuity (the one that does not do cardiac pts keeps most of their babies and has many high risk deliveries) but the other hospital in downtown gets all the transfers from surrounding hospitals. At this point as a new grad with no real NICU experience I just don't know what I really need or like, you know?

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Specializes in Maternal - Child Health.

One more thought. While the one hospital does cardiac cases, are you sure that those babies go to the NICU?

It is not unusual for pediatric cardiac surgeons to want all of their patients to be housed on a single unit. I've worked in 2 hospitals that did pediatric cardiac surgery, and in both facilities, the babies went to the PICU post-op, regardless of their age. They only came to the NICU when they were extubated, had chest tubes removed and were stable. We pretty much worked on feedings and DC planning.

So while cardiac surgery is fascinating and challenging, in some institutions, it is only the PICU staff that is exposed to those patients.

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Specializes in NICU Level III.
One more thought. While the one hospital does cardiac cases, are you sure that those babies go to the NICU?

It is not unusual for pediatric cardiac surgeons to want all of their patients to be housed on a single unit. I've worked in 2 hospitals that did pediatric cardiac surgery, and in both facilities, the babies went to the PICU post-op, regardless of their age. They only came to the NICU when they were extubated, had chest tubes removed and were stable. We pretty much worked on feedings and DC planning.

So while cardiac surgery is fascinating and challenging, in some institutions, it is only the PICU staff that is exposed to those patients.

Our NICU gets them preop and pretty soon after postop. They can still be intubated and on drips and have chest tubes. They are in the PICU for a little bit when they're on tonnnnns of drips, but we are working on keeping our kids immediately postop.

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Specializes in NICU.
but we are working on keeping our kids immediately postop.

Ah that'd be such a disaster imo!!!

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Specializes in NICU Level III.
Ah that'd be such a disaster imo!!!

I think at least the ECMO folks could handle it. If they were expecting a kid coming back I'm sure they'd be 1:1.

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Specializes in NICU.
I think at least the ECMO folks could handle it. If they were expecting a kid coming back I'm sure they'd be 1:1.

Yeah but they are already stretched thin between other duties they commonly do such as charge and precept. I once had a kid that was 1 mo postop and peaked at his immediate post op orders in his old chart. I almost fainted and felt overwhelmed. Numerous drips and vasopressors and boluses etc...to the point that I hoped he was staffed 2:1. Maybe he was an exception, but I just can't imagine these fresh post-ops coming to our unit at this point. We are already understaffed as it is. Plus we'd have to find a place to put all the heart specific supplies. We've had issues coding heart kids with cardiology demanding supplies we don't stock and someone having to run to PICU to get them.

Personally, I wouldn't mind if they moved all the pre and post heart kids to that new cardiovascular building, perhaps open a children's CVICU. They really give me the heebie jibbies.

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Specializes in NICU Level III.
Yeah but they are already stretched thin between other duties they commonly do such as charge and precept. I once had a kid that was 1 mo postop and peaked at his immediate post op orders in his old chart. I almost fainted and felt overwhelmed. Numerous drips and vasopressors and boluses etc...to the point that I hoped he was staffed 2:1. Maybe he was an exception, but I just can't imagine these fresh post-ops coming to our unit at this point. We are already understaffed as it is. Plus we'd have to find a place to put all the heart specific supplies. We've had issues coding heart kids with cardiology demanding supplies we don't stock and someone having to run to PICU to get them.

Personally, I wouldn't mind if they moved all the pre and post heart kids to that new cardiovascular building, perhaps open a children's CVICU. They really give me the heebie jibbies.

Yeah, I've looked through PICU charting and.. OMG. One of the ECMO folks was telling me their goal was to keep them out of PICU all together and have a group of nurses be cardiac specialists or what not; I guess like they do at TCH, plus they have a CVICU there. Heart kids are interesting but I feel stupid taking care of them.

I dread the day I float to PICU. Dangerous!!

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Specializes in Neonatal.

I would definitely worry about the 5-on/week. That would lead to burnout pretty quick. Personally, I would not go with the 2nd hospital. The schedule is too difficult. I couldn't imagine doing 2 weeks of days, 2 weeks of nights and have the 5 on / week for every-other week. No way.

If it were me, I would go with the first choice. 1) You don't need to do transitional nursery or level I to be an effective NICU nurse; 2) the cardiac hospital would be a challenge and if you're up for that - go for it!

Good luck. :o)

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