From Adult ICU to PICU

[caitiecait]

Hey there! I am new to this PICU section. I have worked in ICU for a year and a half and plan to have a solid 2 years with my CCRN before transfering to PICU. I plan to work at Children's Hospital of the King's Daughters in Norfolk Virginia. It is the only Children's Hospital in the region and their pt's are very sick. They get everything from traumas to open heart pts, etc. etc. My question is what is it like working in the PICU? What are the differences of a PICU vs. Adult ICU besides that they are children vs. adults. Let me start by saying that I love critical care and I love children. I love educating families and the pts on their condition and being a true advocate for my families and pts. My goal is to to grad school this fall and earn a degree in nurse education. I would love to teach pediatrics and med surge. I can't wait to start in the PICU so any advice on what books to read and ways to become ready when I do make the transition to PICU would be great!!

[CaliRN29]

I made the transition from adult ICU to PICU a year ago and love it! The kids are so much happier and tougher than any whiny adult! Patience is the key! Blood pressures on a 3 year old can take a few minutes b/c you have to earn their trust first where as adults, you can just walk in there and slap a cuff on and walk out. Also getting used to different vital signs. You will have to know vitals from everyone to a neonate to adult for your teenagers. "Manual of Pediatric Critical Care" is a great PICU book as a resource. The other big thing that is very different from adult ICU is that the kids all have random problems. With adults they all have HTN, DM, obesity, etc but with kids they are usually a clean slate. Of course you will have your broncholitis/RSV kids and others that you become familiar with but there is always one that will throw you off your game :)

You will LOVE PICU! Good luck!

[boomerfriend]

I don't have much to add regarding Adult vs. Peds because I've only worked Peds. Yes, kids generally come with a clean slate however, a large portion of our patient population have chronic issues (lung or heart disease, etc.) You will love the education piece with the families. Brush up on your childhood disorders, cardiac anomalies, and the like. Good luck to you!

[teleRN08]

I have been in tele for 3 years and am considering applying for a PICU position also. I am currently enrolled in my masters for nursing education online.

[HazelLPN, LPN]

I worked in adult ICU (later MICU) for over thirty years before I started doing PICU. If I would have had it all to do over again, I would have done PICU from the start. I liked adult ICU. I stopped because it was getting too physically challenging for me with all of the obese/morbidly obese patients that were starting to become the norm in MICU. In the PICU, your norms are different, everything is based on weight, and kids can change very quickly. An adult (most of the time) will give you plenty of warning they are about to go south. Kids won't give you so much warning....they compensate pretty well. However, they are tough and heal much faster then adults do. I felt like I was prolonging life at the end of my MICU career with many of the patients were chronics who were in and out of the hospital. I felt young again when I started doing PICU... and I was pushing 60 when I started.....75 when I fully retired. I learned that an old dog can learn new tricks if that dog is motivated and willing to learn...and has a passion for what she is doing. Best wishes to you on your future as a PICU nurse....your back and knees will thank you when you are my age.

Best to you,

Mrs. H