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How does NICU experience transfer to adults?


Specializes in ER. Has 2 years experience.

I am a new RN - I just got my license about 3 weeks ago. I did my final preceptorship in a Trauma ICU and LOVED it. Unfortunately, that hospital is not hiring new grads until July, so I am looking elsewhere. I had only applied to critical care units -I figured it was a long shot to get into a unit as a new grad, but since I am working and not in absolute desperate need of a job I might as well try that first.

Well, I got a call back from a NICU at a large hospital, interviewed, and was offered the position. For some reason, I am just not super excited like I thought I would be with my first job offer as a nurse. And, now I have been told that transfering from neonates to adults is very hard. I hate to take this position just because it was the first one offered to me and not be getting the experience I need to transition to my long term goal since NICU is such a specialty. But, I also hate to pass it up because the managers I met with were super nice, it's a great hospital, and a lot of other hospitals in my area are not hiring new grads right now, so I'm scared it might be my only offer.

I love kids, and of course babies, and I loved my peds rotation in school, but I just don't feel like it is the place for me - when I got a tour of the unit I couldn't imagine working there. That seems awful, but I am trying to be honest with myself, and I don't want to take a position that I don't feel my heart is into.

Oh, and I just applied to some general med/surg and tele positions last night, so I haven't even given those a chance, but I have to tell the recruiter my decision by the end of the business day tomorrow.

So, does anyone know if the experience I get in the NICU will help me at all for my goal of working in trauma? Maybe I am just nervous about taking the first job offer, or maybe it is just because it is not my dream position. Would I be better off working on a med/surg floor? Or am I stupid to pass up this opportunity?

Any advice/insight would be very much appreciated!


Specializes in NICU.

Usually people who work in the NICU have a real passion for it. If you don't think it is the right fit for you I would not take the job. Like you mentioned, it IS extremely specialized so not many skills will carry over to the adult world in my opinion. Also, if you take the job and hate it then you are taking the opportunity from someone who really does have a passion for NICU and from someone in which this job wouldn't just be a stepping stone for them.

It truly is a personalized decision whether to take a job or not. It is based on what you feel is the right thing to do for YOU. But if you feel you aren't going to even like it, and you already have a different job to hold you over until a better job comes along.. then it may be a good idea to just wait for a job that is more in your ideal type of unit. Just my opinion.

Good luck in whatever decision you make!


Specializes in NICU, CVICU. Has 4 years experience.

I agree 110% with Baby*Pink. I have done both. I went into NICU as a new grad because I had a definite passion for neonatal ICU. At the time, my plans were to continue to on and become an NNP. Along the way, I decided to pursue the CRNA route and after two years, switched to adult CVICU in order to get the best foundation for CRNA school (my plan is to do neonatal and pediatric anesthesia, so my NICU background definitely laid the foundation for my future).

I have to say that not much carried over from one specialty to the other. Obviously, I had learned to be a nurse in the NICU, so the basic nursing stuff was established, but as far as meds/skills/knowledge of disease processes, nothing was the same. When I left the NICU and went to the CVICU, I started an orientation just like a new grad (thankfully, mine was only 10 weeks instead of 24 weeks because I was an experienced ICU nurse already).

I would emphasize that the NICU is an environment that truly needs nurses that wholeheartedly WANT to be there. I would also guess that without the passion for NICU, few new grads would survive orientation -- you really, really have to want it in order to do it. And, if nothing else, the babies and their families deserve to have nurses with the passion to be there.

NICU is not for everybody...and there is no shame in that at all. But, if I were you, I would pass on the job and find something that you are at least interested in.


Specializes in NICU. Has 8 years experience.

Something else to think about; most orientation programs for NICUs are pretty extensive and it will take you a fair amount of time to feel comfortable caring for your patients. If this isn't going to be something you love, it's not worth the trouble. It also costs a lot to train you and leaving early on tends to be a bit frustrating to management.

Good luck in your decision. Finding jobs as a new grad in some areas seems to be very difficult, so I can understand your hesitation to turn this one down.

helicoptergal, BSN, RN

Specializes in NICU, ER.

First of all I think it is really great that you are putting serious thought into your decision to accept a new position especially in the tight job market. Most people would just take the job :yeah:. I have a long career based in ER and flying on a medical helicopter so I thought I new sort of what I was getting into when I accepted a job in the NICU. I was very passionate about my prior career and I LOVE critical and emergency care. I loved the adrenaline rush of new experiences, it was very satisfying getting a "train wreck" trauma pt from the field through ER to surgery to walk out of the hospital. I loved that the chance of seeing the same thing twice was unlikely and I really like working as a member of the pt care team. That was the good things :wink2: with every dream job came down falls :rolleyes: LOL. Always short staffed, being so busy that being able to provide adequate pt care was difficult sometimes, not being able to treat the emergent pts as human beings because there was so many tasks/tests to do. So after 10 years I decided to switch gears into the NICU after a very dear friend of mine had a baby who was critically ill and spent time in the NICU, I was so amazed by their compassionate pt care at the same time they worked in a very dynamic critical care environment. So I am 6 weeks into my new career as an NICU RN and I really like it, I am not passionate yet but it is coming. I think I need to spend more time and become familiar with a totally new environment and than I will be hook. There is an amazing opportunity in the NICU to have a career that parallels an ER/Critical care environment, and you are allowed to really like your pt and their families and guess what they like you to. You get pooped and vomited on but it is not intentional. You can also become a member of the transport team if you are well experienced! Good luck.

NeoNurseTX, RN

Specializes in NICU Level III.

99.9% of the stuff you learned in nursing school isn't seen in the NICU and pretty much all you'll take from NICU to trauma ICU is time mgt and charting...and maybe a few other things like chest tube management. If you don't want to stay in NICU long term, I wouldn't take the job. Most people I know, including myself, are NICU or nothing else inpatient. If I'm not a NICU bedside nurse, then the only thing I'd want to do nursing related is education or research...in a NICU.

prmenrs, RN

Specializes in NICU, Infection Control. Has 42 years experience.

Adults and neonates are like two different species! Most of your "basic nsg education" is geared towards adult medicine, some programs add a bit of peds, but as far as NICU, they barely throw you a bone.

If you then spend that magic "year in med-surg to get your skills/organization down", you just cement all that grown-up junk in there. Which is why it takes so long for someone coming to NICU after Med-surg/adult ICU to get comfy. In some cases, longer than it would have if they went straight to NICU out of school.

In YOUR case, you're already not so sure it's a good fit, so I think you're very wise to think this over very carefully. Unless this is the only job in town, wait a little longer for what you really want.

Best wishes!!

I just started a thread to the opposite of this a couple of days ago, I went from adult nursing (1 year exp ) to NICU and am having a huge confidence issue. I feel like I know nothing. Other posters on that thread have commented on how long it takes to feel good about where you are at. I think adult nrsg took a lot less time, yet look at all the multiple diseases, MEDS, docs, hospitalists (who know nothing about what's good for my patient unless persisist and are just fillers IMO) and come to a very specialized unit where anything can happen. Jut learning that I do NOT have to watch the monitor cardiac lead waiting for an abnormal rythym to pop up has finally let me rest a bit. So, what I learned in adult probably didn't help me get to NICU a year later. The new grads probably have it easier, they have no hang ups, no prior experiences no other "habits" that may make it easier to make mistakes.... like the 10 cc flush does not get used all the way. It's 0.5 cc. No more IV push, etc. It has made me a bit more nervous as just mixing these special formulas compared to mulitple patients on mulitple gtts/solutions. And I only have 2 criticial babies to care for and I used to have 8 adults spread out and I can still get behind? If you think that NICU isn't for you, leave it for someone else and go for adult. I never regret the last year in it, but it did not give me an advantage. If nothing else you will probably feel fearful of transferring from NIC to adult because it will be all that you will know. Good luck with your decision, but other than peds/m-b/L-D/p-p there isn't much else to do with your NICU experience.

prmenrs, RN

Specializes in NICU, Infection Control. Has 42 years experience.

Before I went to NICU, circa 1971, I spent 2 1/2 yrs in med-surg, CCU, a surgical ICU that took renal transplants and cardiothoracic pts. It took me 6 MONTHS to be able to look @ a kid and know that what I was looking @ was normal or not! I didn't realize how accostomed I was to using my "Gestalt" impression in assessing my pts!

I thought I was going nuts. And they didn't think I needed all "that much" orientation. It was a tough (and SCARY) 6 months.

@ this stage of my "career", ie, one foot in the grave, one on a banana peal, I am an old dog and I only know ONE TRICK: babies.

So, since our census has been so low lately, they want us to float to post-partum---and take care of teh mothers, too!!!!! Lochia, fundi, catheters, oh, my.

:no: :eek: :angryfire :bluecry1: :chair: :redlight: :nono: :smiley_ab :trc:


Florida NICU RN

Specializes in Neonatal.

I've been in our NICU for a little over a year now (and had started as a new grad). Before that, I was a tech on an adult floor. From what I've seen and been through, NICU won't help in the adult world, except for maybe prioritizing. We're very specialized to the point where I would not feel comfortable in the PICU (unless it was a child

Good luck on your decision. If you want to start in the NICU, be aware that it's is specialized and any specialty should be where you want to be for a good period of time...not just to get your foot in the door. You're already having regrets and you should LOVE your job, not be there just because of the money (there are too many nurses out there that do that and we know who they are). They spend a lot of money on training you and it wouldn't be fair to them either if you left.

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