ICU to NICU

NICU_Nurse, BSN, RN · Jun 4, 2003

Well, let's see. I think that the critical care experience (or at least, the EXPOSURE to the critical care unit and its goings-on) will definitely give you a tiny boost; you'll know more regarding what to expect, the dynamics of a critical floor vs. a non-critical floor, etc.

On our units, we use basically the same vents, etc. that are used on the adult floors; they are just set differently to be appropriate for the babies. Our RT's work on both the adult and neonatal units (they float, but we do have a "core" staff of about four that always get placed in NICU), so the differences can't possibly be that vast (although I'm not an RT!) as far as basic equipment, etc. is concerned.

We use traditional vents, oscillator vents, nitrous oxide for the babies. We have trachs (these are exactly the same care-wise as the adults, as far as I know). We have Peg's, use the same Jelco catheters for IV's, have OG/NG/NJ tubes, etc. just like the adult units (just smaller, or perhaps a different brand, but care is virtually the same). We have the same monitors but different pulse oximeters than our adult units (at my hospital; may be diff for you). Then there are pieces of equipment that are COMPLETELY different than the adults- like bili lights (crap...I'm tired...having trouble thinking of things to list today! Forgive me!).

On top of all the similarities, there are some very distinct differences in diagnoses, treatments, allowable values, etc., but at the same time, metabolic acidosis is acidosis in babies AND adults, know what I mean? The organs are still the same, but sometimes symptoms may be different, or occur in a different order, or not happen altogether. Meds are pretty different, and are in nearly microscopic amounts sometimes. However, we still use Versed, Morphine, Ativan, Heparin, Insulin, Dopamine, Dobutamine, etc. Is that making sense? (Sorry; I'm REALLY tired!) Different. Same. Complicated!

Are you considering teching on an adult ICU? You said you weren't a nurse yet; I'm guessing here. I think that if a position in the NICU isn't available, and they have nothing in the well-baby nursery or mother-baby (which, IMO, are a TEENSY bit more applicable than an adult ICU), here are some other suggestions. Have you considered working in a Children's hospital or Pediatric ward? Frequently kids who end up in those places were preemies, or have a history stemming from birth, and you can still learn very valuable things there. Well Baby nursery is great (as is Mother Baby) because when you're in the NICU, you're still handling things like feeding, changing diapers, restocking things or knowing what type of equipment is used, and lots of parent teaching (newborn care, breastfeeding, infant safety, etc.).

If the only job available to you is on an adult ICU, I say grab it and enjoy! Learn as much as you can. You may love working with adults and never want to leave. :) At the very least, you'll learn about normal vs. abnormal conditions, equipment that you may be seeing, rationales for interventions, etc. I always say that no experience is bad experience. You can always take away something valuable.

Hope that helps a little! Yawn!!!

NICU_Nurse, BSN, RN · Jun 4, 2003

Durrrr...I said I was tired, didn't I? I just re-read; you're working there now. Forgive, forgive! Sorry!

kookyscientist · Jun 5, 2003

Thanks Kristi for the reply. I guess I just feel overwhelmed with everything I'm learning right now...sooo much information, and I know in my heart that I'll wind up working with children when I'm through with school. So I wanted reassurance I wasn't wasting my time. I can't work in Mother/Baby or peds until my last semester of school unless I go to Childrens Hospital but that would be a $4.00 pay cut I just can't afford to take right now. Everytime I'm pulled to Mother Baby I love it so much. Adult ICU is exciting and I think it is amazing what the nurses do for the patients. I'm sure it is equally great in NICU plus maybe a little more rewarding to know when you help them they usually have a whole life to live as opposed to ICU where you help an 76 yr old end stage renal ,or whatever, live for another few months or a few years. Anyway, thanks again and if you think of anything other NICU specific equiptment or info let me know.

fergus51 · Jun 5, 2003

Heck, it can't hurt! I got hired into NICU with OB experience (which was helpful in certain aspects), but I definitely think you would have an edge coming in with the technical experience and ICU offers, not to mention the fact that you will have developped excellent communication skills dealing with family members of the critically ill. Motherbaby is great for learning about what normal looks like in infants, as well as breastfeeding and communication experience, but I certainly don't think it prepared me to work with sick babies without a lot of extra training. I am finding there is a TON for me to learn, but I like the area. Good luck.

Mira · Jun 8, 2003

Some facts about NICU:

the mistakes of my colleagues who come from ICU are only based on forgetting that they r dealing w smaller human beings but as soon as they realize-they`re ok.pressure limits on pumps are really important,always expect resistance when changing trachy dressing,they hate it.u don`t need 1cc blood just to check gases a third of the capillary tube would be enough.O2 is toxic at higher level.the effectivity of vents/osci depend on how skilled you are on handling this machine.u don`t see thora tube on a baby for a long time compared to adult.baby`s poo is more pleasant,expect rota virus if it is foul smelling except with other formula fed babies&if it smell like an adult`s it`s time for them to be moved to PICU.there are only few contagious disease in the NICU,a deadly RSV can be just colds in adult.Some parents may become unpleasant once they feel they are not in control of the situation,some are just plain rude and ungrateful.