Level 2 or level 3?

Level II (specialty): a hospital special care nursery organized with the personnel and equipment to provide care to infants born at more than 32 weeks' gestation and weighing more than 1500 g who have physiologic immaturity such as apnea of prematurity, inability to maintain body temperature, or inability to take oral feedings; who are moderately ill with problems that are expected to resolve rapidly and are not anticipated to need subspecialty services on an urgent basis; or who are convalescing from intensive care. Level II care is subdivided into 2 categories that are differentiated by those that do not (level IIA) or do (level IIB) have the capability to provide mechanical ventilation for brief durations (less than 24 hours) or continuous positive airway pressure.

Level III (subspecialty): a hospital neonatal intensive care unit (NICU) organized with personnel and equipment to provide continuous life support and comprehensive care for extremely high-risk newborn infants and those with complex and critical illness. Level III is subdivided into 3 levels differentiated by the capability to provide advanced medical and surgical care. Level IIIA units can provide care for infants with birth weight of more than 1000 g and gestational age of more than 28 weeks. Continuous life support can be provided but is limited to conventional mechanical ventilation.

Level IIIB units can provide comprehensive care for extremely low birth weight infants (1000 g birth weight or less and 28 or less weeks' gestation); advanced respiratory care such as high-frequency ventilation and inhaled nitric oxide; prompt and on-site access to a full range of pediatric medical subspecialists; and advanced imaging with interpretation on an urgent basis, including computed tomography, magnetic resonance imaging, and echocardiography and have pediatric surgical specialists and pediatric anesthesiologists on site or at a closely related institution to perform major surgery.

Level IIIC units have the capabilities of a level IIIB neonatal intensive care unit and are located within institutions that can provide extracorporeal membrane oxygenation (ECMO) and surgical repair of serious congenital cardiac malformations that require cardiopulmonary bypass.

I started out in a Level III nursery and learned a lot. I really think it would be wise to start there if you are wanting to do NICU.

I am currently orienting in a Level 2 and 3 unit. I get several weeks in a level 2 then another several weeks in a level 3. I havent started level 3 yet, but at first i was all for going straight into it after i got off orientation. now I am thinking that i should start in level 2, work there for 6mos to a year, then go into level 3. I dont know what to do either. I guess I am just a little worried since many level 3 RN's say that level 3 involves a lot of critical thinking, more so than level 2. I just wanna make sure i get a good foundation in level 2 before working my way up. what do you guys think??:innerconf