Med/Surg to NICU - thinking of making the switch

[MedSurgRN193, BSN, RN]

Hi all,

So I've been working in an acute med/surg setting for just over two years now. Though I feel like there will always be something new to learn in nursing, I have the desire to try out a different specialty - my plan has always been to do 1-2 years of med/surg to get my time management and assessment skills down, as well as to improve upon my critical thinking and leadership skills.

I have always wanted to work in postpartum/public health, as I love health promotion and working with babies. However, I had never considered working in the NICU up until this year...a nursing friend of mine suggested it to me. I'm going to do a shadow shift with her in the NICU she works at next week, so that I can learn more about what NICU nursing entails and if it's right for me. I think that I never considered it as a new grad due to lack of exposure to NICU nursing/feeling inexperienced as a nurse, but now that I have a couple of years of experience under my belt, I feel more open to the idea of pursuing a nursing career in this field.

I guess my main question is for those nurses who have worked or are working in the NICU - what do you like about it? Do you find that it's a better work environment than a med/surg ward? From what I've heard, there is more support, and while it is a high stress environment, and has the potential to be extremely sad/challenging, it is very rewarding and the nurses are better supported than in med/surg. To be honest, working in med/surg right now, I feel that the nurse to patient ratios are so bad that I'm hardly making a difference anymore...not to mention the extremely physical toll it takes on my body. I know there is a lot of standing in the NICU, but I would think it would be better than running around for 12-13 hours each med/surg shift, sometimes with missed breaks?

Any insight and/or advice would be very appreciated! Thanks :)

[Soliloquy, MSN, APRN, NP]

I made the switch. I did Med-surg telemetry for about 2-3 years and then recently entered the NICU. It can be a high stress environment for sure. New admissions always freak me out because I never know what the heck is coming through the door because usually your baby isn't born yet! You just have to prepare. But I can honestly say it's not nearly as physically exhausting as it was on Med-surg. Case in point: after work on med surg, getting out of bed to go to the gym the next day was virtually impossible! Now I can and do. My feet and calves don't hurt as much nor as long and my back doesn't hurt from lifting patients. My stress levels have definitely gone down since working in the NICU. I still have some stress since I just started and I'm learning the ropes and I never want to hurt someone's child but I'm hoping the prework/post work angst goes away with experience and increased knowledge.

Also, family members are no longer a major stressor to me. Here, I like them and welcome them for the most part. I want their involvement and they're more grateful just to have you taking care of their baby. They bring you food, take pics you (or try to), write you more thank you cards. Take your advice more (usually). That makes me feel better. Also, when parents come in, having them check the temp, change diapers and feed their baby is 3 less tasks I have to perform when I'm doing cares and at the same time I'm getting them involved and educating them on how to care for their baby at the same time so that always makes me feel good too.

I like NICU because my patient population is smaller, the diagnoses tend to be more specific (RDS, Prematurity, R.O sepsis is usually why a new born comes in followed by Hyperbilirubinemia and Fluid electrolyte nutrition) and the tasks are a bit more routine. But it's still a very high stress environment, and I always tell people who think the NICU is more of a cake walk that in the NICU you generally get 2 ICU babies max for a reason! You're on a schedule and it's usually time sensitive, babies don't use words to express what's going on so you need to rely on your assessment skills even more so than when you're with adults on med-surg, and babies can take a turn for the worst relatively quickly. I'm not kidding, my first care tends to take a long time but it's because I really want to assess my baby well. Very well. I'm new, I know I can miss things, I don't want it to be because my assessment was lacking when I knew I shouldn't. You get to see the results of everything you do with them. It makes me want to know more and understand the disease process more and I can see how everything is connected. The unit I work on also encourages my curiosity and desire to ask "Why?" in a way that a busy med-surg floor did not have time to explain and I'd have to wing it and figure out on my own many times it seemed like. It's very specialized so it's just awesome to have that focus. Also, it's babies.

Anyways, I hope that helps. I've been in the NICU for almost 4 months now and so I'm enthusiastic about everything. lol Idk how I'll feel 3 months from now, but right now I do like it even though the learning curve is kind of overwhelming and I feel stressed from that but it's more of a new to NICU angst than anything else.

Good luck! Maybe you'll like it :)

[MedSurgRN193, BSN, RN]

Wow, thank you SO much for your post! I appreciate all the info and your personal experiences and insights. So many of the things that you mentioned resonate with me in terms of wanting to make the switch to a more specialized area...I think that I would definitely find it stressful being new and not knowing a lot, but as you mentioned and as I've heard, the NICU is an environment that typically supports critical thinking and education better than a med/surg floor could. And it's nice to know that it's not as physically heavy as med/surg...I had the same issues with the gym after working my shifts, just too exhausted and sore to even get out of bed.

I'm really hoping I like the NICU as much as you do! Thanks again :)