New grad...ER or NICU?

LoveMyBugs, BSN, CNA, RN · Mar 22, 2011

Congrats on getting interviews in specialty areas! Go to both interviews try for both and if they both offer you a job...then you will have a choice to make

linearthinker, DNP, RN · Mar 22, 2011

I think you will get better exp and open up better opportunities for the future w/ the ED job. We regularily got apps from NICU nurses, and we never even considered them. As far as we were concerned, NICU or peds ICU might as well have been new grad, b/c it just wasn't applicable to adult critical care or most of what we did in the ED. Even L&D exp was preferred over peds or nicu. However, the big caveat is, do you prefer neonates? If you do, then I'd take that position b/c you could just stay there forever and be perfectly happy. If you are looking for a stepping stone to something else I think it will be too highly specialized to be of much use. good luck.

hiddencatRN, BSN, RN · Mar 22, 2011

I vote ER but I'm biased NICU is so, so specialized, but with the ER you get a really wide variety of patients in terms of acuity.

dthfytr, ADN, LPN, RN, EMT-B, EMT-I · Mar 22, 2011

Congrats, you're on your way. I wish I could remember who made the observation, but the best way to tell where you should work is based on your personality type. OCD = ICU/NICU ADD = ER

Old.Timer · Mar 22, 2011

I think you will get better exp and open up better opportunities for the future w/ the ED job. We regularily got apps from NICU nurses, and we never even considered them. As far as we were concerned, NICU or peds ICU might as well have been new grad, b/c it just wasn't applicable to adult critical care or most of what we did in the ED. Even L&D exp was preferred over peds or nicu. However, the big caveat is, do you prefer neonates? If you do, then I'd take that position b/c you could just stay there forever and be perfectly happy. If you are looking for a stepping stone to something else I think it will be too highly specialized to be of much use. good luck.

Agree with every comment made. My sentiments exactly.

DarkBluePhoenix · Mar 23, 2011

Congrats on getting a job in your choosen specialities being a new grad in this economy!

AntMarchingRN, RN · Mar 23, 2011

I would go ED...I am also biased, but the points made above make a lot of sense. As a new grad, ED gives you a chance to go anywhere if you find out its not for you, where as NICU somewhat limits your choices.

I would just make one suggestion...if you do go ED, drop calling it "emerge".

Its just odd. Fitting in the ED is a huge part of making it work.

Good luck in whatever you choose!

Bobbkat · Mar 23, 2011

If you are offered both, but aren't completely sure that you want to stick to NICU, I'd take the ED. I'm in the NICU, and while I love, love it, I realize that one day if I want to switch departments, it will be harder than if I was coming from a different area. As everyone has mentioned, NICU is super, super specialized. If I want to move to a totally different area, it would probably be easiest for me to transfer to L&D, and after a while from there to another area so I would at least get a broader experience base. Two steps, instead of one. Keep that in mind when deciding.

helicoptergal, BSN, RN · Mar 23, 2011

This is a great dilemma that you are in, both great opportunities many people would give anything for. Kudo's to you!! I am a long time Paramedic new RN who went to NICU to learn to be a nurse since I work in an area where everyone in the ER's would know me as a Paramedic and not a nurse. I love the NICU. I think all the comments are totally applicable and worth considering. My 2 cents is definitely evaluate who you want to be, do you see yourself in ICU or ER, and NICU is highly specialized and not applicable to many areas. I am so glad I started in NICU and here is why. I learned time management, prioritization, delegation. And I honed my assessment skills and the ability to look at labs and know when to be concerned or not. I can pull up an xray and look at my ETT position, and position of central lines, and can alert the md if something is malpositioned, or looks concerning. Now I know the assessment is different in a neonate, but labs are somewhat universal: If your lytes are different that is concerning, if you have a shifted CBC that is concerning. I also learned to work complex social issues in an environment that is not as busy as the ER. All in all I feel more prepared to go to the ER. If I ever go back to the ER I know I will have a lot to learn, but I am glad I learned some very important lessons along the way.

Shanlee79 · Mar 23, 2011

I think you will get better exp and open up better opportunities for the future w/ the ED job. We regularily got apps from NICU nurses, and we never even considered them. As far as we were concerned, NICU or peds ICU might as well have been new grad, b/c it just wasn't applicable to adult critical care or most of what we did in the ED. Even L&D exp was preferred over peds or nicu. However, the big caveat is, do you prefer neonates? If you do, then I'd take that position b/c you could just stay there forever and be perfectly happy. If you are looking for a stepping stone to something else I think it will be too highly specialized to be of much use. good luck.

Thank-you for your insight! I'm really not sure if I prefer neonates yet. I know that it has been an interesting and enjoyable learning experience and I have been facinated by many aspects but I have always worked with adults and sort of miss that relationship too. I have never been someone wanting to stay somewhere forever and seeing that majority of the unit is comprised of such is daunting at times. My preceptor has reassurred me that this isn't always the case and that many get accepted into the critical care course that's offered by the hospital and this leads to other doors being opened. Definately gave me food for thought. Thanks.

Shanlee79 · Mar 23, 2011

This is a great dilemma that you are in, both great opportunities many people would give anything for. Kudo's to you!! I am a long time Paramedic new RN who went to NICU to learn to be a nurse since I work in an area where everyone in the ER's would know me as a Paramedic and not a nurse. I love the NICU. I think all the comments are totally applicable and worth considering. My 2 cents is definitely evaluate who you want to be, do you see yourself in ICU or ER, and NICU is highly specialized and not applicable to many areas. I am so glad I started in NICU and here is why. I learned time management, prioritization, delegation. And I honed my assessment skills and the ability to look at labs and know when to be concerned or not. I can pull up an xray and look at my ETT position, and position of central lines, and can alert the md if something is malpositioned, or looks concerning. Now I know the assessment is different in a neonate, but labs are somewhat universal: If your lytes are different that is concerning, if you have a shifted CBC that is concerning. I also learned to work complex social issues in an environment that is not as busy as the ER. All in all I feel more prepared to go to the ER. If I ever go back to the ER I know I will have a lot to learn, but I am glad I learned some very important lessons along the way.

Your reasons for picking NICU mirror my reasons when deciding what skills I wanted to develop for my final practicum. These are areas I had not yet developed in school and I feel that I had great exposure with this and am grateful that I had this learning opportunity. I definately found the unique social issues challenging at first but I enjoy tackling these unique challenges now as well and have had great opportunities along the way building relationships and teaching that I had not yet experienced. Food for thought as well. Thanks!