New grad - PCU or ED?

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Hello!

So I just got accepted into a new grad residency program, and I was hired for a PCU floor. My eventual goal is to work NICU, but I obviously know I need some serious training/experience before working with that population. The program also has some openings in the ED for new grads. I feel like I will be able to get some really fantastic skills from PCU that will definitely transition over to a NICU setting, but I'm wondering if ED would be a better place to start. I could ask my recruiter about switching to the ED track. Opinions? My facility doesn't have any peds, but the ED obviously sees a certain amount of pediatric patients.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Moved to the Emergency Nursing forum for more responses.

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

If you ultimately want to end up in an inpatient setting in the NICU, you might want to stay on the inpatient side and stick with the PCU. The ED environment is vastly different, in general. Good luck, whichever you pick!

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Thank you for your opinion. I am leaning towards staying PCU, I am just a bit worried about getting stuck in adult nursing and being unable to make that transition.

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.
Thank you for your opinion. I am leaning towards staying PCU, I am just a bit worried about getting stuck in adult nursing and being unable to make that transition.

Is there a peds ED anywhere near you? That may be a good transition: ED with peds, to peds ED, to PICU, to NICU? Or just peds ED to NICU? Kind of depends where you are. But if you get comfortable with peds emergencies, that might be helpful to your trajectory. I can tell you that in my experience (and again, it really depends on what facilities are available in your area), the sicker kids tend to go to the dedicated peds EDs whereas what shows up in the all-ages EDs is typically "well child checks" (they aren't really sick, just very concerned parents) and kids with fevers, with a few random sickies and traumas thrown in, plus your usual kids sports injuries.

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Is there a peds ED anywhere near you? That may be a good transition: ED with peds, to peds ED, to PICU, to NICU? Or just peds ED to NICU? Kind of depends where you are. But if you get comfortable with peds emergencies, that might be helpful to your trajectory. I can tell you that in my experience (and again, it really depends on what facilities are available in your area), the sicker kids tend to go to the dedicated peds EDs whereas what shows up in the all-ages EDs is typically "well child checks" (they aren't really sick, just very concerned parents) and kids with fevers, with a few random sickies and traumas thrown in, plus your usual kids sports injuries.

There is a hospital that does peds nearby (including L&D and NICU), but it's with a different hospital system. I applied but never got any interviews. I'm in the StaRN program with HCA, and I signed a contract to stay with this floor (the PCU) for 2 years. I imagine that I could probably manage to switch hospitals/floors as long as I stayed with HCA, but the nearest hospital with peds or NICU is about an 1.5 hours north. I took the new grad position, figuring experience is better than waiting for my dream job to come around.

I was thinking maybe stay at the PCU for 6 months, get comfortable in my role as a nurse, and then start sending applications to the hospital with NICU nearby and see what happens. If I manage to secure a job on a pediatric floor, I'll pay the money back for the training, and take that opportunity. I wouldn't want to burn that bridge, but I got into nursing to do NICU. Does that sound okay?

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

I would be wary of burning a bridge or making yourself possibly ineligible for rehire by such a large hospital system. I know someone who got around the contract issue by staying PRN, but that would be subject to the terms of your contract. I am not a fan of breaking commitments — even if you pay back the balance of the contract, they have invested far more in your training. It's a lot to consider. Good luck!!

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I would be wary of burning a bridge or making yourself possibly ineligible for rehire by such a large hospital system. I know someone who got around the contract issue by staying PRN, but that would be subject to the terms of your contract. I am not a fan of breaking commitments — even if you pay back the balance of the contract, they have invested far more in your training. It's a lot to consider. Good luck!!

I will have to look back and read through the contract more closely - I like the idea of staying PRN to avoid leaving on poor terms. Thank you for your input. I got this job very suddenly (interviewed on a Friday and offered the position an hour later and had to accept that day since it was the last day for decision). I had been searching for a job for over 2 months at that point, so accepted it and figured I would make the rest work. I will probably just have to wait until I get on the unit and see how it is. I know 2 years will fly by. I am just worried I won't like PCU (I was never a fan of med-surg, not big on adult ICU either), and that working with adults for 2 years will make it hard to break into peds/NICU.

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Specializes in ED, Cardiac-step down, tele, med surg.

Be careful about burning bridges. Do read your contract more carefully. You will get great experience by staying 2 years if that's what you decide.

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Be careful about burning bridges. Do read your contract more carefully. You will get great experience by staying 2 years if that's what you decide.

Yeah, I don't think it would be worth the risk of making myself ineligible for hire - I didn't even think of that so I'm grateful someone mentioned that. I just hope that I can break into something with babies after working this unit. I imagine pediatric cardiac ICU wouldn't be a bad transition, but I don't think there are a lot of units like that.

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Specializes in critical care.

If you don't like adult inpatient care, you will hate PCU. However, remember you've been exposed as a student. You might feel differently with a bit more autonomy. I know I did, and I was going to be the best CNM the world had ever seen. :) I'm a PCU nurse, now.

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Specializes in School Nursing.

Is there any particular reason why you can't start in NICU? I did as a new grad as part of a residency program. My only experience was 8 months in pediatric home care.

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