New grad in Pedi - then later go into adult?

[fleur-de-lis, BSN, RN]

I am just past halfway through my accelerated BSN program, and within a month or so I have to decide where I want to do my clinical internship over the summer. Many of last year's class ended up hiring on where they interned, so I want to choose wisely.

I just started my Pedi clinical and LOVE it - which actually surprised me a little. Before this, I had thought Oncology or Hospice was my place, now I am thoroughly confused. I have come to the realization that I like working with vulnerable populations - pedi, gero, etc. At this point I am still weighing my options.

My question is this - if I intern in Pedi, then end up hiring on into this field, how hard would it be to go back to adult nursing in the future if I wanted to? I'm not talking about "I don't like this I wanna do something else" - I'm not like that, once I commit I'm going to do it. I mean maybe 5-10 years into my career and I am ready for a change. Would I have trouble going from general Pedi (probably in a Children's hospital), to say, an adult Med/Surg ward or Onco floor. Or is it easier to go from adult to Pedi? Thanks in advance!

[jamonit]

pediatrics is a whole different animal (and specialty). i think most people have a true love/hate relationship with working with sick children. that aside, have you considered trying an extern position in heme/onc on a pediatric ward? if you enjoy kids and you are interested in oncology, this could be a good fit for you.

otherwise, i would say just wait and think on it for a while. you could start in peds and then go to adults--as an RN the limits to areas of practice are ever-growing. me, personally, i choose to dive right into peds--and critical care in the PICU because i don't like working with the elderly and prefer working with kids.

it's something to think about for a while, you have some time to weigh options. talk to people at different hospitals in different areas and see what they have to say about it.

good luck!

[NotReady4PrimeTime, RN]

There are those who will tell you that going from adults to peds is much harder than the reverse. For one thing, normal vitals in adults are pretty much one-size-fits-all, but not in peds. And then there's the whole med calc issue... adults get 1 gram of Ancef for intra-op prophylaxis, but kids get 30 mg per kg. 1 gram of Tylenol vs 15 mg per kg. See what I'm saying? With adults there are fewer developmental issues, there are fewer people to keep in the loop, and they can usually tell you what's wrong, where it hurts, how much it hurts, and so on. It's my opinion that you should do what seems right for you, and if later on that changes, well, you're not blazing any trails there.

[lauron9]

My personal opinion is that all new nurses should have at least 1 year of general med-surg experience before going into a specialty unit. I think it's beneficial to have a good skill base. There are skills and procedures that you will do with adults that you don't necessarily see in children that often.

I've always wanted to do pediatric nursing and nothing but. The pediatrics unit at my hospital took hospital overflow for the first 4 years I worked there, so I was able to take care of both children and adults. Last year, they decided to downsize our unit, and we take kids only. Now our new nurses are worried that they are "losing their skills" they learned in nursing school because they're not using them as much on the kids. Since I took care of both kids and adults for 4 years, I'm comfortable with my skill level for both peds and med-surg. Now that we've been downsized, in the summer, we close a lot if there aren't any sick kids, so the nurses on our unit float to other units. Our newer nurses seem to have a harder time floating to other floors since they aren't used to the adults and having not used skills they learned in nursing school, they've forgotten a lot. I just think that having a least one year in med-surg is good for everyone.