NICU managers - what do you prefer?

Nori.Giselle · Mar 30, 2016

I'm not a nurse manager but I think the well baby would look good simply because Adult ICU is a completely different ball game compared to NICU. Good luck and keep applying to NICU positions. Some managers will hire a RN with different experience. Maybe you should apply anyway and see what happens.

adventure_rn, MSN, NP · Mar 31, 2016

I'm a NICU nurse, and asked many managers this same question when I first started began applying to NICU jobs.

Unfortunately, the answer depends on the manager. In my city, one NICU manager said she preferred ICU/ED experience, another said she preferred mother-baby experience, and a third said she'd prefer peds experience; often the answer depended whether the NICU was part of the OB or Peds service line. Some would prefer to hire a newborn nursery RN from an outside facility, while others would prefer to hire an internal candidate from a non-newborn specialty.

On my current unit, we hire both former newborn nurses and former adult ICU nurses, and they all bring awesome things to the table. Nursery nurses will have great 'well baby' assessment skills, so it's easier for them to spot abnormalities in sick kids; however, some people can find the nursery a little boring. Adult ICU nurses have an intimate knowledge of drips and ventilation so they aren't intimidated by neonatal critical care; however, adult ICU has a steep learning curve, and NICU has its own brand new steep learning curve.

If you're trying to get into the NICU at the same facility where you've got job offers, there is one huge benefit to working in the nursery: you can probably get cross-trained in NICU and be floated to NICU. We have mother-baby and nursery nurses float to our unit all of the time (often against their will); they get our low-acuity feeder-growers and our drug withdrawal kids. If you volunteer to get cross-trained and float, your manager may see it as taking initiative in a positive way. That would be a great way to transition into your facility's NICU. Even if you want to work in a NICU at a different facility, when you apply you can point to your NICU float experience as a unique strength.

Obviously, you should try to consider which job you'd prefer (since you'll likely be doing it for at least a year). Nursery can be a little bit tedious (and at times, kinda boring), whereas ICU can be very high stress.

Best of luck!!

nursealisha, BSN, RN · Mar 31, 2016

Thank you both for your responses.. That's why I'm having such a hard time deciding! Adults and babies are completely different.

Unfortunately the NICU, ICU and nursery positions are at 3 different hospitals! I did apply to the NICU and was told she's only looking for experienced candidates. I have an interview with that hospital's ICU tomorrow and plan to stop by the NICU and get her input on the dilemma.

My only concern with the nursery position is the unit is only about 13 beds, so it's super small and I'm worried will be super slow. The manager did say there's an opportunity to float to post-partum and get that experience as well.. However, I'm afraid to let this ICU offer slip away. I've applied so many times in the past and finally got the chance at an interview. I just have a lot to consider... Thanks again!

RN_jess · Apr 11, 2016

I am not a NICU nurse manager either but just recently transitioned from the adult critical care world to NICU. Based on my experiences, I would suggest taking the position in the well baby nursery simply because you will start to learn what a healthy, "normal" baby looks like. When you get to the NICU, you will start to see the "sick" babies. Having a background in normal newborns would probably help you more than a background in adult ICU. When I became interested in NICU, I started taking any and all classes offered through the hospital. I kept my adult critical care job through this process but the manager was happy to see that I took the initiative to get certifications. Perhaps you could work on getting NRP/STABLE certified during the slow nights in the well baby nursery. It is a HUGE learning curve going from adults to neonates and the ICU would have few similarities. In my short time in the NICU, I've realized just how different the neonatal world is compared to adult nursing. Time management, diagnoses, medications, etc are all very different and I think the exposure in the well baby nursery would be way more beneficial for your career. Just my two cents but good luck!! I have never been happier than I am at work in the NICU. Our babies are special, special people.