NICU or Med-Surg

[Enurse1234]

Hello everyone, I'm seeking seeking career advice and hopefully I can make a decision. I was presented with two options a position on a Med-Surg unit and a position on a NICU unit. Both positions are at different hospitals and the hospital that offered the NICU unit has a better reputation and name compared to the other. I currently work in a post-acute/ acute setting and have been doing it for a year now. I love what I currently do, but because there is no room for growth, I made the decision to move on elsewhere. I'm stuck between NICU and med-surg, I have never dealt with neonates/babies but I'm willing to experience it before declining. As a new nurse I want to experience different areas before I say that's not something I love. Since I've been in a sort of med-surg unit for a year, I started loving it, however, since it's not a hospital setting, the shifts would become repetitive. I'm seeking advice and opinions which would be a better option in the long run, which would you choose, and if your currently in that speciality, what makes you love it/hate it. Thanks!

[brownbook]

I'm not sure what a post acute/ acute care setting is? It sounds like med/surg. If so, you know what med/surg nursing is like.

Generally speaking acute care med/surg nursing in a hospital setting exposes you to a wide variety of experiences and patients, while NICU only exposes you to newborn infants.

VERY generally speaking, (this doesn't apply to every nurse who's ever worked ), it's easier to transition to other areas of nursing with a hospital setting med/surg background than a NICU background.

The "better reputation and name" is meaningless. The staff morale, friendliness of the charge or head nurse and orientation that is offered are more important.

[NICU Guy, BSN, RN]

Don't go into NICU unless you love babies because once you do NICU for a while, you lose your big people skills. It will make it difficult to transition back to Adult world.

[Nurse SMS, MSN, RN]

What are your long-term goals? Most people who go into NICU REALLY want to go to NICU and usually are very focused about that. If you are wanting to be a CRNA, then NICU isn't going to get you there. If you want to work on itty bitty babies, a dream job just dropped in your lap, but only a dream job if that's where you really want to be. As a previous poster mentioned, once you go babies, it can be difficult to do anything else. However, if babies are your passion, that won't really matter to you.

[RNperdiem, RN]

Why not shadow on both units to get a feel of the culture of the places. Observe the interactions of staff with each other. Do they help each other? Do you feel like you would fit in? Does anyone go to lunch?

In many ways, happiness at work as a lot to do with how you are treated, what kind of schedule you get, and how much freedom you have rather than patient population.

[turtlesRcool]

Since most patients in acute settings are adults, there are usually more jobs available caring for them. With fewer available NICU positions, competition to get into them can be fierce for those who want to focus on neonates.

But, once you get into that specialty, it can be hard to go elsewhere. The skills you learn in NICU are very specific to delicate and sick newborns. You will not be looking at the same disease processes you'd see in the adult population.

Also, any pediatric position is going to involve navigating family dynamics far more than if your patients are adults. Some of your NICU patients will be feeders/growers who graduate and go home as healthy babies, but others will be seriously ill, and some will die. Death of a patient is never easy, but I think it hits particularly hard when you're dealing with a newborn and his/her grieving parents. I hate losing geriatric patients, too, but there is a comfort in knowing that they lived full lives. This is entirely my own opinion, but from an emotional standpoint, I don't think I could handle the bad outcomes in NICU nursing.

I could be wrong, but I feel like if you have to ask the question NICU vs Med-surg, then you are not one of the people who is passionately drawn to NICU, and you'd probably be better off taking the Med-surg offer.

[Luckyyou, BSN, RN]

I made the NICU to adult ICU switch. IV skills are a lot different. That’s the extent of the “big people skills” I felt I was at a disadvantage in. Otherwise, sure, there were new things to learn, but isn’t that the point of switching specialties? To learn something new?

[AlwaysLearning247, BSN]

It really depends on the patient population you want. Some people love med-surg and some people only want NICU. To be in the NICU, you need to really have a desire to work with critically ill babies and their families. I can imagine that job can be very draining on someone, especially if they’re not sure they want to do it.

In med-surg you’ll have a wide variety of adult patients and see so much as well. You could have an 18 year old patient and an 100 year old patient in your assignment. I’d say go with med-surg if you prefer taking care of adults. Med-surg is the gateway into other specialties such as the ER, ICU, step-down floors, etc. Not saying you wouldn’t be able to work within the adult population later if you choose the NICU though!

You’ll get great experience in either field, good luck!!

[ThePrincessBride, MSN, RN, NP]

I do both. Started in med-surg, went contingent when I got a full-time position in a level III NICU and now I am back full-time adult world and work contingent as a NICU RN.

I initially thought about becoming a NNP but then decided against it for various reasons and now I am going for FNP. The thing about NICU is that it is very limiting. If you want to go back for something other than NNP you will be struggling in school because the vast majority of programs are adult- entered.

That being said, I love the NICU and plan to stay contingent even after I graduate and work as an FNP.