NICU to PICU

SteveNNP, MSN, NP · Aug 24, 2006

Hi!

I am also a NICU nurse who just transferred to the ER FT, but still working PRN in NICU. while in NICU I also had a desire to try PICU, so I emailed the NM of the PICU asking if I could orient and work on an as-neede basis. Since then I have worked quite a few shifts there, and it is very different from NICU. Your pts are all ages and sizes, get a whole world of meds you never use in NICU, have an entirely different assessment/code process, and you have to learn to actually interact with your patient on a developmentally appropriate level, eg a 5y/o or a 15 y/o. You depart from the typical "RDS" "Sepsis" "PPHN" etc dx of NICU and see almost anything, such as sickle cell crisis, DKA, trauma, Toxic Shock Syndrome, seizures, encephalitis/meningitis, etc. A whole new world, scary but challenging. In NICU you have to wait a while to see results, but in PICU you get to see a child go from comatose/sick as snot to awake and watching shrek with you. They have a life to go back to that NICU babies are just beginning. SO .....after all that rambling, YES it's very different, I don't necessarily like it better than NICU, but it breaks the monotony that I feel in the NICU sometimes.

NiteRocker · Aug 29, 2006

So, Steve, do you feel safe practicing in PICU with all these unfamiliar variables? Is the unit helpful in assigning age appropriate kids? Are you self-motivated to independantly learn what's needed in all areas?

Honestly, just seeking my own comfort level. My unit has hired 10 or so new RN's. Any extra time will soon be drastically less in my unit, except for the multiple RN's that are going out on maternity leave. (short term problem)

kate1114 · Aug 31, 2006

I moved from NICU to PICU for a full-time position and found it to be a mostly positive experience. It was a VERY busy PICU and I made the switch in early summer, so I was able to tag onto a new grad orientation and attend many classes. I think this made a huge difference. I would say go for it, and negotiate a good orientation.

Since you have 2 children, you will have a leg up on development. Also, being the NICU person, there's a good chance that you'll be given the babies. I wound up taking care of some infants who were receiving VP shunts and found a lot of opportunities to share knowledge about developmental care.

Good luck whatever you decide!

BittyBabyGrower, MSN, RN · Sep 2, 2006

I moonlight in PICU when they are short. I had a quick orientation and then took PALS. They usually gave me smaller kids as I was a NICU nurse, but I learned alot about some of the traumas and such. They were awesome about teaching me stuff! We have PICU nurses that moonlight in our unit also.

Pediatric Critical Care Columnist · Sep 3, 2006

We have a number of permanent positions in what we call the NICU-PICU pool. Nurses work in either place depending on the census and acuity level in each. They aren't given any special consideration when it comes to patient assignments.(If we get a float from NICU who isn't in the pool they will be given a baby. Lord knows we always have a bunch of 'em.) Most of them really enjoy the variety and find that it allows them to remain separate from the politics in both units.

Some nurses really have a problem looking after kids the ages of their own. They project a bit and have trouble keeping it from affecting their work. I personally don't have a problem with it and didn't expect that I would. You know yourself... will it cause you grief? Then don't do it.

I tried neonatal for two years and really wasn't happy. I like to interact with my patients, and I love kids, so PICU is a great fit. Ask for an orientation. You'll know soon enough it's gonna be a go.