NICU to PICU

[BNE103]

I'm a certified (RNC-NIC) NICU nurse who has worked in the same urban Level III NICU since I graduated nursing school about 3 years ago. I'm strongly considering taking a part-time job in our hospital's PICU to get a broader peds critical care experience but I feel really foreign to PICU in a lot of ways. Any tips or advice on similarities, differences, and general things that might be good to know would be really helpful before I start this journey!

[NotReady4PrimeTime, RN]

You'll find that there are more similarities than differences. One notable difference (other than the size of our patients, of course!) at my hospital is in how we dose our patients with drugs. The NICU likes mcg/kg/hr for Versed, for example, and we like mcg/kg/min. We mix our own infusions so when we transfer a baby back to the NICU post-op CV surgery, they throw out our infusions and mix it their way. NICU runs D10W with 'lytes (NaCl, KCl, +/- CaCl) added where we run D10NS with KCl added if required. Mostly though what we do is no different from what they do. Oh wait... we don't kangaroo intubated babies.

As for advice, this thread offers some... https://allnurses.com/picu-nursing-pediatric/nicu-nurse-making-553945.html

[meanmaryjean, DNP, RN]

There's a greater variety of ILLNESS as opposed to CONDITIONS that you find in NICU. And (this is really strange coming from NICU) your patient can understand you and often talk back. They cry louder, too.

Not sure what type of patient population your PICU handles, but ours is 50% under 1 year of age. You've got the basic skills (vent modes, weight-based drug dosages, assessments) and you'll find the curve challenging but not impossible. The big thing you have in your favor is that you are not afraid of babies. You got this.

[NicuGal, MSN, RN]

When I worked both units, the traumas were the ones that made my hair stand on end! We don't see anything like that in NICU! Lol