NICU vs. Peds Med-Surg/Step-down

megatronRN · Oct 22, 2015

Hi!

I am currently working in the NICU. I love it, but it is extremely unit specific and I couldn't see easily transitioning into PICU. As a level III NICU, the main diagnosis you work with is prematurity. Neonates are a different beast all their own. If you're serious about PICU, I'd think Peds Med-Surg would give you much better experience. You'd see more diagnoses and work with different ages. I'd go that route. That's my two cents :)

nurse-samie · Oct 22, 2015

Thank you so much! i have finally received the answer i was looking for :up:

bc i have no experience in peds i was totally lost! you have set my mind at ease!

having the option of what floor to go to was also driving me crazy bc i did not know what to do

again thank you!!! :yes:

llg, PhD, RN · Oct 22, 2015

I totally agree. NICU is great if you love NICU ... but it doesn't prepare you for much else. The preemie physiology is so very different from anything else, it's not a great stepping stone to other ICU's. If your ultimate goal is PICU, do peds. A peds step-down unit or general med/surg unit is great preparation for PICU.

Pediatric Critical Care Columnist · Oct 23, 2015

I echo what meanmaryjean and llg have said. If your hospital is anything like mine, the kids on the med-surg units and the step-down patients are still pretty sick. Our step-down includes trach-vent kids, kids with EVDs, kids with ventricular assist devices and a lot of other patients who would be in PICU at other facilities. The other up-sides are getting used to communicating with kids, involving family in the plan of care (much more than with adults) and learning the new math - med doses are usually weight-based... you could be giving a small infant 50 mg of Tylenol or 100 mg of Ancef. The shift to pediatric critical care from that would be easier than from NICU.

nurse-samie · Oct 23, 2015

thank you all so much!

I wish i knew more about what type of pt. population the floor that I will be going to has. My hospital is on a different campus then where the children's hospital is and my current hospital does not have a peds floor. all I was told is that they do get children with resp issues, and kids that come out of the PICU and post op.

the nicu is a level 3 nursery so they do preform ECMO and have very sick babies. which i thought would give me the ICU experience that would help me transition to PICU, I only thought this bc when i did shadow in the PICU there were 2 babies post open heart surgery and i remember one was only 17 days old.

but i will deff. be taking your advice and going to the step down/med surg floor bc i only have adult exp. and i've only been a nurse for 1 1/2 years and those peds assessments skills im sure will help me in the PICU when im able to transition over.

you all have set my mind at ease. i have been going back and forth on pros and cons to each and i've been going crazy hoping that i make the correct choice. and i know no one thats in the peds field that could give me some insight on which would be the better floor for me in my situation

again, i can not thank you enough for taking the time out of your day to respond to my post! :shy:

littlepeopleRNICU · Oct 23, 2015

I work in a level 3 that performs ECMO and am on our ECMO team...you're right. It's great experience. However, if you really see yourself wanting to go to PICU, go with the peds med surg/stepdown. As a whole, you will learn a lot more in regards to pediatrics as a specialty more than you will if you narrow it down so much as to focus on only the NICU population. Learn general kids of all ages, and then the ICU stuff can be learned later when you get to PICU.

nktxo · Oct 24, 2015

When I was reading your post, I actually thought I was the one who wrote this. A little crazy but I actually worked in adult neuro until I had the opportunity to work in both a NICU and PICU. I eventually chose NICU because it was ultimately the patient population I've wanted to work with. It is very specialize so I agree with the posters above for you to work in peds until a fellowship in the PICU is available. Unless you would like to wait until a PICU position is available, that's always an option :)

sergel02, BSN · Dec 5, 2015

This seems to be the sentiment I here from everyone. If PICU is your goal, go peds, since it'll prepare you better. Interestingly enough, a lot of the folks I know that want to do NICU actually DON'T want to work on pediatric floors. They like babies, but not kids, and believe that NICU prepare you for NICU, but not a ton else. I mean the experience is great, but if you have the option for a peds floor, I'd take it.

littlepeopleRNICU · Dec 7, 2015

This seems to be the sentiment I here from everyone. If PICU is your goal, go peds, since it'll prepare you better. Interestingly enough, a lot of the folks I know that want to do NICU actually DON'T want to work on pediatric floors. They like babies, but not kids, and believe that NICU prepare you for NICU, but not a ton else. I mean the experience is great, but if you have the option for a peds floor, I'd take it.

Yes. I do have a PRN pediatric home health job and that's okay, but idk if I could do inpatient peds. I haven't before, and used to think that's what I wanted, but now even just when I go to Children's to stick a kid they couldn't get a line on, it breaks my heart!

So I echo my first response...if you know you want PICU, go with peds floor, for sure!