NICU vs. Peds

[nperks]

Hi Everyone - I'm a new grad BSN and have two job offers at two different hospitals. One is a NICU position and the other is peds, both night shift. The distance to the hospitals is about the same, and both are highly ranked on a national level. I'm really struggling with which route to go - I'm equally excited about both opportunities. My only hesitation with NICU is that I'm afraid I'll become unfamiliar with general medications and lose some basic nursing skills I've yet to perfect. I think I could love the NICU, but it's not something I always thought I was going to do. With peds, I know I won't get the same level of critical care experience as in the NICU, but it would be an easier transition (I actually already work at this hospital as a CNA and am familiar with the documentation, etc.) and I would see a lot of varied cases. Any insight would be much appreciated!

[NicuGal, MSN, RN]

We don't get cross trained but float to peds areas. If you want specialized, go NICU. If you want a broader spectrum, go PICU. Keep in mind most places won't let you transfer for one year.

I've worked both. I oriented to PICU to do overtime many years ago. I liked the change and the different knowledge base, but those older kids broke my heart in a million pieces. I just recently started working up in peds again for extra time and I do miss having the little older kids who talk with you.

[lorichka6]

I'm a peds float pool nurse. New grad (last May - wow, I'm not really new anymore... ). I have been working gen peds since graduation but just started orientation in the NICU. Now take this with a grain of salt because change is always hard so I'm a little nostalgic for patients who can talk to me... go with gen peds.

You will learn a lot of acute care skills in NICU. But they will be soooo specialized. NICU babies usually have one of just a few diagnoses - they need to grow, they have bad lungs b/c of prematurity, they have a bad heart b/c of prematurity. That probably gets you 80% of the NICU population. The skills you will learn will help on a gen peds floor but when you are faced with a patient you can't hold in one hand it is A LOT different. However, on a gen peds floors you will get days-old kiddos from time to time and you'll get 18 year olds. You'll see ortho, pulmonary, infectious disease, neuro, psych (maybe?), surgical, GI, oncology... you may never be an expert in all of these things but you'll gain exposure. If you get the 4 day old who was admitted for bili lights and you just love dealing with that little peanut... in a year or two get yourself a NICU job. Or PICU. Because after peds you can do either - but playing with the big kids after NICU... I'm not sure how applicable your skill set will be. Your critical care skill set will certainly be very marketable but you will have had very little experience with the age groups and variety of problems they are hospitalized for.

And the other thing I've noticed is that NICU nurses LOVE babies. Like love love love love babies. They are crazy for babies in a way I don't really think I've seen peds nurses crazy for kids... so if you aren't pushing mom's out of the way to baby talk to their little ones on the street... go peds :)

[kmac315]

I have done NICU for 31 years. Get the general peds experience first! There is so much to learn about organizing and doing general care that you will not get in an NICU. I am so glad,although I didn't want to,they made me have a year on a med-surg floor. I am so glad I did it but I would be VERY hard pressed to be able to do anything but NICU at this point. Always keep your med-surg or other area open for yourself!

[sergel02, BSN]

This is something I struggle with myself. Difference being I still need to go through my rotations. From what I heard, PICU or peds is better for general experience unless you ABSOLUTELY want NICU (many nicu nurses went into nursing for that). There is also the loss of some general skills. I know one NICU nurse who told me that if an adult or teen went down at the store or something, all she would know to do is call 911, since she doesn't really use ACLS or PALS in the NICU. A PICU nurse told me that he gets to see some of the babies like some nicu nurses do, but also kids and teens, so a bit more variety in ages, diagnoses, and treatments.

Still, the technology is fascinating in NICU, along with the continuity of care.