NICU vs. Adult Step-down

  1. So, for 6 months I've worked med/surg/tele at a medium-sized hospital. This is my first hospital job. I worked peds home health for a few years before the hospital, and still work it prn. I'm hating med/surg.. I handle the workload well and enjoy the work of nursing but I'm just not happy working this floor when other floors in the hospital are much more employee-friendly. I'm tired of being so walked-on by patients and employees and being around so many people who hate their jobs..

    So any advice on the pros of these floors? I get excited when I think of working NICU, working with more intense problems in a population of sweet little patients. Or, there is the stepdown unit where I could get more experience with adults. I think I could technically handle either unit but idk where I would be happier.
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    About MJPN2012, BSN, RN

    Joined: Jul '13; Posts: 32; Likes: 14


  3. by   jrt4
    I think that's a difficult question to answer as there are so many things that should be factored in your decision but Ill try to offer some advice.

    -NICU is different from everything else...including a PICU. NICU handles pretty much a set number of conditions/surgeries just due to the nature of the business. There isn't much variety and the patients can be very challenging.
    -Adult Step Down...I have no idea. I would imagine working with this population would be similar to what you are doing now but the patients are just a little sicker.

    What I am hearing mostly from your post is that you are unhappy with the environment and culture on your unit. If you are interested in working in the same hospital start looking at opportunities available and speak with people who work on that unit. Most people are more than happy to share their "dirty laundry".

    When interviewing ask about retention, as about staff engagement, ask about shared governance. If a manager has a good foothold on these things it will be obvious by their response. If its a "we have a unit council" and there is no more explanation its likely that they do not truly have shared governance. I happen to have a very engaged group of staff so it usually takes me a while to explain our shared governance process. There are great places to work out there!!! I wouldn't focus on a specialty necessarily unless you are confident you want to work in NICU or step down...if its just about the environment then you have a lot of opportunities...

    Good luck!!!
  4. by   OnTheSearch
    Step down can be just like medsurg but 3 patients instead