Switching from ICU to Peds..need advice

LoliLolly · Jun 25, 2016

Hey there! I haven't worked adults as a nurse but I did throughout nursing school so I am a little familar with the craziness of adult med-surg nursing. I can't speak too much towards the transition; I was in my third year of nursing school when I went from adult cardiac-step down to PICU/PCVICU, but it did take some time to learn the different vital sign ranges for age groups, calculating adequate urine output, learning appropriate doses by weight (Everything is weight based in peds), etc, etc...But that stuff will come with time.

If you're looking for reading material, a good place to start is Wong's Guide to Pediatric Nursing...If you'd like to transition from ICU to PICU, Hazinski's Peds Critical Care book is also an awesome resource.

Units definitely vary hospital to hospital. My two cents? If you want to give yourself a true peds experience before making a leap, try and shadow a floor nurse and an PICU nurse at the closest children's hospital to you. You'll get a full pediatric immersion, perhaps see how codes are ran differently, how we involve Child Life Specialists in procedures, complex rounds of high risk patients, pick up tricks on how to draw blood and use therapeutic play during med passing and the like. You won't get the same experience by going to a small peds unit at your local community hospital; I've worked large peds hospitals, small units and in-between.

Hope that helps! Good luck, feel free to PM me if you have any questions!

LoveMyBugs, BSN, CNA, RN · Jun 25, 2016

What is it that you are not liking in your current position?

I worked 11 months with adults in SNFs before I made the jump to peds.

Pediatrics can be rewarding and awesome and gut wrenchingly heart breaking

Peds are there not for noncompliance or they damaged their bodies over time like adults, there is not a lot of drug seeking behaviors as usually a sticker and a Popsicle and a bandaid can make the owie go away.

Peds has a ton of complex social issues, you have parents you have to deal with

You either have the well intended parent who clearly loves their child but are surprised the parent was able to tie their own shoes let alone understand any of the discharge teaching....but they love their kid

Then the drama filled parents.....who love their kid so the louder and more demanding they are...the more they love their kid

The over educated "I read this on a mommy blog and Google" parents....who Iove their kid and are trying to figure out what's best for them but aren't so sure about this Western medicine

The rare super easy going listen to what you have to teach them about caring for their kid and they love their kid

The 1st time parents who the baby "slept 2 hours more than yesterday and the poop changed a colors and she never done that before".....these are my favs.....loving their kid

Then you have the parents don't care what happens to their kid until it's too late

that "say they love their kid" but.....the bruises and the abuse

The dark horrible side of pediatric nursing.....you will see how horrible humans can be to defenseless children when the adults in their world fail them.

Peds is a great specialty, I could never see myself working with adults again, but I always want people who are thinking about going into peds go in eyes wide open.

They are cute to have as pts, but when things go south or the social issues cloud everything it can be very emotionally draining as well

apillarofsalt · Jun 25, 2016

I love peds, personally. I'm transitioning into childbirth nursing, but during my time in peds I learned a great deal and may eventually return to it.

Everything said above is accurate. The weight based stuff comes in time, but it does take some getting used to. I worked in the ED, which is a mixed bag. Some days, you might see only breather kids (athsma, URI, bronchiolitis) and protocoling meds for fevers. Another day you might actually save a life if there's a serious trauma coming in. In both cases, though, you can be the difference between a terrified child and one that feels safe and secure...there is little in this field that I have found so rewarding.

As mentioned above, the abuse cases are tough, especially when nothing is done to prevent them from bouncing back and they don't get the kid out of the home. Other nurses can be awful as well. I've seen rape victims come in and there are nurses standing around saying they deserved it because the kid was at a party, etc.

People would always say you need to be emotionally tough to work peds and I disagree. I think you need to be emotionally available and willing to truly leave your judgements at the door in order to be great at a peds facility.

All that said, I think if you're curious about it, definitely give it a go.

AlabamaBelle · Jun 25, 2016

I worked in Peds ICU until 2012. I took a break from nursing and am practicing again after moving to a new state. In my area, the pediatric population is generally lumped with the Women (post partum)/Pediatrics umbrella. And a LONG drive would be necessary. I worked in our community hospital for 7 months and found floor nursing, in general, was not for me, along with some other concerns I had. I am now working in adult acute dialysis. I really, really miss the kiddos!

hawaiicarl, BSN, RN · Jun 25, 2016

I did the opposite, spent ten years in peds, then due to a relocation moved to adult ICU. Loved working with the kids, my only point of advice would be that in adults when you see a patient deteriorate for hours, or days, in peds you have minutes or hours. When they stop compensating, they STOP.

Cheers

Zelda, RN · Jun 28, 2016

I love peds. I work in a children's hospital, and our med/surg units are more specialized... My unit gets kidney (CKD, kidney transplants, etc), liver (disease and transplants), and rehab (much different from adult rehab, as our kids are usually brain or spinal injuries and are getting to the "optimal" level of functioning, whatever that might be). We also get your "typical" med/surg kiddos - RSV, occasionally seizures, cellulitis, etc. My favorite patients are babies and toddlers, but I work with plenty of nurses who prefer the older kids. The oldest we take is around 22 - though those are usually kids who have been followed by one of our docs since they were little. Our docs don't like to let go - and rightly so, as we "spoil" our kids a bit (call to remind them of appointments, find them transportation, etc). We DO get a lot of noncompliance, though that's more the parents fault than the kids'.

You do see a lot of abuse, or parents who aren't available. I can think of one baby particularly whose mom no one has ever seen, and whose dad is only there to admit, do family meeting, and discharge (but my goodness, baby is fun to snuggle). If the parents are there, they can be a godsend, cuddling and playing with their kid. Kids need stimulation and entertainment often, they don't really entertain themselves like adults. And they don't always understand not to pull their NG, IV, port, etc out - so sticking them in a caged crib so you can do your other duties is not always an option.