Peds/PICU/NICU advice?

PediLove2147, BSN, RN · Jun 23, 2011

What an amazing opportunity. Maybe shadowing on each unit to get an idea of what a shift might be like? I personally would start in general med-surg (peds) and move to PICU later down the road once I was feeling comfortable. I don't have any experience in any of those departments BUT if I had to choose where to start, that would be it.

I am sure which ever department you choose you will be happy.

elizanne · Jun 26, 2011

I hadn't thought about shadowing--that's a great idea. Also, you're completely right. I know I'll be fulfilled and happy no matter which area or floor I end up on. I feel very blessed. Thanks!

MeganNYRN · Jul 19, 2011

I am a pediatric nurse on a general floor and most days its great. We have everything from asthma or pneumonia to complex cardiac or oncology patients and even various surgical patients(ortho, plastics, urinary ENT) basically if a kid can be hospitalized for it I've seen it in the last two years. I work at a Large NYC hospital and we only have my floor plus a PICU and a NICU so we get everything and including very specialized conditions such as Familial Dysautonomia(two major centers in the world Israel and NYC). I love seeing complex cases like that and being witness to the diagnosis process on some of our temporary mystery kiddos. I love the kids and most of their parents(except the occasional impatient demanding parent that forgets this is a hospital not a 5-star hotel, coffee? really I don't have time to get your coffee and I can't make a private room appear that doesn't exist).

I oriented to the NICU after being a nurse for about a year and I liked it, the babies are tiny but the nurse does everything(PCT/CNAs do baths and vitals on my floor) I like being in control and having allnot just some patients on heart and pulsox monitoring. Feeding the babies that are allowed is a fun challenge but you have to get used to the constant eeping and alarms and learn which ones to run for and which to just note and watch. Some babies are very complex and the nurse has to learn how to use many machines but some people love that.

PICU has a lot of complex machines(ventilators and a pole full of IV drips running all the time) Pts can turn for the worst in minutes but the train you and work you up to those patients. I know women that started in the PICU and NICU and love it and have stayed for years. Overall people do well starting in all of these areas so do a shadow day or two in each try to do an extern or clinical rotation if you can and make the decision that FEELS right. Good Luck! PM me if you have further questions.

PediNurse3 · Sep 7, 2011

I LOVE general med-surg peds, but I recently did a short observation in the NICU and fell in love with that as well. I'd really like to hear from general peds, PICU, and NICU nurses about these different areas. Pros and cons? What do you love about it? What would you rather do without?
I'm definitely grateful that this is my only dilemma since a lot of new grads are having are hard time finding jobs. Thanks for your help!

I worked in the PICU.

First and foremost, I loved seeing kids that were really sick (or very badly injured) get better. I saw some AMAZING recoveries- and some days, that was the only thing that kept me going back! I loved that I got to use my brain, and that I was frequently challenged. CVVH, high frequency ventilation, hypothermia protocol, drips and monitors galore, I could go on and on. I learned SO much.

The flip side of that- the things that I didn't like. Not everyone that was super sick/injured transfered to the floor and eventually left the hospital. There were a lot of them (too many for me) that never left the unit. Some of them were perfectly healthy children who were fine one day, and the next day they weren't. I was part of way too many care conferences. I also didn't like having to chase someone down to cosign a PRN every time one of my patients started acting crazy or thrashing around, trying to self extubate. That leads me to doctors that firmly believed that sedation and analgesia prolonged the amount of time that patients required mechanical ventilation...so they just wouldn't order drips on the infants. Nerve racking to say the least. :uhoh3:

That was just my experience. I wanted to work in the PICU when I was in nursing school but there were no positions available so I worked in an adult trauma center (much less sad, for me anyway) and quit when I was able to get a PICU position. Initially, it was great and I loved it. I have two young children though, and over time, it began to wreak emotional havoc on me. I dreaded going to work. Some people thrive in that environment and can stay long term, but I was not one of them.

Good luck with your decision!

sergel02, BSN · Oct 27, 2016

These areas are some I'm interested in, and if I could get into any of them that's be great.

So much though depends on the unit itself and theiron system and types of patients. The burnout for the picu in my area is high but thr nurse who stick with it love it. Nicu and peds nurses are happy too, but I think some of the peds nurses wish they had slightly more complex kids. Though now that the hospital is getting a major pediatric surgery department who knows what may change.