PEDS or PICU?!?

Specialties Pediatric

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Hey everyone! I am having the hardest time deciding whether I should go onto Peds floor, PICU or somewhere else when I graduate. In some ways I feel that I would never be able to handle the "critical" part of the PICU but I think it would be an extrodinary place to learn....Or should I be on the Peds floor first since things are a little slower paced? I have no idea and ANY feedback would be really appreciated. Maybe if anyone could share their personal stories that might be helpful? Thanks so much

- Nursing student in need of some guidance here.... :rolleyes:

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Ask around the local hospitals and see if you can shadow in both places to get a feel for what it's like. Of course you may have to do more than one day of shadowing to see what it's like on any given day. If you can't shadow, are you interested in working as a PCT? It is a tough decision because there are so many opportunities out there. If you do pick an ICU, please make sure that they have some type of program in place that will provide you with a good orientation (internship) and that they have or have had other new grads that have been successful in the unit. PICU is a tough place to work and remember you can start in PEDs and then after some time has passed move on to PICU. Talk to other graduates and see what they are doing but ultimately do what will be best for you.

Hey everyone! I am having the hardest time deciding whether I should go onto Peds floor, PICU or somewhere else when I graduate. In some ways I feel that I would never be able to handle the "critical" part of the PICU but I think it would be an extrodinary place to learn....Or should I be on the Peds floor first since things are a little slower paced? I have no idea and ANY feedback would be really appreciated. Maybe if anyone could share their personal stories that might be helpful? Thanks so much

- Nursing student in need of some guidance here.... :rolleyes:

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Thanks for the response. It is just so overwhelming of the areas that are avalible to nurses and I feel like I do not know about 1/2 of them! I think I will be able to figure out somewhere to go soon! By the way, what is PCT? Sorry not familar to all of the unit abbreviations...

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Hi!! Good luck in peds!! It's a great speciality. I started as a GN in a busy pediatric unit, in a hospital that also had a PICU. I really feel I learned to hone my skills and learn to organizemyself on the floor. It helps you to learn to distinguish a really sick kid from a not so sick one. I eventually moved to PICU and was really glad I had done general peds 1st. It gave me the background I needed. There are many PICU nurses that feel you should do reg. peds. 1st and I'm included in that. If you're really lucky, the hospital has a group of Peds and PICU nurses that work well together. I was encouraged by the PICU nurses to join them once I got my "sea legs". Good luck!! I've been doing peds for 18 yrs (how did THAT happen11 :chuckle :chuckle ) and wouldn't trade this speciality for anything!!!!

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Specializes in Community Health Nurse.

Hi ButrflyGurl :)

"PCT" stands for Patient Care Tech....ie...nurse assistant. :)

I recently returned to working pediatrics after being away from it for awhile. I wanted a break from caring for adult patients, and remembered how well I enjoyed taking care of kids. I wish you well in your endeavors to become a pedi nurse. Kids are honest, straightforward, and adorable. There's no better honesty to work with than kids. :balloons:

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mm nurse:

Thanks for the great advice! BTW: how long did you work on Peds before you felt you gained enough experience to make the transition to PICU? Thanks, Steph

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Hey everyone! I am having the hardest time deciding whether I should go onto Peds floor, PICU or somewhere else when I graduate. In some ways I feel that I would never be able to handle the "critical" part of the PICU but I think it would be an extrodinary place to learn....Or should I be on the Peds floor first since things are a little slower paced? I have no idea and ANY feedback would be really appreciated. Maybe if anyone could share their personal stories that might be helpful? Thanks so much

- Nursing student in need of some guidance here.... :rolleyes:

Hi-

I have been a pediatric nurse for 18+ years. I started my career right out of college on the general peds floor. Best thing I ever did. I did 2 years on the floor and then transferred to the PICU where I have worked ever since. Working on the floor first was the right thing to do. I got a strong foundation and new what "normal' was. Let's face it PICU patients are anything but normal. It is hard to assess critically-ill kids, if you don't know what normal kids look like. During my career in PICU, I have seen new graduates burn out and leave within a year. Those that stay have either worked general peds floor, or have worked as an intern or nurse tech in PICU while they were in school. If you have no pedi experience, my advice is to work with general floor for at least a year and then make the jump to the more critical care. You will love it more and be a better nurse for it. Believe me, there are always jobs in PICU. Just don't bite off more than you can handle as you start out.

LoriA:)

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Thanks LoriA!

I have been working in the PICU in my last semester clinical as a student nurse since I wrote the first thread. So far it has been a lot to get used to and I still am trying to get my routine down, but of course, it never fails and I do stupid things as a nursing student does. For myself, I think I would benefit in the long run if I worked on the floor first and deep down, knowing that I WILL be working in the PICU soon enough. I just ask myself constantly, "how do these nurses do it, and do it so well??" I know it is all about experience and I guess I get frustrated wishing I was at that same level right now. I hope that I will be at that level some day, being able to precept a student that feels the way I do right now! Thanks for your words of advice...

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I worked ER for 3 years, now have been in PICU for 6 weeks, I love it, but feel VERY overwhelmed, very sick kids, lots of drips, Pressure lines, ventilators, you name it. My conclusion is that I am having a hard time adapting and I have nursing exp. and organization/prioritization skills already. The hosp. I work at has an intern programs for new grad RN's they started with 18 girls- now down to 4 girls, they say its just very overwhelming, same way I feel. -hope that helps a little.:)

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it really does help to hear things like that believe it or not. i am glad to hear, or more like thankful to hear that it is okay to feel overwhelmed in this type of environment and it is not just me feeling this way. i just think that working here exposes me to so much more of a learning experience rather than med-surg atmosphere. i hope i will be able to be one of those "4 girls" one day too. thanks for your response!

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Specializes in NICU, PICU, PCVICU and peds oncology.

ButrflyGurl, you have to walk before you can run. All of us started in the same place with the same doubts and fears. What you see as effortless performance is actually a craft that has been honed over many months and years of learning, growing and practice. I've learned the hard way that there's far more that I don't know that that I do, and I know that if I stop learning and growing in my career, I'll have to quit. Meanwhile, don't worry that you'll be thrown in at the deep end and expected to swim. Take your ime, it's really worth the trip. If you can see it, you can be it. Good luck. PICU is a great palce to work.

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It sounds like your deciding between reputation and size...Well you will probably have a better opportunity to experience caring for more acutely ill children with an array of dx's in the larger hospital with a great reputation. But reputation definately has it's expectations for nurses too. I have been a peds nurse for 6 years and was having the same dillemma when I graduated... PICU or PEDs I wanted the status of being a PICU nurse and having the knowledge of taking care of critically ill pt's, but as a new grad I didn't feel I had the assessment skills necessary to care for those patients, even with a long orientation. So I decided to work in general peds first. Now I do both and really really think that was the best way to go.

Working as a general peds nurse first allowed my skills to build with experience of caring for children at all levels of thier illness and it made my assessment skills much sharper. I know what a child looks like through the progression of their illness.

Newgrads who start in PICU usually have an excellent orientation and the nurses will most likely hold your hand until you feel o.k. to stand alone. Either way you go you will have a great experience and learn more than you ever imagined.

I think as a new grad you should begin your career with stepping stone. Don't be in such a hurry. Learn everything aspect of Pediatric Nursing possible. You might find that neither one of those departments is not quite what your comfort zone is and decide that your better suited in another area such as NICU (which is an extremely controlled environment and very structured, more so than any other dept) or maybe even L & D.

Always keep your options open and be flexible to learn something new.

Children are amazing and caring for them, no matter how sick, will change your outlook on life. Where ever you start in your career will not be your ending place, it is just the starting point with an endless journey, so follow your gut feeling and go for it.

-Dawn

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