PICU/NICU..what's the difference?

KrisRNwannabe · Oct 4, 2004

i am just a student but, NICU I believe is for newborn babies and babies that are premies. PICU is more for toddlers and up I think.

kris

prmenrs, RN · Oct 4, 2004

A neonate is any baby that is less than 30 days old. NICUs care for sick neonates and premature infants.

PICUs care for infants older than 30 days (NICUs do care for older infants that were admitted to them in the first place--premies and sick newborns can stay for several months) and older children and adolescents. Most PICUs admit up to 16-18 years old, but it varies a lot.

As far as emotions are concerned, I think that varies from nurse to nurse.

Pediatric Critical Care Columnist · Oct 4, 2004

a neonate is any baby that is less than 30 days old. nicus care for sick neonates and premature infants.
picus care for infants older than 30 days (nicus do care for older infants that were admitted to them in the first place--premies and sick newborns can stay for several months) and older children and adolescents. most picus admit up to 16-18 years old, but it varies a lot.
as far as emotions are concerned, i think that varies from nurse to nurse.

that's true, as far as you went with it. however, most picus also admit neonates who have been home and return to hospital with some kind of bug or are a near sids. in my experience, nicu will refuse to admit these "dirty" babies. as well, neonates who have undergone cardiovascular surgery are admitted to picu at many centres around the world, due to the need for concentrating experience and skill in one place. our unit admits children as young as several hours of age (diaphragmatic hernias or hypoplasts requiring ecmo). many of our patients are under 30 days old. we also admit young adults (>17 years old) with chronic health concerns who have not yet been transitioned to adult medicine, if that is the desire of the family.

mac23 · Oct 4, 2004

at my previous job our picu was the same, any cardio kid goes to picu, but we did our own ecmo in the nicu. as far as the "dirty" baby returning to nicu the hospital i'm at now takes kids that have been transferred to another hospital or were home and readmitted back if they need intensive care again (we have one now that just came back who is 11 months old!), i don't think it's right, i think they should go to picu, but i don't make the rules.

that's true, as far as you went with it. however, most picus also admit neonates who have been home and return to hospital with some kind of bug or are a near sids. in my experience, nicu will refuse to admit these "dirty" babies. as well, neonates who have undergone cardiovascular surgery are admitted to picu at many centres around the world, due to the need for concentrating experience and skill in one place. our unit admits children as young as several hours of age (diaphragmatic hernias or hypoplasts requiring ecmo). many of our patients are under 30 days old. we also admit young adults (>17 years old) with chronic health concerns who have not yet been transitioned to adult medicine, if that is the desire of the family.

Pediatric Critical Care Columnist · Oct 5, 2004

Our NICU, and the one at the hospital I worked at before, will not readmit a neonate who has been home. They will accept transfer from another hospital, those babies are considered to still be "clean". Funny that... the NICU at my previous hospital has been locked down on chicken pox quarantine more than once and had a significant RSV outbreak a couple of years ago... brought into the unit by siblings. To say nothing of the TB scare they also had, from a parent.

prmenrs, RN · Oct 5, 2004

We admitted hyperbili babies, sepsis as well. Our unit didn't do ECMO, but if we did, it would've been done in NICU. Post-op of any kind including hearts came to NICU as well.

You are right--it varies widely, depending on the philosophy and politics of the situation.

BittyBabyGrower, MSN, RN · Oct 5, 2004

Sometimes I think we are a PICU....we hang on to those chronics until their first birthday and sometimes longer~! We aren't doing them any justice that is for sure.

Our hearts go out to another hospital, they go the cardiac NICU, if they go to the other one, they go to PICU.

We readmit kids that were in our unit...they are isolated until all the viral screens come back...what a PITA that is as that patient is one-on-one until then! We will take them back for up to 2 weeks after d/c and then they go to peds (I have no idea how they came up with that timeframe :chuckle )

We also readmit overnight for laser eye surgery...we do them on the unit (we have a special room for that) once again, that child is isolated.

Our transport team does any baby under 30 days old, no matter where it is going.

Gompers, BSN, RN · Oct 5, 2004

Sometimes I think we are a PICU....we hang on to those chronics until their first birthday and sometimes longer~! We aren't doing them any justice that is for sure.
We readmit kids that were in our unit...they are isolated until all the viral screens come back...what a PITA that is as that patient is one-on-one until then! We will take them back for up to 2 weeks after d/c and then they go to peds (I have no idea how they came up with that timeframe :chuckle )
We also readmit overnight for laser eye surgery...we do them on the unit (we have a special room for that) once again, that child is isolated.

This is exactly what our unit does as well.

We'll also admit new babies from the ER if they are a homebirth or if they're less than a week old with neonatal-specific conditions - hyperbili, NEC, etc.

Every hospital has it's own policies and procedures, and sometimes it even depends on what doctors are on or what the PICU/NICU census is at the moment.

But the answer the original poster's question: in general, if you want to work specifically with babies, go to the NICU. If you want to work with children of all ages (0-18+ years) go to the PICU. Whether the PICU takes newborns or not isn't really the point - the point is that you won't get an 18-year-old in the NICU!

The emotions are about the same, from what I can tell. Working with sick or dying children and their families is very stressful. But I can tell you for sure that in the NICU, probably 90% or more of your patients WILL go home someday, so that helps get you through the tough times.