PICU to NICU

adventure_rn, MSN, NP · Jun 22, 2017

I've known several nurses who came to the NICU from PICU. I don't have personal experience, but from what I understand PICU to NICU is actually an easier transition than NICU to PICU. You have a lot of the critical care knowledge/experience, so you'd just have to learn preemies.

It sounds like some PICU nurses find the NICU a bit boring, since the care can be repetitive/predictable (which I actually enjoy). On the flip side, you get fewer really sad cases in NICU. You don't see the abuse/neglect cases, since the babies have been hospitalized since birth and you can ensure that they're safe and their basic needs are being met. Also, in PICU it seems like you can get the sad cases where a kid is healthy one day, then terribly disabled or dead the next after a trauma/drowning/accident. In NICU, mortality is very low, and kids generally always get 'better' than where they started out. Even if you have a former 23-weeker who is at risk for permanent disability (which we usually don't even know yet in the NICU), we still see it as a huge victory for them to leave the hospital and go home for the first time.

sergel02, BSN · Jul 21, 2017

Like Adventure said, I heard of a lot of nurses going from PICU to NICU rather than the opposite. NICU is more specialized than even PICU and you deal with many similar diagnoses and get good at them.

llg, PhD, RN · Jul 21, 2017

I agree with the above posters except for one thing: In some NICU's, the mortality is the highest in the hospital. I worked in one fairly small NICU of about 15 beds that averaged 5 deaths per week. (Children's Hospital in city with several other NICU's. That NICU got only the sickest patients.)

NICU's vary greatly from one hospital to the next. Some NICU's have patients that are much sicker, less stable, and much more likely to die and/or have devastating outcomes than other NICUs. Some NICU's have mostly little growing preemies that have good outcomes. A lot depends on the population served by that particular NICU and the availability of other NICU's in the area. For example, if a region has lots of Level II nurseries and some other Level III's nearby ... the local university-level NICU may only get babies who require Level IV care. The routine, stable preemies stay in those other nurseries while the local university hospital or children's hospital become mostly populated by the super-critical ones and the ones with unusual syndromes -- with few cute, stable preemies in sight. If the NICU is the only one in the area, then it will probably have more of a mix of the super-critical and the routine. Also, a NICU might not have the Level IV capabilities and ship all its patients who need that level of care to another unit.

Anyone considering a NICU job needs to be aware of that and decide whether or a particular NICU has the population they are most interested in working with or not. Just because it is called a NICU and cares for sick newborns doesn't mean it is much like the NICU across down. The acuity level is highly variable from place to place.

sergel02, BSN · Jul 21, 2017

Ilg is right. There are about 5 nicus in my area but two are the major hubs with 50 to 60 beds. One gets sick kids but some of the even sicker ones get sent to the local teaching hospital so their rates are gonna be higher.

nycnurse24 · Jul 23, 2017

Thank you for the great info! I was actually floated to the NICU last night and I loved it. However, the NICU in my hospital is a level 3 so there are most definitely some sick little babies and that is something to consider.

sergel02, BSN · Jul 23, 2017

Thank you for the great info! I was actually floated to the NICU last night and I loved it. However, the NICU in my hospital is a level 3 so there are most definitely some sick little babies and that is something to consider.

Thankfully a nicu will train you up to those babies. If it's also something you don't like, I do know if nurses who spend most of their time in the more stepdown nursery part of the nicu rather than the ICU part.