Getting attitude about transferring to PICU!

Specialties PICU

Published

Specializes in ICU, Home Health and Hospice.

Hi all,

I am a NICU nurse who is transferring to the PICU within my current hospital in about 2 weeks! I am very excited because while I love the babies and I like my job, it has been getting repetitive and I wanted to see a wider variety of issues so the PICU is very enticing to me. I told one friend I was leaving so naturally the whole unit knows now (silly of me to trust people) and EVERY single person who has come up to me keeps saying I will absolutely hate the PICU and regret going there because it's "crazy" to which I reply, that is why I'm going because I want a lot of experience!

I just don't understand why all of them are saying I'll hate it even though they haven't done it? Is it because the NICU is a more controlled environment versus the PICU?

Can any NICU nurse who went to PICU give me their two cents? Or any PICU nurses?

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Specializes in OR, Nursing Professional Development.

I am neither, but I was told pretty much the same thing when I transferred specialty teams in the OR. It still worked out in my favor- I liked my job much better. I've since moved into a new role, but I never regretted my decision to switch things up even with the naysayers.

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Specializes in NICU, PICU, PCVICU and peds oncology.

I did the neonatal-to-pediatric critical care leap 20 years ago this month and never regretted it for a second. My reasons for moving were similar to yours, the feeling of being a bit of a robot because every shift was pretty much like the one before it. PICU nurses have the broadest scope of practice in all of nursing. We look after the needs of children from birth to adulthood, and sometimes beyond. The variety of problems we see covers the full range of human experience. There is a different focus in PICU; NIDCAP isn't a thing, first of all. If we're able to keep a child alive AND provide for their developmental needs, we'll bend over backwards to do it, but if we can't we don't wring our hands and sigh about it. I remember a couple of years ago we had a little 32 weeker who had a severe cardiac anomaly who needed ECMO and CRRT so was on the PICU not the NICU. We were raked over the coals for having him supine and flat in a bed (transthoracic ECMO cannulation of a neonate precludes flexed positioning) and for not protecting his hearing better. If we COULD have put him in an isolette and covered it with a quilt, we WOULD have. But we needed to see him every second. Our priorities are just different. You'll soon know if you made the right decision.

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I work in both units!! I can understand the NICU nurses' opinions that the PICU is crazy...because it totally is crazy busy. But it sounds like that is what you are looking for. It's very different from NICU, but having NICU experience will be helpful in PICU.

One reason that it is stressful for NICU nurses is because of the lack of orientation. I know when NICU nurses float to the PICU we try our best to give them the youngest patients, but it is usually unfamiliar territory anyway. Once you have been properly oriented to the PICU it is much more enjoyable to take care of children of all different ages and this is part of the appeal - some days taking care of neonates and other days having teenagers. Your skill set will grow tremendously as a result!

I love going to the NICU because it sometimes gives me a break from the busy PICU atmosphere. Not to say that NICU doesn't have it's busy days, but it tends to be a little bit more routine.

I would encourage you to try out the orientation to the PICU before you decide. If you are not even sure you want to do that I am certain that the unit director would allow you to shadow in the PICU before you agree to a transfer. It is one of the best ways to see for yourself that it is something you would want to do.

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Specializes in ICU, Home Health and Hospice.
I did the neonatal-to-pediatric critical care leap 20 years ago this month and never regretted it for a second. My reasons for moving were similar to yours, the feeling of being a bit of a robot because every shift was pretty much like the one before it. PICU nurses have the broadest scope of practice in all of nursing. We look after the needs of children from birth to adulthood, and sometimes beyond. The variety of problems we see covers the full range of human experience. There is a different focus in PICU; NIDCAP isn't a thing, first of all. If we're able to keep a child alive AND provide for their developmental needs, we'll bend over backwards to do it, but if we can't we don't wring our hands and sigh about it. I remember a couple of years ago we had a little 32 weeker who had a severe cardiac anomaly who needed ECMO and CRRT so was on the PICU not the NICU. We were raked over the coals for having him supine and flat in a bed (transthoracic ECMO cannulation of a neonate precludes flexed positioning) and for not protecting his hearing better. If we COULD have put him in an isolette and covered it with a quilt, we WOULD have. But we needed to see him every second. Our priorities are just different. You'll soon know if you made the right decision.

I love this because I feel that sometimes the NICU emphasizes patient development so heavily that we forget about the imminent safety. For example, we focus so much on attempting to do as much kangaroo care as possible with our tiny intubated preemies that we have an increase in accidental extubations. I feel strongly that immediate safety and security of an artificial airway is more important at that time than doing kangaroo care every day!

Thank you for your input, I'm happy to hear from a person who has made the jump that I'm about to make. I love learning and I'm afraid that I'll get bored without experiencing all of these different age groups and different disorders.

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Specializes in ICU, Home Health and Hospice.
I work in both units!! I can understand the NICU nurses' opinions that the PICU is crazy...because it totally is crazy busy. But it sounds like that is what you are looking for. It's very different from NICU, but having NICU experience will be helpful in PICU.

One reason that it is stressful for NICU nurses is because of the lack of orientation. I know when NICU nurses float to the PICU we try our best to give them the youngest patients, but it is usually unfamiliar territory anyway. Once you have been properly oriented to the PICU it is much more enjoyable to take care of children of all different ages and this is part of the appeal - some days taking care of neonates and other days having teenagers. Your skill set will grow tremendously as a result!

I love going to the NICU because it sometimes gives me a break from the busy PICU atmosphere. Not to say that NICU doesn't have it's busy days, but it tends to be a little bit more routine.

I would encourage you to try out the orientation to the PICU before you decide. If you are not even sure you want to do that I am certain that the unit director would allow you to shadow in the PICU before you agree to a transfer. It is one of the best ways to see for yourself that it is something you would want to do.

I shadowed after the interview and I found it exciting and very interesting. I loved it! I know that I won't truly understand all that goes on until I'm on orientation, but I am a bit tired of the general routine in the NICU. The problem becomes that we get used to our 9-12-3-6 care times and if anything goes on in between these hours people get so thrown off sometimes, and I do not want to get like that. I love keeping busy and doing new things all the time. I feel that I am not using enough skills right now in the NICU.

Thank you for your input! Love hearing from someone who's been to both places. It is nice to hear some positive feedback on this decision!

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Specializes in ICU, Home Health and Hospice.
I am neither, but I was told pretty much the same thing when I transferred specialty teams in the OR. It still worked out in my favor- I liked my job much better. I've since moved into a new role, but I never regretted my decision to switch things up even with the naysayers.

Thank you for replying! I'll just turn my heads to the naysayers and hope that they're wrong! I'm glad you found happiness in your role :)

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Specializes in NICU, PICU, PCVICU and peds oncology.

I suspected we were kindred spirits.

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I started as a new nurse in NICU and switched to PICU for the same reason, I love PICU and have never regretted the decision. Its a huge learning curve but so worth it! Good luck!

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Specializes in ICU, Home Health and Hospice.

Right on!

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Specializes in ICU, Home Health and Hospice.

Thank you! I'm sure it'll be a ton of new information but I am studying up and getting prepared.

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Specializes in Peds ED.

I think in general, nurses can assume that what they love/hate is going to be the same for everyone. I get responses of varying degrees of disgust and horror when I tell adult care nurses I work in Peds ("ugh, I could never do that") and honestly, whenever someone tells me they're leaving shift work for a 9-5 I have to bite back a "why would you do that to yourself?"

It sounds like your coworkers are both projecting their distaste for PICU and sorry see you go. You know your interests and your talents and what appeals to you worst-case scenario, if you don't like it, with NICU and PICU experience you will be so attractive to hiring managers so you really can't lose.

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