PICU transition- adult or neonatal 1st?

[guest769224]

Long term goal: PICU

I have opportunities to be a new grad in a NICU and adult ICU.

Which do you think would be most beneficial to transition into PICU from?

Which of the two would Nurse Managers see as being better prepared?

Appreciate any insight

[NotReady4PrimeTime, RN]

Now this is just my opinion... PICU is more like an adult ICU than it is NICU. Unless you're planning on working with cardiac surgical peds patients, most of whom are neonates. In a general NICU there are about 6 very common diagnoses and the occasional outlier. The main diagnoses are related to prematurity, such as respiratory distress syndrome, feeding intolerance, apnea/bradycardia and necrotizing enterocolitis. The only truly transferable skills from NICU would be drug calculations and managing parents. On the other hand, in an adult ICU you'd be looking after all the same sorts of patients the PICU gets, only bigger. A lot of what you'd learn there would transfer easily to peds with some tweaks to account for size and different responses to drug therapy. The math for drug calculations is simple, desired dose ÷ concentration available. So I'd say go adults until you can apply to peds.

[meanmaryjean, DNP, RN]

Now this is just my opinion... PICU is more like an adult ICU than it is NICU. Unless you're planning on working with cardiac surgical peds patients, most of whom are neonates. In a general NICU there are about 6 very common diagnoses and the occasional outlier. The main diagnoses are related to prematurity, such as respiratory distress syndrome, feeding intolerance, apnea/bradycardia and necrotizing enterocolitis. The only truly transferable skills from NICU would be drug calculations and managing parents. On the other hand, in an adult ICU you'd be looking after all the same sorts of patients the PICU gets, only bigger. A lot of what you'd learn there would transfer easily to peds with some tweaks to account for size and different responses to drug therapy. The math for drug calculations is simple, desired dose ÷ concentration available. So I'd say go adults until you can apply to peds.

Agreed. We currently have TWO adult ICU nurses and one NICU. The transition for the adult ICU nurses was much smoother. The NICU person is struggling.

[babyNP., APRN]

I woud put in that it also depends on what type of NICU you would be going to. Some NICUs hold on to chronic infants up to 2 years old (trach'd/vented, on chronic meds), and they are managed like a PICU patient. These are typically at children's hospitals and it would probably be easier to transition to PICU internally at a children's hospital. We had a couple of nurses from my old facility that transitioned to our PICU that did well.

But if it's a smaller NICU with run-of-the-mill patients, I would guess that adult ICU would be better for your purposes.

[Fl_peds_rn]

NICU is an animal all to it's self. If you are unable to start your career in a Pediatric setting then I would suggest the adult ICU as the better of the 2 choices that you have mentioned. As a former manager of a critical care department I would have given nearly equal consideration to an acute peds or adult ICU background. It is very difficult to be successful in the peds critical care setting without the peds or critical care experience.

[applewhitern, BSN, RN]

I did one year in telemetry, then straight into PICU. That was at a teaching hospital, so I guess the transition was easier. I agree, however, that adult ICU experience would serve you better.

[aerorunner80, ADN, BSN, MSN, APRN]

The PICU where I work prefers Peds experience over adult. Of course every place is different. You could always call the manager of the unit you want to work in and ask them.

[LoveMyBugs, BSN, CNA, RN]

If the NICU is in a children's hospital I would go NICU as you would get an opportunity to float to the PICU.

Learning to manage parents in addition to your pt is a skill.

It also depends on the type of PICU you want to get into....if they have a lot of heart babies then NICU would be valuable to have.

Generally having any kind of Peds experience is good, when you are ready to try and transition.

[babyNP., APRN]

Hey ICUman, what did you decide?

[guest769224]

Hey ICUman, what did you decide?

Thanks a ton to everyone that replied and helped me.

babyNP, I think I have decided on the adult ICU- which is shock trauma/surgical mixed.

I would have loved to do NICU, but they just got new management and things are not going so pleasant according to the nurses I talk to. I work as a tech in both units. I'll get there eventually!

And I'm sure I will approach you for more advice in the future.

[babyNP., APRN]

congratulations on your new job!! wishing you all the best