My challenge may just be the place where I work and the culture. I came from adults where I did everything...IVs, venous draws, central line dressings, complex wound care etc. In the NICU I work in, you have to be selected to get trained to do IVs, or attend deliveries. So there is only a small core group of nurses who can do venous draws, IVs, attend deliveries and an even smaller group who does central line dressings. The rationale behind this is that if a smaller group knows how to do these things really well, then there will be less adverse outcomes, rather than everyone knowing how to do it moderately well. So I've been in my NICU for 4 years and still cannot start an IV. Part of the culture is they pick their favourite nurses and "groom" them to be part of the group.
Another thing is I know in adults and especially adult ICU there is a lot of atonomy and medical directives. I find in the NICU I need an order for everything. I do miss the atonomy.