Starting NICU, stay ICU PRN?

Specialties NICU

Published

Hello all!

I am an adult Neuro ICU Nurse with 1.5 yr experience. I recently got accepted into a Neonatal ICU internship at Medical City Dallas (Level IV). I can't decide whether I should stay PRN at my adult ICU job or just quit altogether.

I do not like my adult ICU job, but there are times I feel good about the skills I have- detecting Neuro changes, detecting a PE when the docs were going to send the patient home, code blues, etc.

However, even on good days I'm not fully satisfied with my job and a lot of working with adults means working with people who treat you like crap and just want you to be their servant. It really affects me and I try so hard to stay the compassionate person I am but I'm slowly becoming one of those nurses who are jaded. It's hard not to when people are so harsh and we have to smile while they cuss us out.

I always dreamed of NICU and now my opportunity has finally come!! I'm SO excited, but I know it'll be hard!

Anyways, I can't decided whether I should keep up with my skills I worked so hard to obtain or if I should just quit and focus on my true passion. I don't know what the future will hold- whether or not I will want to become a FNP, NNP, or neither. I have no idea!! I feel it would be hard being a NICU nurse wanting to become a FNP.

Anyone able to shed some light? I hope this all made sense.

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Specializes in NICU.
a lot of working with adults means working with people who treat you like crap and just want you to be their servant.

And babies don't treat you like a servant??

FEED ME!!!

CHANGE MY DIAPER!!!

I SPIT MY PACI OUT, PUT IT BACK IN MY MOUTH!! {5 seconds later} WHERE ARE YOU GOING? I SPIT MY PACI OUT, PUT IT BACK IN MY MOUTH!! :dummy1::nurse:

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I'm asking for serious replies only please. I never said NICU wouldn't be hard.

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And another disclaimer- I'm not choosing NICU because I think everything will be fine and dandy and everyone will be nice

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Lol, don't mind Guy. :rolleyes: He's just teasing, but he makes us laugh so we love him. ;)

In all seriousness, I think it's an awesome idea to keep your adult job PRN if you're up for it. I work with several NICU nurses who started out in adult ICU, and they're some of the sharpest, best prepared NICU nurses I know. One of the most bad-*ss started in the CTICU, then transitioned to NICU. She now works 0.6 FTE in CTICU and 0.3 FTE in NICU, and I learn new things from her all of the time due to her CTICU experience.

Keeping up with your adult ICU would also definitely help you keep your skills up and your foot in the door with adults. Win-win.

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Specializes in NICU.
I'm asking for serious replies only please. I never said NICU wouldn't be hard.

When I said that babies can be demanding, I was not referring to the difficulty of the job. I was referring to the patients demanding your attention. I guess NICU humor doesn't translate to adult nurses. Once you get to the NICU, you will realize that it is a completely different world from adults. I am grateful to work on a unit that my co-workers have my back if I get busy, get the utmost respect from the MDs and NPs, and parents that are grateful for you taking care of their baby.

NICU was my dream job in nursing school and three years later, I am still living the dream. Yes, there are days that are rough when you are dealing with a very sick baby and you are physically and mentally exhausted at the end of the day. But that is the exception and not the norm. There is not a day that goes by (especially reading the threads on the adult forums) that I am not glad that I work with babies instead of adults. I have said it numerous times, I would much rather clean a 2 pound preemie butt than a 300 pound adult's butt.

If you have the ability to keep your NICU brain separate from your Adult ICU brain, then keep working PRN in adults until you decide which long term goal you want to pursue.

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Congrats on the new position! I just made a similar move to the NICU after 5 years in adult world - last 3 being in the neurosurgical ICU. I absolutely love it so far and don't regret changing specialties. However like you, I'm unsure of exactly what I'd like to pursue in the future and worked so hard for (and am proud of) the skills that I gained as an adult critical care nurse that I wanted to continue picking up per diem shifts in neuro. Unfortunately, because I am working full time in the NICU of the same hospital as my old unit, I'm not allowed to technically be per diem on my old unit. Luckily, there is a loophole that allows me to pick up overtime shifts in neuro when they are short staffed so I have been trying to take advantage of that when I can. And I gotta say, those OT shifts have surprisingly been a welcome "break" and easy money. I know how things flow in neuro, I was a charge nurse and a preceptor and generally had a good handle on most situations that were thrown at me. If I don't know the answer, I know how to escalate to someone who does or who can help figure it out.

After almost 6 months in the NICU, although I love it, I'm not comfortable yet. There is so much to learn (or unlearn and relearn from the adult world) and the expectation as a newbie on the unit is to take the most critical or admission assignments every night. I'm not complaining, it's been a great learning experience but sometimes you just want to not have to think so hard!! Lol

Sorry for the novel, but I'd say if you have the opportunity to stay per diem in your old unit, I would take advantage of it while your adult skills are still fresh and you are figuring out what your future goals are. If you decide down the line that it's too much while orienting to a completely new specialty or don't feel like you will pursue anything in the future that would require it, you can always quit.

I was nervous going back for the first time after a couple months away from adults, but it was like my autopilot clicked and I got RIGHT back into the swing of things. Plus my BS tolerance is significantly higher now that I don't have to deal with the BS on a full time basis ;)

Good luck!

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Thank you all for your replies!!! I will let y'all know what I decide.

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I decided to stay PRN!! I am required to work once every 2 weeks so I told my manager I would try And if it gets to be too much then I will let her know:)

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Specializes in NICU.

I like Guy's humor - in that babies really are the MOST demanding of patients, since they depend on you for every little thing :p

I came from an adult surgical floor to NICU and it was a big transition. My only concern about working both at the same time would be remembering specific things to each area, I imagine things would get confusing going between the two, as neonatal vitals are different, medication doses etc.

I left adults and will never look back! Working with babies is easier than working with aduklts, and theyre so cute that it's hard t o get annoyed at them :)

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Specializes in NICU, Infection Control.

The thing about NICU vs adult units is that neonates are like a whole 'nother species. Different norms, different clues (more subtle) for those changes that mean life or death, that you've got to catch early and alert the team. Learning these things is what you need to do to be a great NICU nurse, and I have a feeling you won't settle for anything less.

Going back and forth, @ least in the beginning, will make that process difficult, imho. Try to focus on learning NICU for a few months before you go back and forth.

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