Switching from adults to peds, what unit is best to start?

Pediatric Critical Care Columnist · Jun 11, 2007

Hmmm... no responses. So much depends on you in this instance. Your personality will be the biggest factor in where you fit best. Are you a take-charge kind of person, or do you like a lot of direction? Are you unflappable, or do you cry over Hallmark commercials? Do you prefer minimal contact with your patients or do you like to interact?

Med-surg needs some self-starter capability and good assessment and organization, as you know from working with adults. You interact with your patients and get to know them. There is lots of teaching involved, as you know, and it can be very busy with admits and discharges.

PICU needs a person who is confident of their own abilities, a take-charge kind of gal, someone who recognizes impending disaster and acts. Organization and assessment skills are very important. It is typically very busy with many balls to keep in the air at one time. PICU patients can be interactive, but only toward the end of their admissions... they get a lot of drugs. You will spend more time interacting with the patient's family than with the patient, usually. And you must be made of pretty stern stuff, because these kids are really sick and some of them aren't going to make it.

Peds OR is for the person who isn't really a people person. You have limited contact with your patient, and generally speaking, they come in screaming and go back out screaming. The work can be routine, but it can also be quite frantic. You need really good peripheral vision, excellent hearing and a large bladder.

Peds ER is better suited to someone with a short attention span. You get 'em in, work 'em up and move 'em out. And most of the time they're screaming. (Not a fan of screaming, me.) You have to have a high tolerance for stupidity, as many of the kids you'll see are there because they did something stupid, or someone else did something stupid. And parents tend to be rather impatient. Did they not know that every other parent in the city waited until Sunday evening to have that nasty diarrhea/vomiting/rash their toddler has had for the whole weekend checked out so they can send them to day care in the morning? What do you mean, there's a six hour wait to see the doctor?

I'd say start with the one that appeals to you most and if it isn't the right fit, move along.