Transitioning to adult ICU from PICU/peds ED?

jkr2020788 · Jun 9, 2012

Its def doable. You just have be sure to look up all drugs before giving them. I'll be willing to guess that you will actually be a little safer in titrating drips since there are only tiny incriments that you can go up with in peds/ neos. It will def be different, but you will see a lot of things you are not used to seeing which will help you in ur med school career.

HazelLPN, LPN · Jun 10, 2012

I did adult MICU full time for years. When I retired from full time nursing, I worked .2 in the MICU (8 hours a week) and was cross trained at the childrens' hospital where I picked up contingent hours in the PICU and eventually the NICU.

In adult ICU, MICU in particular,you will find that many of the patients are geriatric with chronic conditions and they will never get better. It is also hard on your body. I had to adjust to calulating the meds based on weight when I started doing peds, but it didn't take me long....its easier to go from peds to adults I think. In peds, you know these kiddos can compensate really well when they start to go south and then they deteriorate very rapidly. Adults will generally give you more warning sign and don't deteriorate as quickly.

I know med school is a lot of work. My late husband was a pediatrician. If I were you , I wouldn't try to do adult ICU nursing because it will not be your focus...med school will and working so few hours you really won't get the experience it takes to be really good at it. Experience is the best teacher. I'm sure you could be a decent adult ICU nurse.....you clearly have the natural intelligence by getting accepted into med school....no easy feat these days but to be a great adult ICU nurse..it takes practice that comes with experience that you will be getting very little of. You will be doing well to keep your skills up and only work twice a month in the job you currently have. I worked in the NICU with an NP who had been a NICU RN for 15 years before transitioning into the NP role. She worked full time as an NP and would pick up contingent hours as a staff nurse on very rare occasions...maybe once a month. She got to the point where she wasn't comfortable taking care of the sick kids as a bedside nurse because she was simply so out of practice in that role.

Best wishes to you in school.....and never forget your nursing roots when you become an MD.

Mrs H.

Southgoing Zax · Jun 11, 2012

Hi guys!
I have been an infrequent flier on the boards since the start of my nursing career 6 years ago. I have worked at the same Children's hospital the whole time and have exclusively done PICU/peds ED. So other than school and the random wayward adult patient here and there, my ONLY experience with adults is as a SANE, which I also have done part-time for 3 years.
But, here's the thing...I'm starting medical school this fall (so excited!!!!) and I need to switch to PRN status. I could stay where I am, but I have this burning desire to learn about adults. Specifically, I think I would love adult ICU! There's a military hospital nearby, and I love, LOVE the idea of caring for this population, as I think it would be rather "heartening" in what I know will be a really difficult and busy time in my life.
For those who have transitioned between peds and adults, how different is it really? How much harder/easier? I'm a hard worker, but realistically, I would be in the throes of learning how to be a med student while making this transition, and I don't want to end up sucking at both! Also, when I say PRN, I mean VERY prn. I'm planning to work 2-3 times per month during school. Would I even be able to become proficient at adults?
People always say, "oh, peds is sooo much harder... all that math, and all those parents, etc..." Actually that's one of the main things that worries me: I am used to calculating my drips and meds based on weight, and I don't know much about adult maximums at all. What do you guys think? Is this do-able or a terrible idea? Also, how do most places go about orienting you if you are PRN right from the start?

Thanks guys! At the moment, I'm waiting for a PRN position to appear at my current facility. There are lots of weird stipulations due to the union, so if something doesn't manifest within a few weeks, the decision will be made for me! I'm pretty set on working PRN somewhere. This is for financial reasons mainly, and also because I'm afraid that quitting entirely for the first semester, cramming my brain and then trying to go back, would be harder.

I finally decided I'm going to call the military hospital today and give them a nutshell version of my story (HR, the NM, whoever wants to talk to me...?) We'll see what they have to say. I'll keep you all posted!

Southgoing Zax · Jun 19, 2012

I did adult MICU full time for years. When I retired from full time nursing, I worked .2 in the MICU (8 hours a week) and was cross trained at the childrens' hospital where I picked up contingent hours in the PICU and eventually the NICU.
In adult ICU, MICU in particular,you will find that many of the patients are geriatric with chronic conditions and they will never get better. It is also hard on your body. I had to adjust to calulating the meds based on weight when I started doing peds, but it didn't take me long....its easier to go from peds to adults I think. In peds, you know these kiddos can compensate really well when they start to go south and then they deteriorate very rapidly. Adults will generally give you more warning sign and don't deteriorate as quickly.
I know med school is a lot of work. My late husband was a pediatrician. If I were you , I wouldn't try to do adult ICU nursing because it will not be your focus...med school will and working so few hours you really won't get the experience it takes to be really good at it. Experience is the best teacher. I'm sure you could be a decent adult ICU nurse.....you clearly have the natural intelligence by getting accepted into med school....no easy feat these days but to be a great adult ICU nurse..it takes practice that comes with experience that you will be getting very little of. You will be doing well to keep your skills up and only work twice a month in the job you currently have. I worked in the NICU with an NP who had been a NICU RN for 15 years before transitioning into the NP role. She worked full time as an NP and would pick up contingent hours as a staff nurse on very rare occasions...maybe once a month. She got to the point where she wasn't comfortable taking care of the sick kids as a bedside nurse because she was simply so out of practice in that role.
Best wishes to you in school.....and never forget your nursing roots when you become an MD.
Mrs H.

That's great to know! I would always joke with my SANE friends (most of whom are adult ED) that adults scare me because one minute they're all happy go-lucky... and then they're just dead! Yikes LOL! I can spot a sick kid in a nanosecond, but those adults...! I'm sure I'll maintain a low threshold of suspicion for awhile until I get used to adults' idiosyncrasies ;-)