Transitioning from adults to neonates

Specialties Critical


Hey fellow nurses. I'd love some advice. Currently I am a STICU nurse in a level 1 hospital now for a year and a half. I have recently encountered opportunities to visit the neonatal ICU and the pediatric CVICU and loved it. My end goal is to apply for CRNA school but would love to transition to pediatrics once I reached 2 years with adults. Has anyone else followed this path? What would be a recommended route? Any advice would be much appreciated.

Stay per diem in adult ICU if you are truly set on anesthesia school.

That said, peds and neonates are a dream and appealing units to work in.

I'd think that peds CVICU would be a great way to strengthen your critical care skills for CRNA. The kids are incredibly high-acuity and can be quite unstable (i.e. doing emergent open-heart surgery at the bedside while the RN pushes anesthesia meds). In contrast, NICU can be a bit of a mixed bag (depending on the unit); you'll get your occasional super-unstable baby on drips, but with a much larger proportion of stable 'feeder-growers' who are basically just baby med-surg patients who are learning to eat.

That said, as someone who has worked in both, I find the NICU far more uplifting; on the whole, the kids tend to get better and go home. By contrast, the kids in the peds CVICU are generally very chronic, with a much higher morbidity and mortality than NICU. It's fun to work with kids, but easy to get burned out watching some of them live for months on the unit with a terrible quality of life until they inevitably die.

Either way, prepare yourself to feel like a new grad all over again. Kids, and especially babies, are entirely different from adults; for instance, heart failure in adults is only tangentially related to congenital cardiac defects (which adds a whole extra level of complexity to the normal cardiac anatomy and physiology). It can be a tough transition for experienced nurses since they're used to feeling fairly confident in their practice; it's hard to feel totally incompetent again. As long as you go into the experience open to all new learning opportunities and expecting to feel incompetent from time to time, you'll be fine. Your background would be very helpful, especially in the peds CVICU.

If your end goal is to be a CRNA, would it make more sense just to go straight into CRNA school? The peds CVICU may be helpful, and the NICU could be marginally helpful, but it seems like they wouldn't be all that advantageous relative to your adult CVICU experience. Either way, as my friend ICUman points out, you'll definitely want to keep up your adult ICU skills with a PRN job.

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