Transitioning to CICU

adventure_rn, MSN, NP · Jan 9, 2020

Wow, yes, that is a lot to unpack...

Take a breath. The good news is that you have a lot of good options.

Before you move forward, it sounds like you need to do some serious soul-searching. It seems to me like the biggest red flag in this post isn't the peds CICU or not question, but the FNP/informatics/peds CICU disconnect.

Those are very, very different fields, and honestly, none of them will really help you in the pursuit of the others. Can you realistically pump the breaks on the FNP program while you work through your goals (i.e. taking a semester off)? It seems unnecessarily expensive and stressful to put time and money into a degree that you don't want, especially if you may be changing directions.

Also, I would be...hesitant...to take the peds CICU job given what you've described. First off, I don't think it would be particularly helpful for informatics or even for FNP; most cardiac kids are so complex that they're pretty much exclusively managed by their cardiac team, and I don't think that you'd be able to secure a peds cardiac job without a PNP. Peds cardiac is only tangentially related to anything you'd be doing if you do ultimately choose to get your FNP.

Second, depending on the type of peds CICU you'd looking at, that job tends to be incredibly stressful, especially if the unit you're looking at is surgical and recovers fresh cardiac surgeries. If it's a medical-only ICU mixed with step-down it might not be so bad. However, if it's a true cardiac ICU that takes open heart surgeries, I can almost guarantee that it will be mentally and emotionally exhausting. As with your current job, there will likely be a lot of shifts where you come home wanting to quit.

I recently worked in a peds CVICU where our annual turnover was approximately 50% because people got so burned out. Yes, you will learn a tremendous amount. However, it is very high stress, and it is very often heartbreaking. Peds cardiac also has a ridiculously steep learning curve; even in normal hearts hemodyamics can be hard to grasp, and the array of cardiac defects make it infinitely more challenging. And like I said, if you chose to go into FNP or Informatics, all of that niche-specific info won't be very helpful to you anyway.

I seriously cannot imagine somebody doing peds cardiac ICU full-time and ED part-time, and FNP school. As I mentioned, it may be different if the CICU you're considering is medical-only and relatively low acuity. Honestly, if you're busy with school (FNP or Informatics), perhaps it makes sense to be in a lower-stress, lower-acuity job, like the peds ED job you already have.

I understand the appeal of peds cardiac as a learning opportunity (that's why I did it), but I truly believe that it might add more stress to an already stressful situation.

You mention that you want a job with low burnout. Here's the thing: nearly every nursing job causes some type of burnout in some types of people. All you can do is reflect on your own qualities/priorities and the qualities of the different roles (NP, Informatics, peds CICU) to figure out what's the best fit. Same goes finding a job with the right hours and flexibility for your family. You say your family hates that you work; your best bet is to find the type of job (or specialty) that works best with your family's schedule.

I want to ask this in the gentlest possible way: Does your employer have an Employee Assistance Program or any other program that provides employees will free counseling sessions? From your post you sound exhausted and acutely burned out. Talking this through with a counselor might help you find clarity in your goals, and you may be able to develop strategies to make your current situation more tolerable.

Wishing you the best of luck, OP.

RNNPICU, BSN, RN · Jan 9, 2020

Honesty, I would juust stay in the ER. I am also a student and have been at the same job for a while now and have considered looking, however, I still need to finish my degree and don't want to have to study for school and study/ learn all new things for a new job.

The CICU will not necesarily help you with informatics.

RNperdiem, RN · Jan 9, 2020

Are you excited about CICU, or more looking for an escape from your current situation? If you are not excited and eager to invest the extra demands on you that being new to ICU requires, don't take that job.