Which job should I take

[Nurseelle9]

I am going to be transferring within my hospital system. I have worked ICU and PCU. I am confident in my skills and time management but don't enjoy older people. We have no techs and shower 2 patients a night sometimes 3 showers if they are preop. The patients have chest tubes etc. I don't find myself enjoying my work or feeling rewarded. I've always enjoyed children and mothers/babies. I want a job with less "total care" and a place I actually enjoy working.

I have an offer for a pediatric BMT unit with 2 patients. And mother baby with 4 couplets. Both seem like they'd be awesome and I just need advice

[adventure_rn, MSN, NP]

Wow--those two units are completely different from one another. I guess it all depends on what you enjoy more.

Mom-baby is actually a quasi-total-care population in a sense, as you're helping moms ambulate and toilet post-epidural. There's a lot of helping moms squat over the toilet and assessing/caring for bleeding. Much of mom-baby is education for new parents. 4 couplets is kind of like having a busy med-surg assignment--nobody is that sick, but there are a bunch of tasks to cover on a bunch of people (fundal assessments, pain meds, teaching, breastfeeding assist. Turnover is very fast, so you won't be coming in a week later and seeing the same familiar faces.

Up-side to mom-baby is that it's generally a positive experience, as the sick kids usually go right to the NICU from L&D. It's great if you enjoy teaching, and families are usually receptive and appreciative.

Down-side to mom-baby is that at some point you'll probably have to care for a mom who is grieving a stillbirth or death in the delivery room, and that is always awful for everybody. In addition, some people find it boring and repetative. You see the same condition every day, with moms wanting the same pain meds, requiring the same education, and asking the same questions. Every once in a while you'll have an emergency like a post-partum hemorrhage. It isn't as skills-heavy as many outpatient units.

Bone marrow transplant is much higher acuity. You'll probably have kids die, and you'll probably know them well because those kids have long stays. Things are done in a very particular fashion: lots of protective isolation precautions, giving chemo, etc. Some kids might be full assist, but most won't (and even the largest adolescents aren't as heavy as the larger adult population.

Work-flow will probably feel kind of like PCU or a lower-acuity ICU assigjment; it's more keeping a close eye on a couple of patients, rather than mom-baby where you're zipping from room to room. Again, a lot of the same specific conditions, but a bit more skills-heavy.

So again, I'd do some self-reflection to see which you feel is the better fit. You could also always ask to shadow on the unit to get a better sense for the day-to-day activities.

[OldDude]

I understand what you're saying. I had made up my mind I was going to finish nursing school but never work in the field. My last semester was pediatrics and changed my mind; been here ever since. I would have to quit nursing if adults was my only choice.