For the first 4 weeks of his life that was where he lived. He was in an incubator and was only taken out for his bath once a day and when the nurses let us hold him. I will never forget how there were hours that we were allowed to visit our son, how whenever any test or procedure was taken place we were told we needed to wait outside.
I was unable to comfort my baby as he was pricked, prodded, and scanned. The most they let me do was sterilize his pacifier so the nurses could give it to him. Very few of the nurses let me change his diaper, and it was never when I decided it needed to happen.
I was the mother, but I was unable to care for my baby. He was too big for the incubator by the end of that month, he was maintaining his body temperature and had almost reached full term. The nurses and doctors did not want him out of the incubator because they did not want to have to dress and undress him to see his body.
He had problems with swelling that needed to be kept in check along with some pressure sores that formed because of his tumors. I understood their concerns but desperately wanted him out of the incubator. When Avi was about one month old we transferred him to a bigger hospital that had more pediatric specialists, mainly one doctor that had treated his condition before. We were pushing for him to be transferred to the NICU for our comfort. Looking back it was the best choice for us. In the PICU he was no longer in an incubator, we had a semi private space, and the doctors were so nice.
The nurses now involved us in his care. I was able to help bathe him, comfort him during blood draws, and hold him for as long as I wanted if he was stable enough. I could change his diaper whenever I saw the need, and swaddle him if he was fussy. I made sure to turn him from side to side so he would not get pressure sores and the nurses were ok with my taking that responsibility.
I was still unable to pick him up on my own, but that was now because he was hooked up to too many things and the nurses were worried I would disconnect something by accident. I was not only able to be with him during tests and procedures it was often asked or required of me.
The only time I was told to step out was if the procedure was very scary or needed to be sterile. In the NICU most of the babies are preemies who just need time to grow and get stronger. Most of the parents have the same or a similar situation. In the PICU every child is fighting for his life. Every child who is there for any significant amount of time has serious medical problems.
I no longer felt alone. The PICU was much harder for us in some ways but was the best for us in other ways. I find it so incredibly interesting how different our NICU experiences are. My daughter lived her entire life of During the first week, things were shaky so I had many of the same restrictions as you.
But afterwards, we were encouraged to spend as much time with our daughter as possible. We were allowed to hold her pretty much as much as we wanted. They got to know my baby girl so well that any nurse in her pod could update me on how she was doing, instead of me having to speak to her primary. It was my home away from home and they were much like family to us while we were there.
Many even attended her funeral after her passing. And even after her passing, they were so supportive of me during the first couple of months. They never once got upset with me for calling them out of sheer habit. Like Like.Has 2 years experience. I have narrowed it down to 3, that I feel I may enjoy and do well at. Clearly, I have decided that I want to venture into the pediatric population but I can find pros and cons for all 3 choices.
I thought I would see if anyone at all out there would have insight to share. Or perhaps just pull from a hat Specializes in Emergency Nursing. Aug 27, I have this same dillemma so its interesting to see that someone else is thinking about going into the same areas. I actually work as a tech. ED so my manager and clinical educator have advised me to look into a different area for my last practicum even though I really want to work in this same ED after I graduate this is because they think I need to have a little bit more of a diverse experience so I can see other speciality areas and see if I like them.
I have been told that NICU is really a world of its own and once you work there you usually end up working there for the rest of your career because it is so highly specialized and NICU nurses are really devoted to their patients. I think if your looking at going into Pediatrics overall either PICU or Peds ED when you graduate you should probably choose between those two departments. I think that PICU might be a good place to start because you are taking care of only 1 or 2 very complicated, critical patients and it allows you to develop those highly technical skills and be able to take care of the whole patient.
In the ED it can be very fast paced, busy, crazy and a rough place for a student to start if you have never worked in an ED. This is just one opinion. Specializes in NICU. You will get to care for infants all the way to teens.
NICU is going to be more narrow as in just the newborn population although some chronic kids stay on the unit until they are several months old they all start out there as newborns. I agree with the previous poster about NICU being a world of its own. Thanks Chris I think that goes in hand with that devotion aspect you mentioned re: the ICU. Good luck to you too. Has 11 years experience. I was offered a job in that same unit, and have been there now almost a year, and hope to never have to do any other type of nursing Thanks Bortza.
I certainly loved my day I shadowed in NICU, the nursery side wasn't overall exciting but nonetheless I loved the change in atmosphere from what I have mostly experienced as a student on adult floors and the really nice change from having to clean up lb complaining adult.
Mostly loved when I got to follow the nurse who went to the OR for high-risk births and then back to the obs unit with the sick infant. Never seen such awesome teamwork! Naturally, I would not be able to start here though but in a way that makes it less intimidating too.
My question for you I think you'd likely find that you'd be the most versatile out of the PICU.I realize that the patient population is different, but do you use some of the same treatment methods? Next, for those of you who work in SICU, do you think a new grad could come to work in the unit and be okay? Finally, are those of you who work in SICU happy with your jobs?
Do you like your work environment, and if so, could you tell me a little about what it's like to work in SICU? Thank you! Oct 1, It really doesn't matter when you break it all down. A critical care bed is a critical care bed It's all relative to the facility. The SICU nurse needs to be adept and managing the medical problems of the patient as well as caring for the fresh post-op surgical patient.
Lots of septic, hypotensive, dry, clinically unstable patients at times and at other times they are stable as a rock. You just never know. Depending on your SICU you may have lots of vents, lots of swans, vasoactive gtts, sedation gtts, fluid resus, etc.
I say check out the ICUs, see where you feel like is the best fit for you Get in there and seek out the sickest patients, ask questions of the experienced RNs and of the docs Go to the unit that has the sicker and more unstable patients on a regular basis. Brett has a good answer. There are lots of things to learn from all the 'specialties' and to be the best nurse you can be you should experience them all before you lock yourself into one unit and plan to stay forever. Those were really good responses, and it's great to get feedback from experienced nurses.
I do agree that working in more than one ICU would be a good plan, and I hope to have worked in at least two before I retire. Specializes in SICU. Oct 2, Brett already pointed out a lot of differences, which I would agree with. The MICU patients tend to be more chronic. At my hospital you cannot get a job in any of our ICU's as a new grad. We have a great ICU internship program, which I think turns out some pretty great nurses. I myself started this job with just over 2 years of intermediate care experience and it was still pretty hard to adjust to the ICU setting.
If you have any ICU internships in your area, I would highly advise them. Has 54 years experience. Oct 5, I remember the old days when it was just "ICU" However, thoes of us from the old days could freely work in both units if one was short staffed and we were equally comfortable working either.
I think a good critical care nurse can work in either. As a MICU nurse, you will still have complex dressing changes to do no burns though As an SICU nurse, many of your patients.Have heard that you get more experience in PICU with a wide variety of patients but as a nurse with no critical care experience that is very intimidating.
Anyone's thoughts or advice? Edited Nov 15, by Joe V. Has 25 years experience. Feb 19, That's a big part of what we do in PICU - assisting with central line placement, chest tube placement, intubations, extubations, complex dressing changes, endoscopy, bronchoscopy and many other procedures.
Of course, there's a huge knowledge base but no one expects a new-to-PICU nurse to have it. In NICU there are about maybe 10 typical diagnoses and it can be very routine nursing. Some people love it, but I found it didn't challenge me much after a couple of years. In PICU the patients range from neonates to young adults. They present with a wide variety of problems, with a wide variety of underlying conditions.
No two days are the same. One day you could be caring for a toddler with seizures, the next it could be a 15 year old with a traumatic brain injury and the day after that it could be an 8 year old in DKA. My bias is obviously showing but it sounds like you're already leaning that way anyway, so let me give you a little nudge Well it depends on what you are passionate about.
Are you drawn to 1 particular area more than the other? Is this an area you have wanted to go into before? When I was in nursing school I was only interested in kids or babies. I pretty much had no interest in adult care. I was lucky enough to be able to go straight into the NICU and have had no regrets. There are some similarities between these areas but there are several differences as well. Here is a breakdown. I have no experience in the PICU.
Anywhere from newborn to age 18 and it isn't uncommon for some PICU's to have patients older than These kids are living much longer now and adult doctors really don't know what to do with them. Depending on the type of PICU you are in you may see trauma patients, post surgery patients, and of course a wide variety of medical issues.
In the PICU you will see a lot of kids with chronic illnesses that get admitted often. In the NICU you generally see the same type of diagnosis.
Generally if a kid is in the PICU they are very sick and need the higher level of care. In the NICU not every baby is critically ill. Some babies are in the NICU just for a 48 hour rule out of sepsis and may just need antibiotics for 48 hours. A lot of babies are just a little premature and just need some time to grow and learn to feed.
They really aren't "sick. On the other hand you can have some very sick babies in the NICU. You could be taking care of a 1 pound baby on the oscillator with multiple drips.
Also, those babies that don't seem "sick" can turn on you in an instant and become the sickest baby in the unit. Generally speaking though most of the babies in the NICU do pretty well. Remember these babies haven't gone home yet so everything is new to mom and dad. Especially if they are 1st time parents. Throw in the fact that their baby is sick or premature and there is much more teaching that goes along with that.I am a Peds nurse with 5 years experience. I spent 1.
I chose this change because I had more schedule flexibility, no commute, more money, and almost no weekends which allows me more time with my family 4 mos. Sounds perfect doesn't it? Well, the benefits are great but not the work environment. I am not using my critical care skills and feel them slipping away. The NICU's are much closer and there are more employment options.
Also, it seems as if NICU nurses truly love their jobs. Edited Nov 15, by Joe V. Jolie, BSN. Specializes in Maternal - Child Health.
Has 34 years experience. Jan 20, I love NICU nursing, and you will probably enjoy many aspects of it as well. But having come from a more comprehensive peds and PICU background, you may find it somewhat limited.
The scope of patients you will encounter in the NICU is just a tiny fraction of what you are used to seeing in the 1 month - 18 year age range.
Jan 21, Thanks for your reply Jolie. Despite the more limited scope of practice, do you still find being a NICU nurse challenging with room to grow?
Do you find it easier to become more proficient in certain skills? Most importantly do you smile when it's time to return to work?Hi everyone!
I have been a pool nurse for a little over a year, working about 36hrs a week at a small community hospital. I mainly work on medical surgical units that are telemetry, but I've also worked on the observation unit, bariatric, stroke, psych, and rehab units. I usually have a 6 patient assignment, and have had 7 patients at least 3 times in the past year. We are constantly understaffed in every department, not just nursing so the morale is really low. I think my job is very task oriented, and do not feel like I am learning much.
I do not feel valued because I am constantly pulled during shifts and tend to have the highest acuity, most confused, and most needy patients. I am ready to move on to an area of nursing where I can grow and not have to literally give myself a pep talk before I walk in the door because I know I'm going to be taken advantage of.
I understand that the NICU has patients that are months and congential anomalies are commonly what brings them there. PICU seems to be more diverse as the ages range from 6months to 18 years. I would love to work with babies, but I am nervous that I won't feel competent.
I'm hoping I'd feel the same way after orientation and knowing that I have the necessary resources in case I have questions I really just want some insight before I blindly choose one! Thank you!! Has 5 years experience.A Day In The Life Of a NURSE! - Come To Work With Me!
Nov 17, I love watching our babies get better and bigger to eventually go home with their families. Another thing that's unique to NICU that you might not find anywhere else in the hospital is the continuity of care. With adults, as their status changes, patients move to different units. In NICU, we take care of our kids from the minute they're born in the delivery room until we walk the patients and their parents out the door.
You may take care of the same baby from the time they're 1 lb and vented until they're big enough to take a whole bottle themselves. It's incredibly rewarding to watch them get big and strong, and to celebrate as they achieve their milestones i.
You may or may not get that continuity of care in your PICU, depending on whether it's integrated into your Peds unit or if it's its own unit with separate staff. Helping parents do skin to skin, putting a baby to breast for the first time, giggling when a pooping baby makes a goofy smile.I loved how we used a different day tour agent for each of our planned trips, as it made it varied and we could compare how big the groups were. Each one were amazing, friendly, informative and spoke very good English.
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NICU vs. PICU
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