Sunday, May 26, 2013

PICU Questions

I've had a majority of the last several weeks off of work and while I'd love to say they were days off spent on vacation, or doing something amazing (or even productive), they weren't.  They were taken off for health reasons, but now I'm back.  Back to work, and back to blogging about work. 

And I must say, I am glad to get back into the swing of things.  I wasn't really looking forward to waking up at 5 am every morning again, or even the stress that the PICU occasionally (ok, frequently) holds, but once I went back to work last Thursday and Friday, I was reminded how much I truly love it.

How much I truly love the patients that I care for.  How much I love my co-workers.  How much I love the feeling of a long day of work being over...and yet how productive and gratifying that long day can be!

And now that I'm back, I've had a few questions on the blog that have gone unswered in my absence. Ironically, as I read through them today, I realized they were some of the same questions that a friend from church who is going into her 3rd year of nursing school asked this morning.

And I love answering these questions.  I love watching the excitement of a nursing student, or brand new nurse.  I remember back to the days that I was in undergrad, still trying to decide what it was exactly that I wanted to do.  Make sure the pediatrics, and the PICU more specifically, was right for me.

So today I'm going to take a bit of time to answer a few of the questions I've missed today.  If I've answered some of these in the past, you can just skip it.  Or, if you've been a nurse for awhile (or a few days!) and want to chime in, feel free. I think the more nurses students can talk to, the more prepared they will feel once done with school entering into the real world!

Q: Why did you pick the PICU?

A: I think to best answer this, I have to start with why I picked pediatrics in general.  In nursing school early on, I narrowed my choices down to Labor and Delivery/Mother Baby, and Pediatrics.  I did an internship after my third year of nursing school and didn't get my first choice Peds, but rather my second choice Mother/Baby with a couple of weeks experience in L&D.  While initially I was disappointed, I am SO glad I had this amazing experience.  It was not my clinical rotation in nursing school that showed me I didn't truly love L&D, it was the internship that did that.  So while I had a great time in Mother/Baby, there were many things that just made it not right for me.
     So that narrowed it down to Peds for me.  And then I applied for a nursing assistant job at the Children's hospital in my town and the position just happened to be in the ICU.  Now let me just say, I didn't necessarily have an interest to work in an ICU setting.  Although I also didn't have a disitnerest.  I just didn't really know much about it.

    So I took the job, liked the people (although hated the nurse assistant job b/c you don't get much hands on with the patients!), and decided, "Yeah I think I'd love this as a nurse."  So once I was done with shool, it was an easy decision.  Why work on a general pediatric floor, or a specialized pediatric floor when I could work in the PICU where I already worked? 

     I have to say looking back onto my nursing journey,  I feel like while there was some decision making, there was a lot that just fell into my lap.  And luckily for me, it has worked out well.  Better than I could have even planned it, I suppose!

Q:  What are the top 3 things that you love about the PICU?

A: 1.) The amazing patients and families that I get to work with, get to know, and spend a lot of time with.  I guess this could fall into "top 3 things I dislike about working in the PICU" if the family is crazy, or the child is a total brat, but for the most part I absolutely love the relationships that are formed in the PICU that cannot compare to any other unit.

2.) The adrenaline, the stress.  Don't get me wrong, there are many days where I think "Why in the world did I not just pick a desk job!?"  But really, I know myself.  And I know that I would be bored out of my mind if I didn't work in an environment that is as exciting, exhillarating, adrenaline filled, which can often translate to stressful, as the PICU. 

3.) I love working with kids of all ages, from neonates to young 20s (and ocassionally we do see some older) with all kinds of diagnoses. I love coming into work knowing a little bit about a lot of topics (although hopefully as I get more experience, it will turn into knowing a lot about a lot of topics!).  I love that my job focuses on the body as a whole, and not just focusing on one organ.  I love that no two days look alike in the PICU.  So I guess to sum it up, I love the diversity that the patients and diagnoses bring into the PICU.

Q: What are the top 3 things that you dislike about the PICU?

A: 1.) Death.  I hate seeing kids die. Sometimes it is bittersweet because the kid has been suffering for so long.  But in the end of it all, I hate watching parents watch their child die.  But it's a part of working in the PICU.  And if I can be a light, provide support, or just a presence to the families of these little angels, than I consider myself one lucky person to be able to have a job that has such a high calling and responsibility.

2.) Night shift.  I hated working nights as a nurse, and I hate it as an APN.  I would love to say, "Yeah, I kinda sorta dislike nights" but really that's an outright lie.  I hate them. HATE them!  I hate staying up past midnight on any given day...New Years is a stretch for me!  I hate the way that I feel at 3 am after already having been up for 20 hours.  I hate even more how I feel at 9 am when the bed is calling my name and I'm not yet home, after being up for 26 hours. But that too is a part of the PICU.  The PICU will never close down just because it's late. Or a weekend. Or a holiday.  The PICU will always need excellent nurses, regardless of the shift. 

3.) The stress.  Yes, I know that this also fell into my favorite things category, but I couldn't come up with another 3rd thing.  And thinking about it, while stress can be very beneficial, drive people to do great things, and to overcome fears, there are also negative things that can follow stress.  So it's for the negative reasons that this also is falling into my 3rd thing I dislike category.

Q: Have you ever work in, or floated to a different unit? How does it compare to the PICU?

A:  No, I have never worked as a nurse in another unit.  And as an APN, we don't "float" in my hospital.  But, when working as a bedside nurse I did float to several other units.  And they were all VERY different.  I worked in the NICU most of the time that I floated, and let me tell you while the two units share 3 letters, it's the first one that truly separates them into two totally different worlds.  Teeny, tiny babies, that don't look much like babies, are just not my cup of tea.  But most NICU nurses absolutely love their jobs.  To each their own!

I also floated to the Hematology/Oncology floor twice and highly disliked it.  I can't imagine being surrounded by kids with cancer all day.  Yes we see terrible things in the PICU.  But we see a vast variety of terrible.  Cancer all day, not my thing.

And then I floated to several other floors that specialize in various other things such as Pediatric Surgyer, Endocrine, Neurology, etc.  And while I didn't mind working on these floors for the day, I just didn't like the environment that a non-ICU floor holds.  I guess I like taking care of the sickest of the sick.  I like being able to give all my care and attention to one or two kids and really getting to know them, rather than being spread thin and caring for 5 or 6 patients.

So how's that for a "Welcome Back" party!?!?  Just a long-winded hello!

But I hope for the nursing students out there, or the nurses who are in an area that they are not completely happy with and are considering the PICU, thanks for sticking it out to the very end.  And I hope that I've helped you to see that the PICU is where it's at!!

Yes, there will be bad days.  But if being a part of a team that heals the sickest of the sick kids is something that excites you, the PICU is the place for you. 

I know without a doubt, despite having 3 (and sometimes 33!) things that I dislike about the PICU, it truly is the right place for me!


  1. Hi Dana!
    I'm an aspiring PICU nurse. I'm going into my senior year of nursing school in the fall. It was probably about a year ago that I decided that PICU nursing is what I wanted to do. In my research on nursing in the PICU I ran across your blog. Going through and reading almost every post of yours has reaffirmed in me that this is what I want to do! I'm just worried about not being able to get a job in the PICU from the start. I've been looking into graduate nurse residencies everywhere and everything is so competitive! My nursing professors think I'm crazy for wanting to go straight into the ICU but I can't imagine it any other way. Any suggestions for my future applications to the PICU that will make me stand out? I already am a patient sitter and I will be working as a cabin nurse at a camp for children with diabetes this summer!


  2. Stephanie- thanks for reading my blog! Please don't let professors tell you you're crazy for going straight into the PICU b/c if it's truly what you want to do, why start anywhere else!? Yes, nursing jobs in general can be pretty competitive, and even more so when you pick a specialty like PICU. But it sounds like you're on the right track. The more experience and time you can spend in a PICU the better. Its great to have outside experiene (like your camp nursing this summer) but really what will make you stand out from the rest is having great PICU experience and being able to express in interviews that you fully understand the pace, the stress and the environment of the PICU because you've spent so much time in it. Let me know if you have any more questions! Good luck on your last will go by so fast and you'll be a PICU nurse before you know it : )

  3. I am doing my last semester in general pediatrics in a hospital, but my dream has always been to work in a children's hospital. However, I'm not sure I'll like the peds ICU because one of my favorite parts of nursing is talking with the kids and interacting with them. Do you get to interact with your patients very much? Could I shadow at the PICU before I apply to work there? Also, why do so many travelers work in the PICU?

  4. Great post! You must be really happy to be surrounded by all the cuteness that is kids! And yes, children dying can be quite a traumatic experience. Hang in there!

  5. I was wondering what your opinions are of the health care reform? How has it effected your job and how will it effect your job in the future? And how will it affect your patients? Also what is the autonomy of Np's in your state?

  6. Dana! It's been forever! Hope all is okay..