PICU vs. NICU: What’s the Difference?

Ever wondered which nursing specialty — PICU vs. NICU — aligns best with your career goals? The pediatric intensive care unit (PICU) is where nurses provide care to seriously ill or injured children. On the other hand, the neonatal intensive care unit (NICU) is all about nurturing premature infants or newborns with health challenges to give them a healthy start. In both units, things move fast and every second matters, but they cater to different age groups and medical needs.

If you’re a nurse trying to figure out whether the NICU vs. PICU is where you belong, this article is for you. Read on to get essential insight into unique challenges and rewards of each specialty.

PICU vs. NICU: What’s the Difference?

The key difference between PICU vs. NICU lies in the age group of patients they work with. PICU nurses primarily work with children ranging from infants to teenagers, covering a wide age spectrum. In contrast, NICU nurses focus exclusively on newborn infants, particularly those born prematurely or with medical complications at birth.

• PICU age range: Up to 18 years old
• NICU age range: Newborns

It’s important to understand that both NICU and PICU are types of intensive care units (ICU). Despite the differences, the ultimate goal remains the same: provide top-notch care for critically ill minors.

PICU: Key Details

Curious about the day-to-day experiences of a PICU nurse? Here’s a sneak peek into what it’s like to work in this unit.

Who Is a Typical PICU Patient?

Typical PICU patients are children ranging from infants to teenagers who require intensive medical care due to severe illnesses, injuries, or postoperative complications. These patients may suffer from a range of conditions, including:

• Respiratory failure
• Severe infections, such as sepsis and pneumonia
• Traumatic injuries
• Cardiac conditions, including congenital heart defects and arrhythmias
• Neurological disorders, such as seizures and traumatic brain injuries
• Metabolic disorders, such as diabetic ketoacidosis
• Hematological disorders, such as severe anemia and bleeding disorders
• Renal failure
• Gastrointestinal conditions, including bowel obstruction and pancreatitis
• Oncological emergencies, such as tumor lysis syndrome and neutropenic fever

What Does a PICU Nurse Do?

Stepping into the PICU as a nurse means being in a world where each moment counts. Besides basic nursing duties like head-to-toe assessments and comprehensive documentation, PICU nurses handle tasks such as:

• Titrating medications according to individual patient weight.
• Managing advanced medical equipment, such as ventilators, catheters, and intracranial pressure monitors.
• Assisting with procedures such as chest tube insertion, lumbar puncture, and tracheostomy care.
• Participating in pediatric resuscitation efforts.
• Creating personalized care plans.
• Providing complex wound care.
• Collaborating with a multidisciplinary team of healthcare professionals, including pediatric doctors, physician assistants, and nurses of other specialties.

NICU: Key Details

Want to know more about working in the NICU? Explore these essential aspects of working in this field.

Who Is a Typical NICU Patient?

In the NICU, you’ll mainly find newborns, from premature infants born as early as 22 weeks gestation to full-term babies up to 28 days old, although it may vary depending on facility policies. Here are some common conditions treated in the NICU:

• Prematurity (born before 37 weeks gestation)
• Respiratory distress syndrome
• Bronchopulmonary dysplasia
• Jaundice
• Necrotizing enterocolitis
• Intraventricular hemorrhage
• Patent ductus arteriosus
• Hypoxic-ischemic encephalopathy
• Congenital anomalies, such as congenital heart defects and neural tube defects
• Meconium aspiration syndrome

What Does a NICU Nurse Do?

Working as a nurse in the NICU is a deeply rewarding yet challenging role that requires specialized skills and a nurturing touch. Some of the typical responsibilities in this role include:

• Performing neonatal resuscitation and emergency interventions as part of the rapid response team.
• Managing advanced medical equipment commonly, such as umbilical catheters, ventilators, and continuous positive airway pressure (CPAP) devices.
• Monitoring vital signs and physiological parameters using advanced monitoring equipment.
• Providing skin-to-skin care, using positioning techniques, and implementing environmental modifications.
• Collaborating with a multidisciplinary team of healthcare professionals, including neonatologists, respiratory therapists, and nurse practitioners.

How to Become a PICU vs. NICU Nurse

Becoming a NICU vs. PICU nurse will lead you on a similar path, but with some differences. Both specialties require meeting certain educational requirements and gaining relevant experience. Here’s a guide to help you get started:

1. Get a Nursing Degree

Start off by earning your nursing degree — either an associate degree in nursing (ADN) or a bachelor of science in nursing (BSN) — from an accredited nursing program. Just keep in mind, there could be some prerequisite courses you need to tackle before jumping into your nursing studies.

2. Obtain a License

After finishing your nursing program, your next move is to pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to become a licensed registered nurse (RN). Find out about the newest version of the NCLEX exam here.

3. Gain Experience

Some nurses aiming to specialize in PICU vs. NICU choose to start their careers by working in units that provide a diverse array of essential nursing skills, such as medical-surgical, critical care, or progressive care.

4. Pursue Specialty-Specific Certification (Optional)

Obtaining a certification shows your commitment to staying current with best practices. There are numerous certifications available, each tailored to different specialties and career paths:

PICU certifications:

• Certification in Neonatal Pediatric Transport (C-NPT)
• Certified Pediatric Nurse (CPN)
• Critical Care Registered Nurse (CCRN – Pediatric)
• Pediatric Nursing Certification (PED-BC)

NICU certifications:

• Care of the Extremely Low Birth Weight Neonate (C-ELBW)
• Electronic Fetal Monitoring (C-EFM)
• Low-Risk Neonatal Intensive Care Nursing (RNC-LRN)
• Neonatal Intensive Care Nursing (RNC-NIC)
• Neonatal Neuro-Intensive Care (C-NNIC)
• Neonatal Pediatric Transport (C-NPT)
• Obstetric and Neonatal Quality and Safety (C-ONQS)

PICU vs. NICU: What to Choose?

Put plainly, many nurses choose PICU if they prefer to work with children from infancy to 18 years old, and NICU if they want to work with newborns.

Key Advantages of PICU

• Diverse patient population: You’ll care for a wide range of pediatric patients, from infants to teenagers.
• Exposure to diverse specialties: You’ll care for patients with a variety of medical conditions, including cardiac, neurological, and surgical, which opens doors to extensive career opportunities.
• Interdisciplinary collaboration: You’ll collaborate closely with multidisciplinary teams, including physicians of various specialties, respiratory therapists, and social workers.

Key Advantages of NICU

• High-tech field: NICUs are equipped with advanced medical devices and technology specifically designed for neonatal care, such as ventilators, incubators, and monitoring systems.
• Caring for babies: You’ll witness and contribute to the developmental milestones of newborns, from their first breaths to reaching important growth markers.
• Longitudinal care: You’ll care for infants over an extended period, building strong bonds with both the babies and their families over an extended period.

PICU vs. NICU Salary

The average salary for a PICU nurse in the U.S. is $78,000 per year, while the NICU nurse salary is higher, at $84,700. Your exact salary depends on factors such as certifications, years of experience, and employer type. And don’t forget about geography — your location can make a difference. Explore the top-paying states for nurses:

• California
• Hawaii
• Oregon
• Washington
• Alaska

Frequently Asked Questions: PICU vs. NICU

What is the fastest way to become a PICU or NICU nurse?

The quickest route to nursing is through an ADN program, which typically takes two years. After that, you can boost your education with bridge programs like ADN to BSN. While some new grads start in specialties, some employers may prefer candidates with at least a year’s experience due to the high acuity of patients you’ll be working with.

PICU vs. NICU – which has a higher demand?

The overall job outlook for registered nurses, which includes those in PICU and NICU, is projected to grow by 6% in the next decade, which is faster than the average for all occupations.

What is the NICU age limit?

Generally, NICUs are designed to care for premature infants, but more than 80% of NICU admissions are more mature newborns — infants born at 34 weeks’ gestation or more. In many cases, babies are admitted to the NICU immediately after birth and may stay until they no longer require specialized medical attention or until they reach a certain gestational age, weight, or developmental milestone.

What are the challenges of working in NICU nursing?

Experiencing the death of a patient in the NICU can be deeply traumatizing for nurses, especially considering the strong bonds formed with both the infant and their family. This may lead to burnout and compassion fatigue. Therefore, prioritizing self-care is essential when working in this field.

What are the challenges of working in PICU nursing?

The challenges of working in PICU nursing include triaging critically ill patients with diverse and complex medical conditions and providing support to both patients and their families during challenging times. Additionally, they may face emotional challenges when dealing with the trauma of pediatric illness and the potential for difficult ethical decisions.

Why pursue specialty certification in the PICU or NICU?

Certification demonstrates commitment to excellence in these specialized areas of nursing. Here are some additional perks that certification can bring:

• Upgrades your resume: Certification shows your employer that you’re an expert in your specialty, making your PICU or NICU resume a stand out among other candidates.
• Increases salary potential: Certification opens up opportunities for career growth and advancement and higher salaries.
• Expertise enhancement: Certification deepens the skills that allow you to confidently handle complex medical conditions, procedures, and emergencies.

PICU vs. NICU: What’s Your Next Job?

Feeling empowered with your newfound clarity? Begin your quest for the best-fitting nursing job today with IntelyCare. We’ll help you find opportunities that match your unique talents and preferences.