Objectives: The objectives for the study was to describe challenges in caring for children in adult intensive care units as perceived by the intensive care nurse.

Research Methodology: A phenomenographic method was used since the aim of this study was to uncover nurses´ experiences of a phenomenon in their everyday clinical lifeworld. Setting, eight semi-structured interviews were conducted with intensive care nurses working in two different hospitals in Mid Sweden.

Result: The result revealed several qualitatively different internal challenges connected to caring for a critically ill child. Two qualitatively different main categories: Internal Challenges with subcategories Fear and Empowerment and External Challenges with subcategories Learning environment, Another way of working. and Environment.

Conclusion: Children’s vulnerable position in health care is clearly revealed in this study as it uncovers intensive care nurses face fear and uncertainty as a result of lack of adequate experience and knowledge when caring for children in the AICU.

Clinical Relevance: The external challenges perceived by AICU nurses when caring for critically ill children are closely linked to the internal challenges. And highlights the need of a systematic and well-designed in-service training and learning environment for nurses working in an AICU. A systematic and close collaboration with a PICU with possibilities to interchange should be a prerequisite when caring for children in the AICU.