[travelcrazyRN]

ohh..every assignment brings on a new challenge, and an unexpected event. I seriously have to consider if traveling is truly worth it to a med/surg/tele nurse. I just started a new position in a tele unit. I didn't ask in the interview where I had to float too...I just assumed I would float, and I would float to med/surg or other tele units. On my second day (1st off of orientation)...they told me I had to go to ICU. I'm not an ICU nurse!!!! Anyway...something came up and I didn't have to float, but as it turns out Tele nurses float all the time to ICU and of course, travelers always float first. Another Tele nurse without ICU experience was floated the same night and they tried giving her two vent patients. I have no vent experience, along with other things that usually come along with ICU level. They know this from my skills check list. They also asked my vent experience (I have none) during the interview because a sister unit takes chronic vent patients. Has anyone else dealt with this? I would not get a day of orientation in the ICU either. What do you do? They keep saying to the travelers.."dont worry, they will give you an almost tele patient"...hahah...A ICU patient is an ICU patient for a reason. They want them to be cared for by an intensive care nurse. These aren't downgraded patients waiting for a room...There are always empty rooms on the floor that they could transfer to. This also wouldn't be for a helping hand with RN experience. This is CA and the sole purpose would be for me to take patients because of the CA ratio law.

[jmgrn65]

I have worked in an ICU that some of the patients would have been on a tele unit if they were at the sister hospital. Hopefully they would only assigne stable patients, patients on vents can be stabel and somtimes easier to take care of, if they have resp. therapist on the unit they will take care of the vent. part. I know it can be scary. Good Luck and bug the heck out of the charge nurse if you are uncomfortable about something.

[Angie O'Plasty, RN]

I had the same complaint, even though I'm staff, not a traveler. Here's the link to the poll results and the comments:

http://allnurses.com/forums/f8/shoul...it-229015.html

Can your agency help with this situation? I personally don't feel that it's safe. I was really looked down on by other tele nurses who "didn't mind" floating. There was one in particular who insisted it was safe -- until the day that all three of her assigned "almost tele" patients crashed, one right after the other. She became a believer then. I still think that if a patient is in the ICU, they're paying for an ICU nurse and they should get an ICU nurse. ICU is not tele and vice versa.

[ERRNTraveler]

Call your agency to help you out with this. You should not be floating to a unit you are not qualified to work on, and your company should back you up on this- if they don't, find a new company, and always ask about floating when you interview. If a hospital tells you you'll only have to float to med/surg/tele, make sure it's in your contract!

[lorilou22RN]

You have every right to refuse this assignment, I don't feel there are any almost "tele" vented patients. What were they thinking. Definately, speak to your agency and voice your concerns. This is not safe practise, a simple thing like high vent pressures and you wouldn't know to suction, or to monitor ETT placement, sedation, protocols etc. Good for you. Don't let management cut corners at the cost of patient care.

[suzanne4]

Definitely look for another assignment, they are putting your license at risk for no reason each and every time that you float to an ICU when you do not have any experience in that area, as well as trying to give you a patient on a vent with you not having any vent experiece.

If you look at it from the legal side of it, you will see my reasoning:
I have seen nurses get floated to the CCU, that have never worked in that environment and get a patient on drips that needed to be titrated; they were doing that but had no idea of exactly what the pressors were even being used for. And even if there was another nurse there to ask, their name was listed as being in charge of the patient, so with any issues, they were the one that would take the fall for it. Same thing even with EKG strips, most tele nurses have never taken a full EKG course and usually have a monitor tech on their unit. so even with someone reading your strips for you and giving you an incorrect reading, and you treat the patient based on that incorrect assumption, again, it is you that will be legally responsible.

Per any BON, you are just delegating someone to do something for you, but you are the one that is accountable for it; and your license.

No assignment is worth that. And your agency should back you on this, or find another agency.

[travelcrazyRN]

update--I did let my recruiter know what was going on. Haven't heard back yet (it's been about 10 minutes). The next day I was floated to ICU. Before I went I told my supervisor that I did not have ICU experience. She looked like she had heard that many times, and said it is in your contract to float. I said I have no problem with floating to like units but I do not have ICU experience. She says "all the travelers" are required to float. I said I would not take a vent patient. She said well you won't take a pt with an ET tube, but I would be required to take an Trach with a vent. I told her I would go to ICU to see what they wanted me to do before I said anything else. I ended up with a q1h accu check and insulin gtt with titration, and a elderly post surgery patient with q1 everything. Just a very busy night, but no major gtts or vents this time around. :-)

[Valerie Salva]

I agree with Suzanne.

It is so immoral for mgrs to assign nurses with no ICU or vent experience to care for such pts. Imagine how scared any of us would feel if we had a loved one in ICU being cared for by a non-ICU nurse.

It's an injustice to both pt and nurse.

You don't assign a cardiologist to do brain surgery.

I do not know what has gone wrong with these mgrs. What are they thinking?

[angel4gramma]

In a recent assignment, the asked my to float to Icu. I am a Tele nurse and said I was not comfortable. My contracts always say "float to unit where competent". They assured me I would be taking care of pt waiting for a bed. When I got there I was getting ICU pts. I politely said I was not comfortable. The charge nurse was not happy and called the staffing office to "talk with me". I was sent to another Tele floor and they never asked me to go to ICU again.

[travelcrazyRN]

I just hope this place doesn't send me to ICU and I have to refuse an assignment I can't handle. They have cancelled several travelers over the past two years for various reasons. If I refuse an assignment I feel like they will cancel my contract and I will be stuck in Los Angeles without a job and apartment and nothing else lined up. I'm sure the company I'm with now will not pay be the completion bonus if they cancel the contract.