[mattcastens]

Does anyone out there work in a hospital that has a "closed" critical care float policy, that is, a policy where CC nurses only float to CC areas? I am currently on a committee that will be submitting a proposal to our hospital's Staffing Advisory Committee for closed floating. If anyone has such a policy in place, please leave a message here ore-mail me. Thanks!

[OrthoNutter]

That kind of policy sounds like a fantastic idea....similarly, I think there should be some sort of policy in place which allows non-critical care nurses to be floated only to non-critical care areas. Of course, making allowances for those nurses who have the necessary experience/desire to delve into these areas.

In my organisation, it is in our employment contracts that we can be floated anywhere within the hospital in times of extreme acuity, regardless of experience or comfort level working in other areas. I've been informed that I've been seconded to critical care over the silly season and I'm definitely "not happy, Jan!"

But that's how life goes in this place...

[nimbex]

we initially did only float to the ICU's. Here's what happened. I've worked CCU for 6 years now. A patient with a HR of 50 with a BP of 90/40 is not only a norm but a goal in a CCU. Floating to SICU, HR in 120's, CVP 18, wedge of 18, BP 140/88.... I'm calling the Doc to get meds to drop these numbers and rest the heart.

Wrong answer, the above can and usually is normal, unless an AAA with tighter parameters....

We found that a cardiac nurse and surgical nurse are two different entities.... with two VERY different knowledge bases and comfort levels.

So we made the CCU and CCU step down sister(floating) units and the MICU and SICU sister units.

Unless there is a plan to train the nurses.... a surgical nurse floating to CCU taking care of a complete heart block with a rate of 30 will scare them to the enth degree... while a CCU nurse looks at it and says yep.... they're fine.... so what? and it harrasses the MD's too!


Just food for thought... hell, I'll take ANY ICU any day, but I've cardiac surgery experience that my peers don't and floating to cardiac surgery scares them beyond belief.. it's not cardiac... they're surgical.

If you have clinical ladder, use your ladder nurses as training support to develop a training seminar, brief but full of hand outs.... Most nurses, if given advance training will be more likely to get buy in from... then just floating them... which will give you more support through your process.

Also consider survey's with the ICU nurses... with feedback from them, you're more likely to get buy in from management.... after all, decreasing turn over should be a goal for EVERY manager.

Good luck, take care

[ValWai]

It's nothing personal. And I am a nurse in dialysis and I wonder if my mother was admitted and was having a heart rate of 30. So, is she all right? I mean judging my own mother as a daughter. I agree that "We found that a cardiac nurse and surgical nurse are two different entities.... with two VERY different knowledge bases and comfort levels." But is it some kind of defensive mechanism.