Dilemma: FORCED to float to med/surg - advice please!?!?! - page 2
i'm an lpn working in a geri/psych unit at a hospital in ne arkansas- been employed here since october and had 4 days orientation on the unit. previously i worked in a nursing home and before that... Read More
Jan 19, '05Quote from SweetnessBingo. Great call.The abandonment thing is a bunch of bull. You can only be charged with abandonment if you accept an assigment, and receive report, and are technically caring for your patients and then walk off. But if you don't accept the assignment, how can that be abandonment? Stick to your guns.
And as another wise poster said, I'd rather lose my job than my license. At least there is always another job out there.
Offer to assist, but decline to carry a patient load. If they insist, don't do anything you aren't qualified to do. Walk out before you agree to carry a patient load on a unit you're not competent on.
Jan 19, '05never happened to me, but my mother complains of it all the time. She's an LPN in med surg....sometimes they float her to ICU or L/D Postpartum. She goes, but tells them I can only do xxxxx or xxxxx and won't do xxxx. There is no protest form in her hosp. either you go or you quit.
Jan 19, '05Nurses are put in awful positions today and this is one of them. I also feel for the nurse on ther floor who get a float nurse who says 'I can only do ___ and cannot take patients." Its a catch 22 all around for the nursing staff.
They cannot charge you with abandonment if you have not accepted an assignment.
You always have a choice, but there will also always be consequences. Remember your supervisors have licenses too...the supervisor who harassed you into working a unit you didn't feel comfortable with is guilty of unprofessional conduct, maybe more, by delegating nursing duties to someone he knew was not qualified, coercing through threat of firing. I personally would write this to the BNE and notarize it with a copy to administration. If you are moving on and don't need a reference that is. (there's the 'consequence' I spoke of.
If more of us remembered our supervisors have licenses, and we read the NPA and held them to it, perhaps these managers and supervisors would stop bullying.
Unfortunately hospitals needs flexible staff who will float and they WILL bully, coerce and threaten to get them...if we allow it.
Jan 19, '05"When in doubt...DON'T"
Stick to your guns !!! put it in writing and submit it to your DON..If you are uneasy about something, that's your body/minds way of saying WAIT A DAYUM MINUTE...lol...everyone is different and has their limitations..don't let yourself be put in a dangerous situation....cuz guess what? nobody will have your back..can't you just hear it now..'she accepted assignment, I assumed she was capable'..even though you may have expressed your insecurities/lack of experience/knowledge in an area...'if she wasn't comfortable, she shouldn't have accepted the assignment' ...don't be bullied or intimidated...it's YOUR liscense...protect it
Jan 19, '05Another point, I think, on the abandonment issue, is if he TOLD her to go to home, HE sent her.......in no way is that to be construed as her abandoning anyone.
Jan 19, '05[QUOTE=TriageRN_34]The worse one I had was working neurovasc,and all the sudden they needed a body to watch telemetry! Okay..they asked me and I said I don't really know telemetry! They got very curt with me and said..."when we hire a nurse with ACLS experience we assume that person can read an EKG!"...I of course replyed "two years ago I got a glimpse at a THREE LEAD EKG during a mock code and the paramedic there told me what it was and I did my job...ACLS is not a study in telemetry..only telemetry is."
Now I realize I am a bit off topic here......and please do not take this personally...... but this exemplifies what I see as the "dumbing down" of nursing. We have become a profession which awards licenses after answering 75 questions. Our certification exams have become a piece of cake. And then there is the difficulty (or lack thereof) of successfully completing a course in ACLS.........
A prerequisite to taking a course in ACLS used to be successfully completing a basic dysrhythmia course. And for good reason: For one, one of the testing stations was a written dysrhythmia exam. For another, misidentifying rhythms in Therapeutic Modalities or Megacode meant a retake the first time and a failure the second. It is true that ACLS is not/was not a study in telemetry----rather a command of basic rhythm interpretation was a given because in those days there was so much material to cover. Indeed, although we did have teaching stations, there was no way an individual could complete the course without significant precourse preparation to include didactic study and megacode practice.
I don't know what rock the supervisor in this scenerio has been hiding under....ACLS has been a joke for a quite a number of years now. Yet remarkably ACLS' reputation for difficulty and stress inducement remains.
Management, in it's zeal to contain costs yet maintain a perception of competency is reaping what has sown: more ACLS providers than ever, yet many are unable to recognize a normal sinus rhythm unless it's in lead 2.
Jan 19, '05Quote from bonemarrowrni think you're right. if i come to work and find they are going to float me or make me take care of 60 patients alone...i can just leave if i haven't done narcotic count/accepted the keys. if i do count and then leave , it is abandonement...i thinkcall me crazy (and please correct me if i'm wrong, any legals out there) but isn't it only abandonment after you've accepted the assignment? or if your relief doesn't show up and you leave? i don't believe you can abandon a pt for which you have not accepted care of.
Jan 19, '05thank you all for your kind words and encouragement - means a lot to know that there are others out there who have "been there, done that" and survived.
my monday went by slowly, but i looked at it from an orientation view. the nurse that i was replacing showed up around 11:30 pm, but instead of sending me back to my area, they left me where i was. and i was lucky enough to be working that day with nurses i knew personally, and who understood my predicament. the med/surg nurses do primary care - each nurse takes anywhere from 5-8 patients each. that day they decided to can the idea, what with only 4 nurses (2 lpn, 2 rn) and 3 cna's. amazingly, the next day they had plenty of staff - thanks to agency nurses. but for some reason, the 3 nurses who called in for monday (and called in before midnight sunday night) just couldn't be replaced. "couldn't find anyone willing to work". i bet there were some agency nurses who were willing, had they been asked at all!
it's not that i couldn't do the things they needed me to do, i just didn't know how they did things - how they chart, how they do orders, etc. just like the cpr issue: yes, i know how to do cpr...have known how for years. but i don't have a piece of paper at that moment that states that i am certified to do it. i have been cross trained in lab and xray since back in 1991 and have done phlebotomy very well. was called on many times at the nursing home for the hard sticks. but right now i have no paper that states i am certified in iv therapy. i've never given an iv med, never even hung fluids on a patient. i have no idea how to push specific iv meds or flush porta caths. and i'm not going to unless i've learned how and been certified to do so. i did begin my iv instruction on monday, and dc'd 3....and started my first one on the first try. ta-dah! 2 more sticks and some med education and i'll be on my way. heck, i might even just leave the geri/psych unit and go for the floor work....who knows! but thanks for all your support.
one last note: arkansas is an "at will" state, where the employer may fire you "at will - and for any reason they wish". you don't even have to refuse; they can fire you simply because they want to. period. had i stuck to my guns and gone home, i would have been fired, and would be required to pay back a $2500 sign on bonus from when i hired on. thing is, after taxes, the first half of the bonus was only around $800... so will the second half i am to receive the end of this month. but if i were fired, i would be required to pay back the entire $2500. aint life grand and fair?Last edit by anndoodle on Jan 19, '05 : Reason: Addendum
Jan 19, '05Sorry to hear about your dilema. It must be very frustrating. I work in an ER and we almost never float, as we always need to maintain a minimum staffing level. But where I work floating on other units is very common. Even floating to the ER is common. When census is low staff are sometimes given the option of floating to aunit that needs them, or to go home.
In the ER we sometimes need help d/t ill calls or even just being swamped with patients. I don't know how the supervisors/managment present floating to the ER to staff, but I can tell you in the ER our expectations are not aimed too high. Sometimes all that is needed is an extra hand to pass meds, or check vital signs, and if a non ER nurse watches a patient and something needs to be done that they are not comfortable with, or don't know how or in what way to do it in the ER, we all understand when they ask for help, and encourage it. We are always very thankful just to have a hand.
There is no excuse for rudeness though. We all have to work as part of a team, even other departments.
Jul 23, '11good morning everyone, new nurse here,
I was working on 3-11 shift at LTC, filling in for another LPN who went on vacation. I had 29 pts patients at that time. The second nurse I was working with was told to go home early and I was told to take her assignment of 30 patients on top mine. I refused, and now I was given a choice to resign. Has anyone had this experience?
Thank you and have a good day
Jul 23, '1159 residents for one nurse on 3-11? Ridiculously unsafe. I have to staff to census and acuity, but that is too many residents for one licensed nurse.