Floating of ICU RNs

  1. Would like to hear from other RNs about floating in their hospitals. Is there a lot of floating to other short staffed areas like ER and Telemetry by ICU RNs? Is this a problem or are there any good solutions out there regarding situations where rapidly changing patient census is a problem for adequate staffing? Where I work in a ICU in a 120 bed hospital in a rural area, there is so much floating of ICU RNs that it has become a morale issue where RNs dread to come to work for fear of being floated again. We recognize that administration has to deal with changing pt census and short staffing especially as these two areas, ER and Telemetry, seem to burn their RNS quickly but I am looking for other ways to deal with it than burning out our ICU RNS due to floating. Anybody know of any help for this situation? We have an RN nursing pool but as soon as they know they may have to float to ER or Telemetry, they quit. We have an unusually busy ER with many indigent patients.
    •  
  2. 45 Comments

  3. by   ELKnurse
    As a new nurse, it's disheartening for me to see my newly specialized skills under-utilized by my employer. I work in a CCU in a community hospital, however I used to work in a large teaching hospital SICU. From my experience in nursing, CCU/ICU nurses are continually floated throughout facilites to supply staffing to both the units and the floors. Many of my colleagues have moaned and groaned to management. My position is, if the floor nurses can't float to the units because they lack the training, then how can it be safe to float critical care nurses to the floors where they may not have the skills needed to care for those patients?
  4. by   traumaRUs
    Our ICU nurses take PTO rather than come to the ER. I'm an ER nurse (large urban level I trauma center) but the ICU nurses WON'T come down. However, recently, with the increasing nursing shortage, there aren't enough ICU nurses to staff their own units, let alone FLOAT.
  5. by   oldnurse
    OH! The days of floating out of ICU/CCU, UGH.The floor that bothered me the most was pediatrics(babies can"t communicate well and toddlers just wanted their MOMMIES). Don't know any suggestion re: floating to telem. unit but if your hospital would be willing to look at other hosps. that have a Promt Care setting for non-emergancies and semi-emergancies that seem to be flooding the ERs these days. Have the nurses been ask specifically what the problems is re: floating? Not knowning where supplies are is frustrating-and that is just a little thing. Do the ER and Telementry nurses ever have to float to ICU? Many times ICU's low census comes after a period of being almost worked to death and a couple of slow shifts are welcome to get caught up with the notices, different manufactures news/updates (esp. the pharmaciticals-just recentlly Mellaril received a black box warning(can mess up QT and Potassium)and sometimes the best is just to have TIME do do patient care, pt.education and get your charting done before your shift ends. Hope you find a working solution- having nurses quit just because of this needs to be brought to the attention of the Hosp. Administrator. Hope you are reading the entries under Fab.idea by Bunky.

    ------------------
    Paula
  6. by   ccnurse
    I work in a 300 bed hospital in the CCU. We used to have to float to the floors, but no more. The problem I had with floating to the floors is trying to treat them all like ICU pts. I am used to doing total pt care and am not used to having a CNA. I caught myself a million times doing thier job! Our manager is great and had the policy changed. We now float only to MICU, SICU, or ER. She said the same thing as above, "if the floor nurses can't float to the units, then why should my nurses float to the floors?"
  7. by   RUsincere2
    Originally posted by ELKnurse:
    As a new nurse, it's disheartening for me to see my newly specialized skills under-utilized by my employer. I work in a CCU in a community hospital, however I used to work in a large teaching hospital SICU. From my experience in nursing, CCU/ICU nurses are continually floated throughout facilites to supply staffing to both the units and the floors. Many of my colleagues have moaned and groaned to management. My position is, if the floor nurses can't float to the units because they lack the training, then how can it be safe to float critical care nurses to the floors where they may not have the skills needed to care for those patients?
    Floating should make critical care nurses more thankful for their training, and well rounded. It can improve those triageing skills, (determinging which tasks or care should be performed in the little time left.)
    It gives you a chance to see the patients that you've transfered out and to view their progress. It affords you the oppertunity to network with,and educate your floor nurses. You'd get to meet more people and break the monotony of those beeps, tones and alarms.



    ------------------
  8. by   johnboy
    I have to disagree with the above posting. I'm sure the lawyers and jury wouldn't quite understand that i'm just "improving my triage skills" by floating to the floor where I've never worked before, no orientation as to what paperwork I'm expected to fill out, what signatures go where, what discharge instructions need to be given ("initial here, here, and here please!") Oh right! When does one get time to go in, sit down and chat with the patient you've taken care of when they've been on death's doorstep down in the ICU?

    I know you're intentions were good in the above post, but not fully grounded in reality.

    We also have an suburban, small 150-bed hospital. Many times the ICU nurses staff every unit except L&D. The TCU nurses will sometimes float to ICU, but will only take the "lighter" patients ready to transfer over to step-down. The ER nurses DO NOT float over to ICU ("they do their own staffing"). Yeah, right. What really gets me is that floor nurses want "advanced skill" pay like the ICU nurses, yet "can't" float over to the ICU like we have to do for them. We're the ones that go everywhere, guess that means we're "flexible". Rolling my eyes right now!
  9. by   NtLilyWhtNeMore
    I work in the Medical/Surgical Intensive care unit at a county hospital. You wouldn't think that there would be a need to be floated, but yes, we have to go to the ER as well as to IMU. When we go to ER, we only work in the holding area, and no one even bothers to orientate us to the unit. Until I was floated to the ER, I thought that the ER nurses had skills equivalent to the ICU staff, boy was I wrong. ICU Nurses are the BEST !
  10. by   PhantomRN
    All I can do is laugh at the above post....because that is a clear indication of how different ICU and floor nurses are and better still how management has no clue. There is absolutley no reason that a unit nurse should be expected to know the culture and little intricacies of another floor. That manager should have been kicking herself because she should have known that patients generally dont get discharged from the units. It was the managers or at the very least the charge nurses responsibility to ensure that the float got patients that were appropriate.

    I mean no offense--- I work in the unit. However, I am not sure an ICU nurse is capable to take care of more than a couple patients after working in the unit for a long period. It really is a skill for a floor nurse to learn to juggle 6-10 patients just as it is a skill for an ICU nurse to notice and act upon the very small changes in an ICU patient.

    I never have thought it was fair that an ICU nurse had to go out to any floor and deliver care to any kind of patient, but a floor nurse---if they float to the unit at all--only comes to pass meds or do turns.
  11. by   PhantomRN
    Oh yah forgot to comment on RUsincere2.

    GET A D#%$ GRIP ON YOURSELF!!!!! Tell us how often- IF you are an ICU nurse- do you float to other areas? Why is it the units problem that other floors WON'T OR CAN'T- DUE TO CRUMMY CONDITIONS- staff appropriately?
    Do NOT give me that team crap, there is not a nurse on this board who would not help out their fellow nurse. But floating to another floor frequently gets old.
    We have one floor that we float to at least 3 times a week. Is that fair to us...NOOOO I think not. Because If we were not busy bailing out this floor some of the unit RNs could get some well deserved time off and just maybe this would HELP TO KEEP THEM FROM BURNING OUT AND QUITTING!!!
  12. by   Goofball
    Our ICU has a number system, so that we take turns floating out to neuro, ortho, oncology (all these units have many tele beds on them, but we don't necessarily get those pts. when we float there; it seems we get the PIA pts that the staff needs a break from instead) We only cross-train to E.R. on a voluntary basis, then only have to float there a max of twice every two weeks.
    We all HATE floating, especially to the floors. Mostly because, we are so out of practice with the volume of patients; or the specific specialty p.o. meds, treatments, etc. I barely survive, am always drowning on the floors, and I usually feel like I can't even operate at a safe/competent level as a med-surg or tele nurse can. Also, we don't do team nursing in ICU, so it's hard to do when floating.
  13. by   prmenrs
    There is this thing called "Assignment Despite Objection"; in fact, somewhere on the web is a copy of it--possibly @ cna.org, the CA nurses assn site. It tells management that you are not oriented to that floor and/or that type of pt., meds, etc., and that THEY are responsible if anything gets messed up. Like, someones life!!!

    I will try finding the form. Also, your union, if you have one, should be notified. You are risking your license sometimes going from ICU to floor and back. It's never a good scenario. If you can be crosstrained to another unit and float there, that is slightly better, but floating in general sucks.
  14. by   prmenrs
    I tried to find it, no luck tonight. I'll get back to you.

close