Non-ICU nurse pulled to your unit...

  1. How would you feel?

    I've been a R.N. for 6 years. My nursing background is step-down nursing. (med/surg and cardiac) I've never dealt with ventilated patients.

    My supervisor E-mailed us. She informed us when pulled to our "sister" unit CICU we cannot refuse vent patients.

    I've been pulled twice to CICU. Neither time was I assigned a vent patient. I do not feel comfortable with vent and balloon pump patients.

    A lot of unit nurses say caring for a vent patient is nothing. But I don't feel comfortable. I've had no education. And when the machine beeps, which they seem to do a lot I don't know what to do. My supervisor says there's an R.T. up on the unit...he'll take care of it. Sure there was a R.T. up there but not continuously.

    I'm going to ask for info. on ventilator's. And read up on it. But working contigent it's hard enough for me to keep up with changes on my unit....let alone learning about vent patients in case the time should come.

    Am I worrying about nothing????
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  2. 12 Comments

  3. by   fergus51
    No! I won't even take a real patient assignment on a med-surg floor let alone a vented patient in ICU! I am an OB/L&D nurse so it's a completely different area so when I float I do tasks like catheters, IVs, etc. I think if you feel unsafe with vents you shouldn't risk your liscense by taking a patient with one. Couldn't you switch patient with another nurse if you were given a patient on a vent?
  4. by   justanurse
    Don't take the assignment unless you're trained in caring for the vent patients. You need at least some orientation in what care you should provide these patients with. Some training on the ventilator itself. Not to mention managing the airway if a problem should arise. Surely they can train you. And, if they can't then they should readjust the assignments to allow for patient safety.

    Should not ever take a balloon pump patient unless you have been trained. Very dangerous to the patient. They are unstable, that is why they are on the balloon pump in the first place. Too many things can go wrong with the slightest miscalculation or oversight.

    Stick to your guns.
  5. by   RNKitty
    NO FLOATY! I was spoiled by working on a closed unit. No-one floated to L&D, but I also didn't have to float to sick pts. I now refuse to float outside my clinical expertise unless I am used strictly as a nurses aid, ie bedpans, vitals, etc. I again found a hospital that won't float me off maternal child, and I LOVE it.
  6. by   snickers
    Can you not send a copy of her e-mail to your nursing association?, Where I come from, that request is a violation of nursing Standards of practice and is unsafe.

    Remember...its your license not the supervisors.

    sj.
  7. by   prn nurse
    Re vents: The fastest way to be comfortable with them is to get the R.T. to orient you to the vent. I love vented patients because if anything goes wrong, an alarm will go off. You won't walk in and find a patient in agonal resp. , etc. Vents are fairly simple. The R.T. can teach you more in 5 minutes than you will learn in 3 hours with a book. And ask each R.T. to explain it and show you. and ask each one to show you how to suction....you will develop your own technique after receiving 1/2 dozen lessons from them. If the vent alarm is alarming for an extended time, it usually means the tubing has come disconnected. look for a hose that has come loose. Never push the cancel alarm button on your vent...read the alarms and you will get an idea of whats wrong...most of the time the pt is coughing and needs suctioning. # 1 rule...repeat ... # 1 Rule, when a vent is alarming, whether it is your patient or not, Get UP and go check on the patient !! # 2 Rule...make sure there is an ambu bag available at the bedside of the vented patient.....# 3 Rule... Find out the beeper # and name of your R.T. when you come on...the R.T. is your best friend...(No more rules)...Learn how to push the 100% oxygen button, so you can oxygenate your patient immediately prior to and after suctioning. It only takes a second and helps your patient immensely. Look at your patient and tell him what you are doing. When turning intubated patients, keep your eye on the tube, that is the # 1 priority, let the nurse assisting you take care of cleanup, linen change etc, you hang on to the tube, don't let it get kinked, pulled, etc. I always hold onto the tube in this situation and reassure the patient. Take my suggestions and you will do fine and feel in control and confident..good luck.
  8. by   Bobrn
    1) Tell your supervisor they're crazy as hell
    2) You can refuse assignments. Depending on which state you work in, this can affect your employement status
    3)Pulling a non ICU nurse to take care of ICU patients is dangerous. Not only is your license in danger, but if the unit is busy as hell, and your patients aren't doing so well, who's gonna help you?
    4)Tell your supervisor she is crazy as hell again. Sounds like this decision came from admin above your supers head.

    Vent patients aren't bad. Stable vent patients anyway=)
    Balloon pump patients need to be 1 to 1. There are complications that can come up and sometimes be prevented but you must have training in order to spot those problems. In our faciilities, they are 1 to 1 only, with a CCU/CVICU RN who has been certified to care for this patient population.

    What your boss is doing to you is wrong. Stand up for yourself, and refuse the float. Get your unit to follow your lead. If something happens, and you go to court, it's gonna look bad for the non ICU personnel explaining why they were working in ICU and their patient ends up expired because of any oversight or potential error. The hospital would also be charged for the decision, but they'll crucify you first.

    Now, floating and taking care of tele type patients in the ICU that are waiting for floor beds is another story all together=)
  9. by   RNKitty
    .
    Originally posted by Bobrn
    [B}
    Now, floating and taking care of tele type patients in the ICU that are waiting for floor beds is another story all together=) [/B]
    Not if you are an L&D nurse
  10. by   CYNTHIA WOODS
    Never take on any assignment you are uncomfortable with. As previously stated it is your license and no one elses. Reading about ventilators is a great initiative on your part and after that continue to educate yourself about vents. they really are not all that complicated and when you become comfortable care for a vent. patient and you will be glad you have over come your fears and obtained new nursing knowlegde.
  11. by   live4today
    I must agree with all the other nurses here and say do NOT take an assignment that you are not qualified to safely manage! NO ONE can protect your license but YOU! Tell that Supervisor the following quote (if you can remember it next time she tries to float you somewhere you aren't qualified:

    "No, I will not float to that unit and take vent or balloon pump patients because I am not qualified to do so, nor can you legally get away with making me accept a patient assignment that I'm unqualified for. If you persist with this nonsense, I'm afraid I'll have no other recourse but to write you up to the State Board of Nursing."

    That should shut her up! If not, repeat the phrase to her -- perhaps she is in shock over your assertive stand with her, and she couldn't quite believe her ears! :chuckle :roll :chuckle

    ___________________________________________


    "If you can't be a good example, then you'll just have to be a horrible warning." -- Catherine Aird :chuckle
  12. by   traumaRUs
    What is your nurse manager thinking???? Does she want to dress up and go to court???? I'm an ER nurse (level I trauma center) and in our hospital ER nurses don't float. I actually have worked OT in the ICU but I used to work ICU so don't feel uncomfortable, but would never accept assignment that I didn't feel comfortable with.
  13. by   PRFICURN
    I think that your are very appropriate to feel uncomfortable abou being ordered to take care of a vent dependant patient.

    Always think of your level of traning and experience. If you don't have the trainng then your supervisors have no right to ask to do something out of your scope of practice.

    I hae worked in aspect of critical care for 20 years. That would be like asking me to work a shift in the newborn nursery. I don't have the proper experience or training to do that.

    Keep sticking to your guns and refuse the assignment until you are offered the proper educational experiences and the clinical orientation to do the job.

    PRF
  14. by   fedupnurse
    Hi Askater,
    You have plenty to be worried about! I have 10 years of ICU under my belt. That's all I have done since I became an RN. Sending a step down nurse to an ICU is like sneding an ICU nurse to med surg or OB!! We wouldn't know what to do there! You have to be balloon pump certified to take a pump patient. My hospital does routinely pull staff from step down to the unit (and vice versa) and they do get vented patients. We fill out Short Staffing Forms to document the unsafe conditions and one of us watches out for the pulled nurse as much as possible. You can give them stable patients but they can circle the drain at any time-that's why they are in the unit.
    I don't know if you are working in a unionized facility, I do. We can also complete an Assignment despite Objection form. It has the date, time, supervisor's name and the general conditions of why you feel you cannot safely take the assignment. It is important to CYA. If something happens the suits will all play dumb and say "the staff never said anything". You can also document it by submitting a professional, matter of fact type letter to the manager you work for. After working with people in the same position you are put into, I can tell you, it is scary for everyone!
    Good luck!
    fedupnurse

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