Pulled to other floors?

[DroogieRN]

Are you pulled to other floors to work? At my facility, we are, once we are three months off of orientation. The only nurses in the hospital who are not pulled are ER nurses. I think ICU is at least just as specialized as ER, and I don't think we should be pulled. I am newer to ICU and have spent the last six months trying to think like a critical care nurse. Totally messed with my chi the other night to be pulled to a telemetry floor and have eight patients (for the first time in my career). I am feeling a bit dejected because I feel like I didn't give great nursing care to any one of them. Just hoping for some encouragement or advice. I love my job but a steady diet of this would make me look for a different one...

[OnlybyHisgraceRN, ASN, RN]

I have two months to go before I will be floated. Not looking forward to it at all. However, I will do the best I can do. I feel like I'm at a slight advantage coming from LTC to ICU. Taking care of six to eight patients won't be easy but won't be unfamiliar either. I fear of going into task mode. Obviously, I won't be able to do a thorough head to toe assessment on all tele/medsurg patients.

[PediLove2147, BSN, RN]

We only float to our "sister unit" which is another post-surgical unit, just a different patient population. We are cross-trained (4 hour orientation) so if the need arises we should be able to function. It doesn't happen often though. I have worked at my facility for a year and haven't had to go yet.

If you work ICU, IMO you should only have to float to other ICUs. That would be so hard, going from critical care to taking care of 6-8, maybe ready to be discharged patients. Do you even know how to do a discharge? I know our ICU nurses don't! They don't even use our computer system. They would be lost!

[CrystalSSA]

I got pulled to another floor just off orientation to find that they think five patients is "just too much" (I have six). I spend my days chasing my tail and they sat around discussing how to best care for their patients. I was shocked at the difference.

[RNGriffin]

A nurse is a nurse, regardless of where the facility places you, you should be able to provide competent care. You may feel out of place being oriented to the new floor, but your care should remain the same. This is my philosophy.

[echoRNC711, BSN]

Throw any fears of "good care "out the window.If you survived and did not crumble that is absolute success. I have witnessed some really tough experienced nurse's completely fall apart when out of their own environment. (and there is no shame in that either )

Floating is tough but the more you do it the easier it gets. I had the misfortune or fortune in having a battle -axe manager early on in my career in med surg. To get away from her I volunteered to float. . Because I was volunteering,my attitude was different. I looked on it as I was interviewing all the floors for where I might like to go and also made a personal goal to become as skilled in as many areas as possible. I took some chances, I went to critical care,which in retrospect was probably a bit crazy . What resulted was I arrived happy, people noticed and managers in several places offered me a spot when the next ones opened up.

This was the best decision I made in nursing and it has made me unafraid to try. I used fear as my catalyst. I went to CVRU because codes scared me again while there I volunteered to take the beeper to be on the code team when it was our turn.

For now you could volunteer to go when a float for critical care comes up then when a floor comes up it will never be your turn.It will give you a chance to advertise yourself in other areas.

I am currently in cardiac rehab,the "hook house ". I got the job because the manager remembered me the "happy floater "10yrs previously

The quote "Leap and the net will appear " has always been my guide . Explore all of it,you will be glad you did.Best of luck

[evolvingrn, BSN, RN]

I think our icu nurses just round and offer help....they don't ever take pt assignments on a reg floor. nobody aound my town has to take 8 patients. most have a max load of 4 pts. and I think the icu ratio i 1:2 or 1:3 if acuity is not very high. I would think they would be able to function.... but it certainly wouldn't be ideal. our icu's are overstaffed and we have a dedicated float pool that is trained for the units so they float there when there is a need.

[MomRN0913]

It is a part of the job no one likes. I understand it has to be done, but it was done unfairly in my old hospital.We had 2 ICU's, MICU and SICU. I worked MICU. We would get pulled to the ER for the ICU holding patients and to telemetry: and SICU if need be. sICU however, was a closed unit. Well not so much closed but a one way door whew MICU could get pulled there, but they couldn't get pulled to us if we were short. Before I left they started pulling us to staff other units when we were already painfully short. Now I heard it is much worse where we are Already painfully understaffed, yet are still getting pulled to ER hold while nurses are taking 3 critical vented patients and we have to respond to all the RRT's and code blues.My friend/ coworker is working on a proposal to make our unit a closed unit. If he accomplishes it, I'll probably go back part time! Well, I was considering anyways, but my ex coworkers are kind of scaring me at how unsafe it currently is. But there is my rambling.Oh, and prior to icu, I used to float, and I would float to mother baby. While ICU never floated there, they asked me one night when the. Users was short. So, I gladly ga e up my vented patient trying to jump out of bed with multiple decubitus and my other patient to feed babies and change their diapers.

[babyNP., APRN]

A nurse is a nurse, regardless of where the facility places you, you should be able to provide competent care. You may feel out of place being oriented to the new floor, but your care should remain the same. This is my philosophy.

Well, I think that is very unsafe. I'm a NICU RN, always have been (more than likely always will be), never done anything else. I wouldn't know how to recognize signs of distress in an adult unless it was super obvious like he was gasping. Heck, I don't even know what a normal O2 sat is for an adult because my kids range 85-95% most of the time. Do you think I remember from school, 4.5 years ago? heck no.

We have to float to the PICU and the Cardiac ICU (still pediatrics). Everyone on my unit hates it. We don't feel comfortable with the population and don't really know any nuances that would be helpful if the kid suddenly starts crashing. I had a 4 year old the other day that was weak-bodied, but still able to groan, which we as NICU RNs (several of us had him over the past few days) took to mean pain. The attending said, "It's not pain. He's just being a 4 year old and is cranky." "So...what do I do with him?" "Well, what you normally do with a 4 year old?" "I don't know. I've never taken care of a 4 year old in my life. I don't have kids." "..." Kid was too heavy to cuddle, too mentally out of it to understand any comforting words as well as watching anything comforting like tv. All I could do was change his position, hoping that it might be the cause of his groaning.

At least the PICU and the CICU both have older kids, so they know more of what they're getting into.

edit: if it truly feels unsafe, then we can call our charge or even our manager. Thankfully, I haven't had to do that, but other nurses have. It just upsets me that these other units try to dump bad assignments on us that they know we can't handle and expect us to jump on it.

[JessiekRN]

UmcRn..to answer your question about what the ER does when we need help..well when the bus loads start arriving we simply just have to handle it. The sickest are seen first, and everyone else just has to wait. Sometimes, if its really crazy, we'll put out calls to see if anyone at home can come in, but that's always a long shot. Long story short ER we do the best we can with what we have and it becomes a real triage situation. Much of the population that comes through the doors are not that sick (contrary to what they may believe) and can sit in the waiting room until we settle down. Sure it gets hairy. But there are times- although short lived- when things slow down and we can all breathe for a minute. Just the nature of the ER- unlike the units where every patient needs ongoing care. Hope that helps.

[stopthepenguins6]

From our ICU we can be pulled to anywhere the "critical care" nurses work in our hospital...namely PCU (max 4 pt a nurse) or to the ER. We never get pulled to a med/surg floor. Our PCU staff will go to ICU or they will go to telemetry. And our ER...well, they'll stay in the ER, or they'll go home . The only time I've ever seen an ICU nurse go to med/surg or telemetry floor was when a nurse called in to staffing for extra hours and was told they only had an opening in med/surg and she was given the option to voluntarily go for some extra hours. We rotate turns for our floats, so if you're number is up, you go, as long as you've been off orientation at least 6 months.

[SalineFlush]

Floating can really stink as it never makes for confidence when you are pulled into an unfamiliar environment and made to care for an unfamiliar patient population with unfamiliar staff. I am also an ICU nurse, but at our hospital, while we can float to the big telemetry and medical floors, we have a four patient limit. If it were suggested to me on a float that I was to take more than four patients, I would call my director and raise civilized cane. If that didn't work, I would probably refuse. It isn't safe, and while the hospital can always replace me as a nurse, my license is my livelihood.

[Mas Catoer]

When staffing efficiency is among priority in nursing management, floating system is inevitable. But it is wise to be done by considering the appropriate skill levels between floors. This is less stressful to the staffs.

To be true, no one likes it. But still, can get used to it.