NICU nurses working on Peds

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    hello nicu lovers! i have a question/concern! our nicu census has been low for several months now and we have been furlouging a few nurses daily. unfortunately, our pediatric floor is hopping to due rsv/pneumonia/rds, etc. because these units are under the same direction basically, we are being asked (told) to float to this unit, or else. the majority of our nicu nurses have never worked, let alone been oriented to this unit, or any other! we are being told that because we are a specialty/critical unit that this is basically a step over, or down for us. our nursery nurses, who float to nicu and take care of babies with abx and o2, are not going to have to float because they are not "special!" as if there wasn't animosity between the nicu/nursery nurses already!

    my concern is our nursing licenses. no, i don't want to furlough 2x in a pay period and i want to keep my job, but administration is looking at #'s and not patient care. yes, we take care of respiratory issues all the time, but nothing is similar in these 2 units. plus, we may work 1 day on peds and come back the next day to nicu after being exposed to lord only knows on the peds unit. one nurse worked for 3 hours on peds and then had to float back to nicu and take care of 2 recent admissions.

    does anyone see a problem, or are we all over reacting?

    would appreciate any comments/concerns!
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  3. 6 Comments so far...

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    hmm hard to say. At my hospital NICU/PICU/PCVICU all float together, right now we are all hopping and nurses are floated between the three units all the time, if there is a bonus out for overtime it is offered to all of the ICU's. Now when I go to PICU or CICU they TRY to give me a baby, but it doesnt always happen, anywho I still have my one or two patients, drips, lines, vents which is similar to NICU land...being on the floor could be pretty different with such a different flow and differences in priorities. Sorry i'm not much help, I'd be interested in seeing what others think
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    We have an age limit of under 1 unless we are comfortable with the older kids. Nursery people float under that stipulation also. Most everyone will take the older kids, but if there is something we aren't comfortable with or don't understand we say something and if the charge nurse refuses to change the assignment or if we feel they are dumping on us then we call the supervisor to interfene. Almost all of them are just grateful to have the help and are pretty decent to us. They know that we don't have to float up there, we can take the cancel instead, but like you said, who wants to go without pay or eat up their vacation time because census is low.

    We can float and come back to the unit the next day, but we can't come back to the unit in the same day unless we shower and change our clothes if we have rule outs or positives. That is in our float policy. And you license is only in jeopardy if you accept something out of your ability or you don't open your mouth if something isn't right. You always have to think "What would the reasonably prudent nurse do in this situation".
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    We float too. We are supposed to only float to infant/toddler if we are gong to a general peds floor, and we are supposed to only get babies....but. Sometimes we get older kids, and sometimes we are sent to schoolage/adolescent. I totally agree with you with the safety concerns regarding not being oriented to the unit or the patient population. I have to say that I think being concerned that your patient might have something contagious may be grasping for reasons to not float though, since you encounter so many 'outside' people in the course of the day in the NICU that you can't really control sicknesses coming in anyways. Proper hand hygiene and a mask and/or gown when appropriate should really be sufficient.
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    At my hospital, we have to float to pediatrics or newborn nursery. No one wants to go to peds, but I don't mind it because I started out there. We recently had a nurse float there from newborn nursery though and she contracted mycoplasma pneumonia and was on disability for MONTHS. Frankly, we don't have the acquired immunity of peds nurses, but it's a losing battle at our hospital.
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    My first job as an RN was NICU. I recently switched to PICU (but still work NICU PRN) and found there to be a HUGE learning curb going to PICU. I don't know if it's because NICU is so different than any other unit, or that it was all I never knew as an RN. I found in PICU the kiddos are alot sicker, have more disease processes, and the unit I'm in does solid organ transplant so throw that into the mix. I think that if you have to float you should have atleast a "shadow shift" where you just shadow a peds RN. Everything is so different, it doesn't seem safe or fair to just throw you into it and expect you to float. Good luck!!
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    We also float to peds/picu in low census. We only care for under 2 years. We have a resource and we always refuse unsafe assignments, we don't do admissions there either. It is difficult to step onto another unit with different routines and practices but like others noted, you have to think about what a prudent nurse would do. As for infection control, we have peds/ picu floats often and we haven't had any issues but several of us have got upper respiratory issues after floating there.
    On a side note, we were floating to med surg and Ed as "helpers" where we could only assist nurses and techs, run to pharmacy and lab, take vitals (then report to rn). That was a challenge because we had to argue the safety of our ability levels in adults and why we couldn't accept assignments on an overwhelmed, understaffed floor.
    Bottom line: floating is uncomfortable but necessary evil sometimes.


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