NICU to the PICU :(

Heather333 · May 1, 2003

I was floated to Peds a couple of weeks ago. They gave me all babies. I had a 3 week old, 6 week old, and 11 month old. I didn't mind it too much, but I wouldn't want to do it all the time.

iceNICUnurse · May 2, 2003

I Hate it.

We don´t have a PICU but we get floted to Peds surg and ER.

I never know what to do there and the staff seems to think that I can do everything even if I have newer set one foot in the ward before.

I am pretty sure that when things will go crazy at NICU then we won´t get any help from the other ped wards.

iceNICUnurse!

Brownbetty · May 2, 2003

I don't like the Peds floor or the Pediatric ICU. Granted some of the patients are ex preemies, however as they get older it is a different ball game. When I floated to the Peds floor for the first time (mind you without cross training:rolleyes: ) I had a 6 month old, 2 year old, 13 year old and 17year old. I had to admit one of these patients and discharge a patient. I am new to the NICU and get so unnerved giving meds i don't normally give, it takes me forever to get my meds as I am searching for med books to look up my dosages etc. Charting is different on the Peds and PICU units. It took me an hour just to complete my charting in the PICU today. It was so frustrating, while at the same time trying to transport a patient on a vent to another hospital. I just cannot stand how our unit just throws us to the wolves when we go to these other units.

When peds nurses float to the NICU we give them feeders and growers, NO admissions, discharges or anything like that.

Teshiee · May 2, 2003

Brownbetty,

You know they are wrong for doing you like that especially when you are learning NICU. I know in some acute care facilities will not float anyone for at least 6 months but to not give you some orientation I would have flat out refuse. I can't stand floating I hate it especially peds, just a kid medsurg. I am glad right now our census is so high that floating is nearly out of the question. :-)

MR.PICURN · May 2, 2003

Brownbetty, I know what you mean about having to float and not be crossed trained. I am new to the PICU but was informed that there will come a day that I will have to float to the NICU. Fortunately like NICU Momma said the facility I work for has a no float for the first six months policy, of course they also told me that they dont plan on giving me any orientation to the unit prior to being floated there. Humm, doesnt sound like something I want to do.......By the way.. Cute picture...:)

NicuGal, MSN, RN · May 2, 2003

We float to maternal child, including PICU. Actually, we would rather go to PICU than peds floors in our unit! No orientation to the floors we float to either.

Also, we are to be given age appropriate kids, no teens unless absolutely necessary, no admits or discharges either. No kids that are going for procedures, no fresh post ops.

Remember, you have to stick up for yourself. If you feel the assignment is unfair then open your mouth and say something....always remember that people only walk on you if you let them, and believe me, the peds floor try to do it to us all the time! PICU treats us very well...we float to them a lot and they float to us a lot, so we all know each other pretty well.

We don't float new people for 6 months, but you also aren't oriented to the floor you go to. We can refuse to go, but then your name just goes back in and the next time it comes around you'll have to go. Keep refusing and they can punish you in some way...don't know, none of us have ever refused to float.

And go with a good attitude...going with a poopy attitude just makes your day longer and more miserable.

NICU_Nurse, BSN, RN · May 2, 2003

Ick. I know how you feel. I chose NICU for many reasons, and purposely didn't do PICU because of the vast differences. Boy, I sure do admire our PICU nurses. THEY CAN DO ANYTHING!! Very talented bunch of people. PICU, to me, is a hodgepodge of every possible diagnosis and it may be called "Peds" but that name spans one month old to 17 years, which is a huge, huge age variation. Even ADULT ICU's are broken up into more categories than PICU is: You've got SCU, ICU, MICU, SICU, PACU, CVICU, CCU, NeuroICU, yadayada. In PICU you just get 'em all. WAY too much for me to handle. I lovelovelove our PICU nurses, but I HATE being pulled there! I always want to start crying. They try, bless their hearts, but inevitably, I'll end up with the "babies" who are on every drug and drip known to man with diagnoses that we simply DO NOT GET in our NICU. Just because they're babies doesn't mean I know how to properly care for a 2 month old with a gunshot wound to the skull, okay???

The real kicker is that we, as part of Maternal/Child, are expected to float to ALL of these units if needed:

Nursery 1 (Okay, I can do that!)

Labor & Delivery (Umm...)

PostPartum (Love this unit! No problem for me; almost worked there after graduation)

High Risk Antepartum (Detoxing drug mom's? No thanks, that's for someone else...)

Peds (I like this unit)

Peds ER (I don't like this unit! LOL I don't know crapola about trauma)

PICU (Read above paragraph!)

Umm, I"m sorry, cross-training or not, I don't know enough about nor have the experience to safely perform in these areas to be willing to work in them! One day of cross-training is supposed to help me? I think not.

When these people are floated to OUR units, we give them the safest, most stable assignments. They NEVER float to the Level III nursery EVER. Wish we got the same treatment. I work with babies- and you want me to attend deliveries? I've never done that in my life. SOOOOOOOOOOOOO horribly unsafe.

cindylouwho · May 2, 2003

amen brownbetty......the same goes for the unit I work in...I hate Pedi.....they throw you to the wolves and think that's ok....however..when they come to our unit we also give them feeder growers because we CARE about our patients and want the most critical ones taken care of in an appropriate manner.........floating to pedi is a lawsuit waitin to happen

Brownbetty · May 2, 2003

"lawsuit" I am glad you mentioned that word. the situation is a lawsuit wating to happen. After thinking about this matter and why I just get so upset and nervous when I have to float is that I don't feel like I can give a high level/standard of care. I just do whatever it takes to get by aand keep the patients alive until the shift over. I never feel good after the shift is done unlike how I feel when I am done a day in wonderful NICU land .

Brownbetty · May 2, 2003

I must agree with the comment regarding PICU nurses. They are wonderful because it is a hodgepodge of every disease or traumatic event possible for a patient 0 to 18 y/o to have.

**canoehead, BSN, RN** · May 2, 2003

I think it is insane to get 4 patients in an intensive care setting, no matter if you are a float or not. They need to cut your load in half to start with, it'll take you twice as long to find and look up things, at least. When we float people to different floors we put them on a help out status is possible (the HO!) and they answer lights, change beds, baths, prime IV lines, feeds, do RN paperwork etc. If the unit is busy there is plenty to do within your comfort area, or you can do this plus one patient who is similar to your home floor, or be paired with a regular

RN with a heavy load of kids under 2years. There is no need for a NICU nurse to take a 17yo.