Floating=dumping bad patients

  1. If a mother/baby nurse gets floated to the antepartum/gyn unit what type of pt is an appropriate assignment?
    Would a pt there for hyperemesis who is on continuous tube feeding, has a PICC line and is described as drug seeking who happens to be one of those pts no nurse wants twice and appropriate choice?
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  2. 12 Comments

  3. by   Mulan
    Why not?
  4. by   lmc512
    why not! because I do not take care of those types of pts daily and haven't since nursing school years ago.
  5. by   ktwlpn
    what "type" of patient? Are you saying you are not comfortable with PICC lines and feeding tubes? Sounds like it was a good learning experience for you,IMHO
  6. by   bagladyrn
    Quote from lmc512
    If a mother/baby nurse gets floated to the antepartum/gyn unit what type of pt is an appropriate assignment?
    Would a pt there for hyperemesis who is on continuous tube feeding, has a PICC line and is described as drug seeking who happens to be one of those pts no nurse wants twice and appropriate choice?
    It would depend on what the other patients on the unit were like. If I also had pts. on tocolytics who were threatening to break through into labor I'd be likely to give you the first patient rather than them as I wouldn't want early signs of labor to be missed when it might still be averted. Same thing with an antepartum PIH'er on magnesium - subtle signs can be significant and I'd know you may not be as used to that.
    Another thought - if she was "one of those patients no nurse wants twice", it might be appropriate to assign her to you as the "regulars" have already had their share, you haven't had her before and likely won't be there the next time with her. It would give both them AND the patient a break, and you may even be the one who can bring a fresh perspective and new ideas to her care.
  7. by   pirap
    IMHO appropriate patients for a floated PP nurse to that unit would be gyn surgeries with patients that are stable. I don't think PICC lines are out of the question as long as you know how to use and take care of them. Feeding tubes are OK also but I agree if you haven't seen them since nursing school and aren't comfortable setting them up I would be nervous too and before I accepted the patient I would have made someone give me a crash course in learning about them. The gyn floor has a hodge-podge of everything..cosmetic/reconstruction, colon resections with total abdominal hysterectomies, mastectomies, vaginal surgeries, chemo patients with portacaths, etc etc!!!

    Yea sounds like a "good learning experience" but what if this was your mother on a cardiac floor and the floated nurse was from a general med/surg floor...would you want her fooling around with cardiac drugs and trying to interpret her EKG? NO YOU WOULDN'T-be honest!!I have enough RECENT med/surg experience to feel comfortable taking care of the patients you described but my co-worker who has been on the PP floor/newborn nursery for 20 plus years would come close to a stroke and she is an EXCELLENT nurse..I would want her to take care of me and my newborn but I would not want her to fool around if I had a trach or a chest tube or new ostomy! And in no situation should a floated PP nurse be assigned to an antepartum patient with no experience in fetal monitoring/assessment-if the reason she was there was PTL or problems with the baby--turn that down in a heartbeat!!

    Yea we can get dumped on when we float..a friend of mine who is a nurse and works med/surg thinks we just rock and cuddle babies all day long. Thinks we don't have real "nursing" skills. There is more to nursing than just doing the best wet to dry dressing change in your life or getting an IV in on the first attempt. I feel I make a difference..who knows one of the babies that I rocked and cuddled may find the cure for diabetes or pancreatic cancer one day..and to think I played a part of getting that baby and mom off on the right foot-physically and emotionally...or did I just get whipped with a wet noodle because I forgot to clamp the feeding bag and jevity leaked into my flush bag in the feeding tube set up?
    Last edit by pirap on Oct 24, '07
  8. by   SmilingBluEyes
    My personal philosophy regarding "floats" is to treat them very well, so they will want to come back! But I have to consider all acuity on my unit and if I have higher-acuity patients to care for, I will take them and give the lower acuity ones to the floats. Familiarity or lack thereof is a problem for all floating nurses. It's best not to "dump" on them for all-around safety and courtesy. That is my take.
  9. by   grace90
    Quote from SmilingBluEyes
    My personal philosophy regarding "floats" is to treat them very well, so they will want to come back! But I have to consider all acuity on my unit and if I have higher-acuity patients to care for, I will take them and give the lower acuity ones to the floats. Familiarity or lack thereof is a problem for all floating nurses. It's best not to "dump" on them for all-around safety and courtesy. That is my take.
    As a full-time float, thank you!
    I don't find I have much of a big problem being stuck with the difficult patients all the time. It seems the staff nurses on the floors I float to have the same philosophy as you. Most of them want to keep 'their patients' no matter how difficult simply because they know the pt so well. I particularly notice this in rehab where they are there longer and on oncology with cancer patients that have been in and out with extended stays.
    I have also noticed that the regular staff nurses on the floors are willing to answer questions or come look at a patient having a problem.
  10. by   ktwlpn
    [QUOTE=pirap;2462432]
    Yea sounds like a "good learning experience" but what if this was your mother on a cardiac floor and the floated nurse was from a general med/surg floor...would you want her fooling around with cardiac drugs and trying to interpret her EKG? NO YOU WOULDN'T-be honest!!QUOTE] Of course I wouldn't-and that is NOT a fair comparison...Feeding tubes and PICC lines require pretty basic nursing skills in my opinion-drips and monitors and drips not so much......
    I am a full time float also-now in LTC,previously in a hospital.It is expected that I have those basic nursing skills-I don't expect the easiest assignment-I'm getting paid the same as everyone else and I expect to earn it.If I am uncomfortable I know where my resources are and I don't expect to be "spoon fed" because I know my co-workers all have a full load.
  11. by   KellNY
    I'm also guessing you got her because if she was hyperemesis, chances are she was too early in her gestation to require fetal monitoring. I'm guessing that since you're PP, you are not trained in fetal monitoring--either placement or assessing the strip. Therefore, this may actually have been the most appropriate patient for you.

    And, uh, antepartum nurses don't take care of "those patients" all the time either!

    As a nurse PICC lines shouldn't scare you--you might end up seeing on in PP (for example if a mother required transfusions for placental previa or something) and so should be comfortable with it. They're really just like double headed PIV lines-you just have to brush up on P&P regarding dressings and flushes.
  12. by   HappyNurse2005
    well, she is an antepartum patient, right?
    so its appropriate. if you need help, ask. you might have a patient on your mother/baby unit someday with a picc line or tube feeding-like hwen this lady delivers. at least you would then be experienced.
  13. by   cardiacRN2006
    PICC lines and tube feeding are basic nursing skills. If you have forgotten how to do them since nursing school, then ask the charge nurse for a 5 minute update. That's about how long it will take.


    SOMEONE has to take care of these patients...I don't see a dump here.
  14. by   richelle362
    When someone is floated to postpartum, they don't take care of the babies. We have to split them up. I think vital signs are not too much to ask.

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