Am I entitled to decline being assigned to a specific unit?

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Specializes in float pool.
Am I entitled to decline being assigned to a specific unit?

For over five years, I've been working as a per diem float pool nurse at this hospital. My primary assignments are to the M/S Units, but I also occasionally work in the M/S telemetry unit due to my ACLS certification. I'm an experienced nurse and feel at ease working in M/S or Acute Rehab Units.

Recently, I've been assigned to the DOU/Telemetry units a few times and found it quite overwhelming. On my last shift there, I was responsible for four patients. Two were confused. The third patient required frequent monitoring post-transradial angiogram, and the last was a non-compliant patient who disputed everything with me that day.

I received about 15 to 20 minutes of verbal instruction on caring for the post-transradial angiogram patient. Later, the night shift nurse informed me of a class I should have taken prior to caring for such a patient. One of my confused patients was in Atrial fibrillation and required an Amiodarone drip. When I questioned my charge nurse if I should be caring for a patient with an Amiodarone drip, her response was that the resource nurse would assist me.

That day was challenging due to demanding patients and their families. I had to stay an extra hour[on my own time] to complete all my charting. The only positive aspect was that the patient converted to SR and the Amiodarone drip was cancelled.

I've emailed the Unit Manager before requesting not to be assigned to his unit again, but received no response. I'm questioning whether I have the right to decline working in that specific unit as I feel my skill level isn't sufficient for it. The stress and anxiety of floating to that unit is significant, yet it seems no one cares. What should be my next step?

3 Answers

Specializes in New Critical care NP, Critical care, Med-surg, LTC.

That does sound like a poorly planning situation. Having a resource nurse "available" doesn't replace having a properly trained nurse. Unfortunately, though, as hospitals are finding more staffing shortages these days, I think that more people are being pushed into similar situations. I know that our hospital has float nurses that are telemetry eligible and those that are not. They should not every be assigned to units they are not trained for, but it does happen. You didn't hear back from the unit manager, but do you have a float pool manager you can reach out to? Are you part of a union? If so, they should be able to back you up if you're not properly trained for a unit. Hope you can get some clarification, good luck. 

Sounds stressful.

But....your verbiage is problematic. No, you are not entitled to work a specific unit as a float pool nurse. Yes, you have the right to decline an assignment, but generally speaking that doesn't include preservation of your position or your employment or freedom from disciplinary action from the employer.

Many nurses feel uncomfortable when their usual routine is thrown for a loop like this and we find ourselves in areas we don't usually work, with unfamiliar coworkers and surroundings, dealing with a different population than usual. It's reasonable to feel some stress in that situation. But it's still important to make a non-emotional appraisal of whether or not this means that things are truly unsafe (no possibility of safe practice/high likelihood of unsafe practice).

For example, you mention the non-compliant patient who argued all shift long and the demanding patients and families. Those are stressors all day every day, any time and any place for every nurse everywhere, as opposed to a situation where you were truly unequipped and lacking knowledge/skills to handle d/t your inexperience on that particular unit.

You have some options, such as asking for training on the areas/aspects with which you feel uncomfortable. That should be provided to you and if the way they roll is to not care who is there or care anything about that person's knowledge or comfort level, then you can choose to look for other opportunities and they deserve to not be able to keep staff if that's their attitude. 

Lastly:

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I had to stay an extra hour[on my own time] to complete all my charting.

Why is that? You did not have to donate your time, no matter what they say or what their policies are. If you allow them to bully you so that they can literally break the law then they SURELY will not take you seriously with your concerns about your comfort level on the units to which they assign you. After your handoff you should have stayed right on the clock to complete your charting and if (when) something was said about it, THAT would have been your opportunity to mention that your complete unfamiliarity contributed to the fact that they were going to be paying you an extra hour--and that it was their choice. They must pay you for time worked. They know that. NEVER donate your time unless you are contributing to a charity of your choice.

 

Specializes in Rehab/Nurse Manager.

Would it be best to apply to a position on a unit that you feel comfortable with? I would think that if you are part of a float team, you should be able to work on any unit they assign (unless otherwise specified in your job description).   Having a permanent unit to go to could help you avoid this. 

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