Are psych nurses safe to float?

[Jelli_Belli]

I'm a new graduate that started orientation on a behavioral health unit about 2 weeks ago. Things are going pretty well and I am actually enjoying my new position. My preceptor is great, my reviews have been awesome. Unfortunately a new policy at work is making me consider jumping ship and finding a new job.

I work on a psych unit that is part of a regular medical hospital. Up until 2 weeks ago, when we hired a new administrator and DON, policy stated that the behavioral health nurses could not be floated to other units, unless it was in the capacity of a "sitter" for the mentally confused or psychotic. Well, needless to say, this didn't happen very often because the hospital doesn't want to pay an RN to do a job they could have a tech do for half the money.

Yesterday I got to work and it was posted that policy had been changed and that us psych nurses are required to float to all "non-critical" areas when a need arises. This includes postpartum, nursery, labor and delivery, telemetry, oncology, med\surg, and ER!

They are not offering any sort of orientation to these units. I'm a new grad so I still remember a lot of medical stuff from school, but some of the nurses on my floor haven't done anything besides psych for 35 years! There is no way they can jump in and hang on a telemetry floor. And it's like I have heard on so many posts here, it takes a year of post school education before you are truly competent in working in any specialty. It is sooo unsafe.

Our unit director spoke to the DON and she said something like, "If they can run a Pyxis they can work the floor." :trout:I'm sorry, but if the new DON doesn't realize that there is more to nursing than just handing out pills, this hospital is in a world of hurt.

So what do you guys think, should I hang in there? I really like this job but this floating thing has me terrified for my patients and my license. How would you feel having a psych nurse floated to your unit that was expected to hang drips and monitor postpartum mothers?

Personally it gives me chills thinking about it.:angryfire

[Katnip, RN]

Leave.

I'm a psych nurse with a critical care and ED background. Even had I still been working in one of those specialties there's no way you would float me to L&D or nursery, or oncology, or most any other unit. Med-surg, maybe. These days, every unit is very specialized.

In addition, it boggle my mind that there will be no orientation to the specialty units, especially for a new grad.

Leave before your license is compromised.

[Midwest4me]

No orientation yet expected to work the units at the drop of a hat???? That's unsafe for everyone concerned. I'd be worried about the patients and my license too. My advice is to look elsewhere.

[SICU Queen]

Yep, you need to leave.

That's just ridiculous. Truly.

[ohmeowzer RN, RN]

i think the DON is not making safe decisions.. never heard such a thing,, thats crazy

[suzanne4, RN]

Psyh nurse in Labor and Delivery with no prior training or experience? No way. And that goes for floating to the ER and the other units as well. If this is how things are going to be done there, you need to get out of there and fast. And after you leave, you need to report them to the state.

There is no way that a nursery nurse would let you near one of those babies without any training or experience.

Better yet, contact the local newspaper or news channel in your area, sure that they would love to hear what is going on in your hospital.

They need to get rid of this new DON for a start. Wonder how she would do with a stat delivery?

[Shantas]

yes you need to look for a new job. I work both in med/surg and psych. These two are totally different fields!! I know most of my co-workers in psych dont even know how to prime and start an IV, how would they function in a L&D or ER?? Its just like floating a ICU nurse to a psych floor where you have to do groups, deal with all these psychotic patients, understand the psychotropic meds and their adverse affects, so on.

They have to give you orientation, only then you can float, other wise it will not only be unsafe for the patients but also for your self.

[classicdame, MSN, EdD]

It is wise to consider any floating RN as an LVN when assigning and delegating. This individual has a basic nursing background, but is not competent to do patient teaching (unless it, too, is generic). Even assessments for particular units are specialized. So, a psych nurse could probably care for someone who is stable, with a predictable outcome. Otherwise, there is risk.

[RanieRN, MSN, RN]

Leave. Heck, run. The hospital I work at has in it's policies (and nurses' contract), that the psych nurses can't float to any medical units. Which is a very, very good thing. I'd never jeopardize a patient, or my license, working in a field where I'd essentially have no clue as to what I'm doing. Although, it is in the policy/contract that med-surg nurses can be floated to my geropsych unit but not the two general psych units. Apparently TPTB figure since we get patients that tend to be medically compromised as well as being labeled with "dementia w/behavioral difficulties", med-surg nurses are able to work with us. We always feel sorry for the nurses coming over for the first time; they're usually very apprehensive in having to deal with our more combative patients. So, we try to give them patient assignments consisting of patients with more medical issues and less combativeness. We've been fortunate that not one float has ever been injured, so most of them say they wouldn't mind if they had to come again. Of course, they really hope they don't .

Who's above your DON? When we had a DON who kept trying to short our staffing, we went to the person in charge of patient care services (I forget her exact title) for the entire hospital. After a few meetings, things eventually worked out.

[withasmilelpn]

It is wise to consider any floating RN as an LVN when assigning and delegating. This individual has a basic nursing background, but is not competent to do patient teaching (unless it, too, is generic). Even assessments for particular units are specialized. So, a psych nurse could probably care for someone who is stable, with a predictable outcome. Otherwise, there is risk.

This is crazy. As a LTC/Rehab LPN, I take care of supposedly stable patients with a predictable outcome. So it should be a piece of cake for someone with a med-surg background 6 months out of school to take a 3-11 supervisor position at our facility, right? We were all very supportive of the poor RN they hired at our facility, but she still quit after less than 2 weeks. Just one more example of that 'a nurse is a nurse' dangerous mentality that continues to exsist in this profession.

Your assessment skills would be totally rusty, slow, you'd be unfamiliar with the meds, lab values, docs, where things were, etc.

If you were a new hire, you would get a period of orientation to a unit right. Why do employers such as these not consider that is needed for the very same employees they already have? Truthfully, I think they just don't care. You are the expendable warm body that they can throw under the bus if you make a mistake.

Oh and another thing - we like to think that our patients will have predictable and stable outcomes, but their is always that one patient...:angryfire

[showbizrn]

:angryfire RRRRRUUUUNNNN!

I also specialize in behavioral health. Gee, I haven't done med-surg in over 20-years---NO WAY!

I hate to "dog-out" one of my colleagues but my opinion of your DON is that when the patient casualties and liablilities take a toll on the facility due to the assignment of unqualified nurses to units for floating purposes....

Yeah, you bet your bottom heathcare dollar the nurse is UNQUALIFIED when assigned to work OUT OF THE SPECIALTY!

I hate preaching...Go somewhere whereby you can practice safely and ethically---YOU JUST GRADUATED FOR GOD'S SAKE!!

Blessings and much success to you.

:welcome:

[EmmaG, RN]

Your DON sounds like a nutcase.

Yesterday I got to work and it was posted that policy had been changed and that us psych nurses are required to float to all "non-critical" areas when a need arises. This includes postpartum, nursery, labor and delivery, telemetry, oncology, med\surg, and ER

Since when are those considered 'non-critical' units? Unless you are functioning strictly as a runner or tech instead of a nurse, you're putting your license at risk. Those are specialized areas.

Perhaps you should also contact your liability carrier and get their take on this situation. I'm sure they would be thrilled at the notion of you caring for L&D patients.