Published Nov 26, 2010
ShimmaShimma0304
124 Posts
Alright. So I just started a job at an LTAC hospital. I have only been there a couple of days now. I was told just yesterday, by a smiling unit clerk that I will eventually be placed in ICU to work sometimes. Um... I have only worked med/surg/telemetry. I have worked on Step-down ONCE in my 15 years as a nurse.
I have also been told that sometimes they place LPN's in their 6-bed ICU. Granted, the LPN's are good and knowledgeable, from what I hear, but still... ???
My concern is: sometimes they have patients back there on ventilators. I was told that "You just call the house supervisor or respiratory if you get in a bind." What??!?? I take pride in my job and I don't want to work in an area that puts my lic. at risk. No one will protect my lic. but ME!! I need advice on this please!!!
thanks!
CVmursenary
240 Posts
try to embrace the challenge and learn something new
Otessa, BSN, RN
1,601 Posts
Alright. So I just started a job at an LTAC hospital. I have only been there a couple of days now. I was told just yesterday, by a smiling unit clerk that I will eventually be placed in ICU to work sometimes. Um... I have only worked med/surg/telemetry. I have worked on Step-down ONCE in my 15 years as a nurse. I have also been told that sometimes they place LPN's in their 6-bed ICU. Granted, the LPN's are good and knowledgeable, from what I hear, but still... ???My concern is: sometimes they have patients back there on ventilators. I was told that "You just call the house supervisor or respiratory if you get in a bind." What??!?? I take pride in my job and I don't want to work in an area that puts my lic. at risk. No one will protect my lic. but ME!! I need advice on this please!!! thanks!
If you truly will be floating you to ICU they should give you some kind of orientation so you have a clue what will be expected of you.
Brandon,
I have thought about that. It's just scary to me to have someone on a ventilator or a drug that I'm not used to (being titrated) and *I* am that person's INEXPERIENCED ICU "watch dog." Seriously, now... If YOU were on a ventilator, fighting for your life, would YOU want a nurse taking care of you who has never taken care of a person on a ventilator? LOL I'm serious!!! It's one thing to have "never put in a Foley cath" but it's entirely different when you've never taken care of someone on a VENT!
I have had moments where I thought, "Well, I'll just have more experience..." BUT... what are the legal ramifications for ME??? Scares me, that's all. I mean, Hell... I think they have already decided that I'm gonna end up working in the ICU sometimes when someone is out for some reason.
Otessa,
They said they would orient me to ICU... but I think what they mean is having someone show me how to chart. LOL They are pretty laxidasical there from what I am told.
iNurseUK, RN
348 Posts
I hope you are joking! ITU takes some very specialised skills. It is a very steep learning curve as I found out when my Plastics unit was shut down and I was transferred to ITU.
I had a preceptor that I needed for a good three months then a mentor and I wasn't allowed to take intubated patients by myself for six weeks. And at that point I was 17 years qualified!
I am NOT joking. I wish I was joking. I was in a floatpool system before and told them that I didn't want to work with the post partum patients because I wasn't comfortable with palpating funduses and teaching new moms how to breastfeed. My bosses were understanding. I haven't spoken with a supervisor about this situation yet, but I intend to do that. When my preceptor, who has only been there a short time herself, told me that she spent a day in their ICU and is not an ICU nurse either, I believed that it was actually going to come to pass at some point in the future. I thought maybe their ICU, since it's an LTAC hospital, isn't a "real" ICU, but I was assured by the medical director "Oh, yes... it's a real ICU!" Ruh Rho!
I am appalled. It's not safe for the patients and not fair for you to dump you in a specialised area like ITU. Ventilated patients need constant monitoring and you need to know what the numbers on the ventilator mean.
Not to mention the constant titration of IVI's. Sedation, vasopressors, insulin....the list goes on.
You cannot possibly do this stuff safely without training. You are asking to lose your license. Have you no nursing unions like UNISON or the RCN?
DizzyLizzyNurse
1,024 Posts
The ICU I just did a rotation in for school has a 6 month orientation, whether you're a veteran or new grad. Can you trust this unit clerk? It just seems weird that you heard this from a unit clerk instead of another nurse or manager or something.
I think I can believe what she has to say, as my preceptor-- who has only been there 6 months-- just smiled and put her head down when the unit clerk mentioned this to me. It was almost as if she couldn't wait to TELL me this lovely bit of news. My preceptor doesn't want to work 12 hour shifts, wants to be home with her kids 5 days per week and does not like the LTAC world of nursing. She is burned out of floor nursing. What a great person to orient me to this new job, right? I left a large hospital setting so as not to have such a revolving door of patients (i.e. 4 and 5 discharges with 4 and 5 readmissions before the bed becomes cold). I'm just disappointed in this bit of news and YES!!! --- I am mainly worried about my lic. I want to call the Board of Nursing and ask them about this but my preceptor said they would want to investigate this facility. I don't want to get them in trouble, but *I* don't want to get in trouble either. I am NOT eager to kill anyone. Holy crap, ya know?
Oh, and No... we do NOT have a union. I live in the southern part of the United States... They are not too big on unions here. The Veterans Administration has one, but I hear that it's not that strong as far as unions go.
Take my advice Marie0304 and go to your BON. Do NOT accept the position before you get details about orientation, mentoring and so on.
I WAS mentored but it was still a huge culture shock moving from my specialised surgical ward to ITU. It took six months before I felt confident I wasn't going to kill a patient.
ITU is a whole different world from nursing on the floor.