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!!!
There are only 6 ICU beds in this facility where 2 nurses work. I guess they "pull" a nurse back there if they have someone call in or something. It's not a full-time ICU position and it's not being "offered" to me... they are just rumoring that I will be placed back there to work sometimes. My preceptor confirms that this will likely happen. I will find out more information next week about these rumors, trust me!! I do not plan to work back there. I didn't sign on to work in ICU.
There is embracing a new challenge, and then there is endangering lives. Taking on patients with such high acuity, especially vented patients, requires appropriate training. Taking this on without appropriate training simply puts the patients welfare and your license in jeopardy.
Some employers are happy to give you the rope you need to hang yourself but don't count on them to be behind you if something goes horribly wrong. Don't get drawn into this unless you are 100% confident that you can handle ANY situation solo. Someone on the other end of the line isn't going to do you much good if it really hits the fan.
Oh, I understand that for sure! I do NOT count on "big business" to EVER stand behind "the little guy"... I do NOT plan on accepting an assignment ANY day of the week in ICU. I will walk out of there first... and you can quote me on that. Just as fast as I clocked in, I will clock my a-- out.
Hi don't think it will be the unit secretary's decision to place you in an ICU. Might want to speak to whoever would make that decision so you can put your mind to ease. You have the right to refuse any assignment that you know you are not trained to handle. But, once you accept an assignment you will be held responsible. You cannot loose your nursing license for refusing to accept an assignment, but you may loose a job over it. I'd rather loose a job than my license.
I just sent my friend who works at their "sister" LTAC hospital an in-depth email about how I will turn on my heels and walk out of there if they try to make me work in the ICU and I'm not comfortable with it. Again, I will speak with a supervisor in more depth about it soon.
The unit clerk does not make the assignments but she certainly hears and sees how things happen around that place. With it being so TINY, she knows stuff. LOL
I don't mind titrating drips of certain meds. I have taken care of patients on insulin drips and stuff, but I would definately NOT accept an assignment for a patient on a freakin' VENT!!!
try to embrace the challenge and learn something new
Seriously? That would be a very risky move. The best nurse is one who knows what he or she is and is not capable of. That nurse would have no issues with demanding a proper orientation and education before taking on advanced responsibilities in which she has no background, experience or training.
OP, good for you for being willing to stand up for yourself.
I would call the board of nursing and find out if this is legal first off..........if it is and you are forced....my thought is this. Spend a few days with the Respiratory Therapists as far as learning the vents. They are the experts really with them. And I found they are usually flattered to have a nurse ask for their teaching. I worked about 2 years in medical in a hospital setting and it was on a medical respiratory floor--granted not an ICU but we did have up to 4 vented patients and so I had to learn them. I found it a lot easier to learn then tele which is another reason I chose that floor as they didn't have tele. So if you can learn tele you can learn vents. I always looked at it this way --if they code you are half way there. The airway is established already so you only have to worry about the cardiac part. I found the RTs super super helpful. They did a lot for us so we didn't have to do a lot but every time there were there and we were in the room they were more then happy to expain why and how they were doing things. Suctioning is much faster and easier on a vented patient, as they have the indwelling suction. Its not that bad really--just seems intimidating. I was nervous at first but ended up usually volunteering to take 2 vents rather then one or none with a coupe of fresh tachs with no vent........they need suction often and you have to set up the sterile suction stuff every time. Pain in the butt.
As far as the other stuff with the meds and stuff I would tell them that you will be willing to go but not on your own until you feel comfortable. See what the BON says..............good luck to you.
Awwwwwww, thanks, MentalHealthRN!!!! That info was super-helpful to me!!! :) I will call the Board on my day off next week. Thanks SO MUCH!!!!!!! Very helpful info, indeed!! :) I remember that I used to be TERRIFIED of trachs until I worked on a floor that had 1 and 2-day post-op trach patients (had cancer so had their wind-pipe operated on) and they were VERYYYYYYYYYYYYYY mucousy and needing to be suctioned frequently. This was at a hospital in the northwest and do you know what? It was a teaching hospital and they said that they had done studies that showed that sterile suctioning versus non-sterile suctioning showed no change in infection rates/occurrences therefore you could rinse the trach cannula in the sink and place it back into their airway. Isn't that just bizarre??!?? LOL But hey... a teaching hospital oughta know, right? Every other place I've ever worked (before or since): sterile to the max!
I would call the board of nursing and find out if this is legal first off...
No. "First off" she needs to talk to someone other than the unit clerk and find out if it is indeed true, then determine what kind of orientation will be offered. The LTAC's in this area won't hire any nurse who doesn't already have ICU/CCU/NCCU experience and a full complement of life support certifications. It's difficult to believe that they are going to just throw a new nurse into the vents unit without at least giving her a little inservicing.
BTW, vents and ventilator patients are not as hard to work with as some of you portray.
Just as fast as I clocked in, I will clock my a-- out. 
ShimmaShimma0304
124 Posts
There are only 6 ICU beds in this facility where 2 nurses work. I guess they "pull" a nurse back there if they have someone call in or something. It's not a full-time ICU position and it's not being "offered" to me... they are just rumoring that I will be placed back there to work sometimes. My preceptor confirms that this will likely happen. I will find out more information next week about these rumors, trust me!!
I do not plan to work back there. I didn't sign on to work in ICU. 