I'm doing this case study and I just wanted some of you all opinions on the situation. Here's the scenario:
A nurse who's been working on oncology med surg unit since graduating from college a year ago. She's a good nurse and is complimented often by her supervisor. she is often pulled to other med surg units when census is low in her department. this particular night, she is pulled to a busy deliver room. she protest because she don't know alot about obstetrics or caring for obstetrics patients. The supervisor tells her that she's the most qualified person and to "Just go and do the best she can". Her supervisor is not at the hospital, and the charge nurse does not feel comfortable in advising her on the situation. she is now confused and torned between professional, personal, and organization obligations. What do you all think she should do?
I was going back and forth with ideas. but I feel that she should not take on this assignment if she does not feel comfortable. If she does not know what she is doing, then she will not be that helpful to the patients or the other staff on that unit. I also feel that she is putting her license on the line if she go in the deliver room and make a mistake of some sort. These are just some of the ideas I came up with. I would like to know what some of the experience nurses thinks because I know you all probably have been pulled to other units during your career.
The two places that I have not seem med-surg nurses floated to are the OR and Labor and Delivery.
Anyplace else goes.
But I do go along with Daytonite's opinion..............that is how I got most of my experience back in the old days. Was never afraid to go and try new things.
Well, I'm going to disagree with the others. Keep a positive attitude and go to the delivery room. She should report to the charge nurse there and discuss her concerns about what she doesn't know about delivery. If the charge nurse is any kind of a charge nurse, she will give this nurse who was floated duties to perform that do not specifically involve actual delivery of an infant. If you've ever been in a delivery or OB area you would know that there are plenty of things that this nurse could be assisting with that do not involve anything to do with actual delivery or assessment of labor, i.e. answering lights, assisting with personal care, starting and maintaining IV's, speaking with visitors, reassuring the patients, transporting patients, etc. If the charge nurse insists on having this nurse perform things that she just doesn't know, then the supervisor should be called immediately and told the situation and asked for help. The alternative to this whole situation is to risk being fired for insubordination by refusing to do what they were asked to do.
After one year of working in pediatrics, I switched over to med-surg and became a float pool nurse. Since that first year, I have always worked float/prn(12 years) so I have been pulled to a lot of areas like post-partum, psych, and PACU; places I had no business even walking through. I found that even in those areas, doing the seemingly simple things you speak of that they are so different than med-surg that I ended up asking a regular staff member at least half the time about "how they do it over there" that I might as well have not been there.
As a float pool nurse, I have had the opportunity to be a jack of all trades so to speak WITHIN the MED-SURG SPECIALTY and I considered it a valuable experience in terms of learning. But I can not recommend that anyone else do it. It's bad business.
The fact of the matter is that no matter what area you end up working in, some patient could come through your doors into your unit with a problem that you know absolutely nothing about treating. Then, what are you gonna do?
If it is a patient whom he/she cannot reliably assess and perform the prescribed interventions, then she/he has a responsibility to refuse that patient. I have taken care of patients in this case but I insisted that the charge nurse serve as my preceptor so to speak so someone with experience in that area could be responsible for what to do for that patient, and so I could learn and be prepared when I had to take care of that patient in the future. Since they were short-handed, that could not be applied here.
...just remember that you should be assigned the most stable and predictable patient...
Operative word is "should" somehow in real life it doesn't always work out that way. Our unit really does give you the easiest patients. We rarely get a unit nurse float to Med/Surg. They are given a normal assignment and they can't handle it. It's not their fault.
I am not an experienced nurse, nor a nurse for that matter, but I have read in Potter and Perry that floating is something a nurse will be asked to do in her/his nursing career. It mostly has to do with staffing problems like other posters have said and since the healthcare staff is (or at least SHOULD be) a team, then I think that everyone should help out each other. HOWEVER, it is from a relative of mine who is a nurse that I know it is a PAIN. She's told me, though, that usually they put you where the most stable pts are. If I'm mistaken, please let me know, but this is the experience my aunt has had in her hospital.
Specializes in designated med nurse,med surg,hh, peds.
I can speak from personal experience on this one. When I worked at a hospital in the Atlanta Georgia area in 2001, on a med-surg floor, as the designated medication nurse, the house supervisor called our floor and needed someone to go work in L&D. None of the floor nurses wanted to go, so she told me that I HAD to go . I told her I wasn't comfortable going to L&D, as my experience was strictly med/surg. (Mind you , the floor nurses - all RNs, refused to go, I'm the med nurse - LPN, and I HAVE to go?) She then said my title ended in nurse,and therefore I was qualified to go. I said "Well, the house podiatrist has MD after HIS name, does that mean he is QUALIFIED to do brain surgery? I refused to go, I did not feel it would be in the patients' best interest to have ME helping with the delivery. She said if you don't like it, go home. I said "OK, I'll clock out now and we can discuss this with the unit director tomorrow" She gasped, I hung up and clocked out. I got into work early the next day, and spoke with the unit director who backed ME up. She then went on to tell the house supervisor that HER med nurses were NEVER to be pulled to another unit, we were specific to that unit, if they could pull an RN to be med nurse, they could pull an RN to another unit. (Not trying to start the RN vs. LPN debate, just relating what happened. I have worked with many wonderful and knowledgeable RNs, CNAs and LPNs. Hospitalists/Interns are another story for another thread...ha ha :chuckle )In this particular hospital LPNs could start IVs, and give meds IV push and piggyback, any med that could be given on the floor,( not ICU/CCU), we could give. The only thing we could not do was "spike" the blood. I would not suggest my exact approach as how to deal with being pulled to a unit you that you feel would not be safe for your patients, ( I KNEW beyond a shadow of a doubt that my UD would support me), but the bottom line is if you accept an assignment that you are not qualified ( for lack of a better term) to do,and a patient is injured or worse, YOU are the one who will have to face the lawyers, jury and board of nursing,AND quite possibly after spending all that time and money to get your degree/license,
the phrase "what would you like to order" could take on a WHOLE new meaning (when you are saying it from behind a drive thru window! )
I am not an experienced nurse, nor a nurse for that matter, but I have read in Potter and Perry that floating is something a nurse will be asked to do in her/his nursing career. It mostly has to do with staffing problems like other posters have said and since the healthcare staff is (or at least SHOULD be) a team, then I think that everyone should help out each other. HOWEVER, it is from a relative of mine who is a nurse that I know it is a PAIN. She's told me, though, that usually they put you where the most stable pts are. If I'm mistaken, please let me know, but this is the experience my aunt has had in her hospital.
The "team" mentality is what admin uses to guilt nurses into doing something that they know is not a good idea. Another tactic is to try to make them inadequate if they do not feel prepared to deal with any kind of patient that is thrown at them.
In a perfect world, float nurses would get the most stable patients (and those patients would stay stable all shift), but once you gain some experience you will discover that the most stable patient can become the most critical patient in the blink of an eye (they are not in the hospital because they are healthy...). Different specialty areas (including med/surg) are set up that way for a REASON. If that were not so, why not just randomly assign a patient to whatever bed in the hospital is available - why have a respiratory floor, a cardiac floor, an orthopedic floor? Why not just put that laboring mom on the cancer unit? or the post-CABG on pediatrics?
As for Potter and Perry, just because a nurse will be asked to do it doesn't make it a good idea. It is really easy to print in a nursing textbook what "should be". It is another matter altogether to be the one with your license on the line.
I'm doing this case study and I just wanted some of you all opinions on the situation. Here's the scenario:
A nurse who's been working on oncology med surg unit since graduating from college a year ago. She's a good nurse and is complimented often by her supervisor. she is often pulled to other med surg units when census is low in her department. this particular night, she is pulled to a busy deliver room. she protest because she don't know alot about obstetrics or caring for obstetrics patients. The supervisor tells her that she's the most qualified person and to "Just go and do the best she can". Her supervisor is not at the hospital, and the charge nurse does not feel comfortable in advising her on the situation. she is now confused and torned between professional, personal, and organization obligations. What do you all think she should do?
I was going back and forth with ideas. but I feel that she should not take on this assignment if she does not feel comfortable. If she does not know what she is doing, then she will not be that helpful to the patients or the other staff on that unit. I also feel that she is putting her license on the line if she go in the deliver room and make a mistake of some sort. These are just some of the ideas I came up with. I would like to know what some of the experience nurses thinks because I know you all probably have been pulled to other units during your career.
I would refuse. I was tried to get pulled to the ICU and I wasn't unit certified. They told me I wouldn't get any ICU patients but I still refused. I also worked per diem and I offered to go to any floor. I left floor nursing when they decided floor nurses, NICU, PICU, and ER nurses should be able to float anywhere. Thats dangerous and its my nursing liscense.
suzanne4, RN
26,410 Posts
The two places that I have not seem med-surg nurses floated to are the OR and Labor and Delivery.
Anyplace else goes.
But I do go along with Daytonite's opinion..............that is how I got most of my experience back in the old days. Was never afraid to go and try new things.