Dilemma: FORCED to float to med/surg - advice please!?!?!

Specialties Geriatric

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Specializes in Geriatric Psych, Physicians office, OB,.

i'm an lpn working in a geri/psych unit at a hospital in ne arkansas- been employed here since october and had 4 days orientation on the unit. previously i worked in a nursing home and before that worked at our family business. about 10 years ago, i worked at this same geri/psych unit for approx. a year, and oriented on the med/surg floor for a couple of days to do my iv therapy certification - not patient care. i had my first 2 stick done then had to quit my job to help out with our family business due to a disaster.

back to now: i came to work on monday morning, and our census was down to 2 clients on the unit. the house charge nurse called my rn and stated that they had 3 nurses call in on med/surg and i would have to go out there and work the floor. mind you, i've only been working here less than 90 days and have had absolutely zero orientation to the floor. i am not iv certified nor certified in cpr (i did my cpr certification on tuesday). my rn new my circumstances, as did my nurse manager when i hired on; they knew what i was and was not capable of doing. however, house charge came back to our unit and basically informed me that (quote)"you can either go work the floor or you can clock out and be charged with abandonment". he was very, very rude - he'd been working all night and just wanted to get home, i'm sure.

i asked him to please allow me 15 minutes to call my nurse manager and the program director, because we'd had this problem before with the floor pulling our nurses out - and we are required to have 2 licensed nurses at all time on the unit. (mazingly, when they try to pull nurses from the floor to help on our unit, they can refuse.) when i called the program director, she informed me that apparently on friday, administration changed our policy so that we only need 1 licensed nurse now on the unit, and that basically if i didn't go work the floor "you will be fired". (no one had informed the nurses of this change.)

i called my nurse manager, who better understood my situation, and she told me that "they can't do that!". she called the house charge and spoke to him, but he blatantly told her that i was either working the floor or he was sending me home. mind you, this entire time i'm trying to explain to this man that i have had no orientation to the floor, am not iv certified, etc..he stated to me that "if you're an lpn you know what to do - you can pass meds and give shots."

in short, i ended up having to float to med/surg, for fear of losing my job...shaking like a leaf and my cheeks stained from angry tears and full of embarassment. thank god my lpn instructor was working the floor as an rn and i worked under her. i was totally and completely lost as to what to do or how they did anything. she gave me the mar for 1/2 the hall and all i did all day - a 12 hour shift - was pass the meds. i thank god that i made no errors. it was the most nerve-wracking day i've had in years, and i ended up crawling in bed and crying myself to sleep thinking about how dirty they treated me (by making me float). this entire situation smells of illegality to me, but i've no idea what to do. the hourse charge nurse knew nothing about me, nor cared to listen to my concerns. he had even put me down for the code team that day! the rn i worked with that day was a saint, and helped me any way she could. she told me that i did a great job, regardless. i even had a chance to dc 3 iv's and started my first one on the first stick. that's the one good thing about that day. i did every thing that was asked of me, and more. the nurses i worked with were so apologetic about me being pulled out there; they were eager to help with my questions didn't mind showing me what to do. i'm grateful for that.

if anyone can please tell me what i can do to keep this from happening again, i would greatly appreciate it. i would like to make a complaint but am not sure of how to start. 2 weeks ago, i had gone to the nursing secretary requesting some orientation days on the med/surg floor, mainly because every nurse had warned me that they would do this to me. she had not scheduled me any orientation days yet. it's not like i don't want to work over there - i don't mind! i just want to know what to do and how to do it right....it's a matter of principles. it's not right to do that to a nurse, especially when that nurse wouldn't mind helping out when needed. i've even called the nursing secretary again to ask for orientation days. now they've got me so pissed off i could care less how short they are the next time. my husband wants me to quit my job and sue the hospital....as if we could actually afford an attorney. i can't keep the bills paid as it is now, and i fear that if i raise cain about what they did they will fire me anyway and force me to pay back the incentive pay they paid me to hire on there and work a year. please, anyone........any advice???????????????

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Specializes in Geriatric Psych, Physicians office, OB,.

One other thing: yesterday, my nurse manager presented me with my 90 day evaluation. I received all high marks - a very good eval, so she said!!! The nurses I work with on our unit are all very nice, and I have to admit I was shocked when our program director told me that I would either have to go out there and work or I would be fired. I thought she would stand up for me, but I was wrong. That hurts, because I thought so highly of her.

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Specializes in Education, Acute, Med/Surg, Tele, etc.

Well...if they are going to do this...I find it becomes a bit of give an inch, they take a mile later on. When hospitals did this to me, I did like you did...did my best, let my limitations be known to the staff on that floor and that I would be willing to help but unfortunately my skills were limited, and I started looking in the want ads on my break!

I am with your husband on the change job issue (not quit if you can...just seek very actively!!!), but suing...not going to happen! Hospitals..you may as well take on the US government! Waste of your time, frustration and spirit! Look for another place to work, keep an eye out for this type of practice in the facilities you interview in!

Oh yes, they gave me the old abandonment deal too...and I basically was like "wow, what a catch 22..I get abandonment, you get endangering patients by unsafe staffing practices!". Of course that burned a bridge or two...yep, sometimes the truth of a situation comes back to bite the innocent...so watch yourself!

Look for another facility, and look at them VERY well before signing on! Ask to speak to a LPN or RN IN PRIVATE as part of your interview too and ask questions about ratios, call ins, managment, and what not...just don't get into any confidentiality issues. I find this to be very valuable..plus I can tell when someone is lieing or stretching the truth...and it is much easier to gauge when you are one on one with someone 'in the trenches' (some will open right up, some are still scared of managment if for some reason you say no...so watch that body language!).

Good luck to you...and remember, you are a professional, you are a human being, your best intrests obviously are you patients, don't take that kind of crud without a plan B! Doesn't matter where I work..I always have a plan B!!!! You just never know!

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Specializes in Education, Acute, Med/Surg, Tele, etc.

OH dear..don't make the mistake of managment caring about you...most will sell you up the river without a second thought if it means a lawsuit, or even a blemish on their records! Trust me, I work with managment team I got to know 2 years before I even made one tiny suggestion about improvements..I was fed to the lions!!!!

No no no...do not trust that anyone, except yourself, has your best interests in mind...just a safer mindset even if your managment team is good! That is just general good business practice in any job! I don't trust my managment to be there for anything I do or say...no matter how important or live saving it is...I trust me and me only because when it comes down to the bottom line...the only person that is going to save my rear in trouble is ME!

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Texas has a Safe Harbor Act that allows nurses to file a complaint regarding such practices. The complaint is sorta like whistle blowing: the company cannot fire you, and the info is supposed to be confidential, but it can backfire. Even with the safe harbor, the nurse must work out that shift. So it pays to complain to the nurse in charge and maybe put it in writing why this practice is not safe for the patients. Ultimately you are responsible for protecting your own license.

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Specializes in Pediatrics.

while this was a rather unfortunate and stressful situation for you, it is all too common. i'm sure this is not what you want to hear, but i would imagine more than half of those reading this thread can share a similar story- myself included. as my name suggest, i work in peds bmt- what the heck do i know about neonates. but obviously they felt it was okay to float me there.

having said that, that still doesn't make it right. and i do not disagree that the response by mgmt was inappropriate. in my experience, it is very rare that nurses are cross trained. and no, a nurse is a nurse is not so. i too, said the same thing about nicu- i didn't mind going there, but i'd like some kind of orientation before i go there, but of course, it fell on deaf ears. i think it also depends on the institution and how their departments are 'lumped together'. in another institution, i (a 'peds' nurse) was floated to another unit within the maternal/child department- it was a gyn/surgical unit, that also took high risk antepartum and post partum overflow. so basically i had about 6 50-something s/p hysterectomies, and 2 post partums (they don't give the ped floats ante-partums, because we're not trained on the fetal monitors (nor any of the other patients, actually :rolleyes: ).

some places have specific rules as to who can float where- they must stay within their service (ie, medical, surgical, critical care, etc). is this the case at your place?

i've seen some institutions do a double float- sending nicu to general peds and general peds to heme/onc. still not solving the problem completely, but it could avoid complete culture shock.

i also think there is a problem with new nurses floating so soon. you relly need to be comfortable in what you are doing, before you can adapt to a new situation like that. and sadly, most co-workers will not go up to bat for you and say "hey, i'll take the float for you". most are thrilled that it's not their turn!!!

maybe a meeting with your educator might be in order. remember to maintain your composure, and present all of your points without sounding like another complainer who just doesn't want to float. and the word "unsafe" is one they don't like to hear, but maybe they need to :uhoh21:

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Specializes in Maternal - Child Health.

I'm sorry about your experience.

I don't know the law in your state, but I suspect that they were stretching the truth when they threatened to charge you with abandonment.

First of all, your employer is not a law-enforcement or regulatory agency, (although they may seem like one!) so they can't "charge" you with anything. Secondly, if you did not accept a patient assignment, then you can't have abandoned anyone or anything. They may discipline you for leaving work without authorization, but that will not cost you your license. Taking a patient assignment you are not qualified to handle may.

Unfortunately, you have learned where your manager's loyalties lie. She is not looking out for your best interests, so you need to! Call your state BON and report that your supervisor placed you on code team, knowing that you were not oriented to the unit, and did not have CPR certification. That ought to get someone's attention.

Next, write a letter to your manager outlining your expectations for orientation to med/surg. If they are going to pull you there and give you an assignment, then you must have an orientation. (Many states legally mandate this.) If she does not agree, IN WRITING to the plan you outline, or an acceptable written alternative, then get the heck out of there!

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Specializes in Pediatrics.
oh yes, they gave me the old abandonment deal too...and i basically was like "wow, what a catch 22..i get abandonment, you get endangering patients by unsafe staffing practices!". of course that burned a bridge or two...yep, sometimes the truth of a situation comes back to bite the innocent...so watch yourself!

call me crazy (and please correct me if i'm wrong, any legals out there) but isn't it only abandonment after you've accepted the assignment? or if your relief doesn't show up and you leave? i don't believe you can abandon a pt for which you have not accepted care of.

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Specializes in Education, Acute, Med/Surg, Tele, etc.

The worse one I had was working neurovasc,and all the sudden they needed a body to watch telemetry! Okay..they asked me and I said I don't really know telemetry! They got very curt with me and said..."when we hire a nurse with ACLS experience we assume that person can read an EKG!"...I of course replyed "two years ago I got a glimpse at a THREE LEAD EKG during a mock code and the paramedic there told me what it was and I did my job...ACLS is not a study in telemetry..only telemetry is."

Yep..they did the old abandoment and job threat...and I still said I could not and would call in the hospital Ombudsman (who I happened to know). They found someone else, but since I stood up for myself, my bridges were burned...and later on I found out the bridges were crashing anyway and left!

The thing is is it happened so fast, and I wound up having to quit...I would have much rather had some time to look for a job first...

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Specializes in Education, Acute, Med/Surg, Tele, etc.
call me crazy (and please correct me if i'm wrong, any legals out there) but isn't it only abandonment after you've accepted the assignment? or if your relief doesn't show up and you leave? i don't believe you can abandon a pt for which you have not accepted care of.
thanks! that is exactly what i thought, and at the time that excuse was given to me!!!!!!!

i looked it up at the time on the bon website...and i believe that is 100% correct!!!!!! you can't abandon a patient unless you except that patient! that is in place to protect patients from racism, sexism, stereotyping, etc. when they can get you is if you leave your shift..then it is abandonment for all your patients...but that is only because that is your assigned shift...

i don't know how it goes with floats since i refused to be one for this very reason!!! well that an the fact i will never work hosptials again! ltc has its bad points...but not quite as soal sucking as hospital (at least all the ones i live by and worked with!).

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Abandonment in that case is more than likely an idle threat. My BON would consider that to be an employment issue not an abandonment issue. You did not have a patient assignment that you left without transfering over to someone else.

I've been threatened the same way by a real witch. Unfortunately, there is nothing you can do about it, if you refuse to float they can fire you, in my state they can fire you for whatever they want.

However, you should request orientation and stress that it is a matter of patient safety, you don't mind floating but you need to be oriented to the unit. Put it in writing and send it up the chain via your manager.

Also, if you don't have nursing I would get some, it is less than $100 a year.

Good luck.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

years ago, when i was working med-surg, the house supervisor tried to float me to micu to do charge. i'd never even seen the inside of an icu -- even in school! "it'll be ok," the supervisor said. "they have some really good lpns down there, and a couple of rns from agency, but we need one of our nurses to do charge." i refused the assignment, arguing that i wasn't qualified.

the supervisor threatened me with losing my job.

"i'd rather lose my job," i said, "than my license." as i said this, i was packing up my things to go home. i don't know where i got the nerve! at that time, i needed my health insurance (and it wasn't portable back then) because i was facing a diagnosis of cervical cancer.

the supervisor backed down. i ended up floating to bmt, and they floated one of their nurses to micu. at least i knew a little something about bmt, and their nurse either knew micu or wasn't afraid of losing her license.

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