Yesterday, I was pulled off my unit to go to to the ER to cover the med/surg overflow patients. Wasn't too happy about it, but whatever. That's life. And it wasn't such a terrible day, but still...
(Unrelated side comment: I'd never been down to ER so someone gave me directions...go down, turn left, use your badge to go thru double doors, etc. Followed the directions...thru the first set of double doors I saw. Proceeded down the hall until I started seeing people wearing masks and caps. Ooops! I was in the OR!! Wrong double doors. LOL )
Anyway, started with 4 patients. Later, the CNO came by and I verbalized my thoughts on being pulled to a strange environment with no orientation and no back-up support. I was the ONLY nurse. Of course, the regular ER staff was down the hall, but you know how it goes when you don't know them, they don't know you, they are busy, etc. I didn't know where supplies were...nothing! But I'm "seasoned" & can generally handle things. Moving along...
Later in the morning, I page my Dept. Director to come down to assist in assessment of a patient. I had paged the doc FIVE times, no response (pager w/dead battery). Was this patient really having respiratory difficulty or major anxiety attacks. Anxiety, I thought, but wanted another opinion. . We agreed. Anxiety. Thanked her for coming. So...I'm talking to her regarding her new policy. Everyone floats. Everyone. So I ask why I floated on Sunday and again today. Said I was the only one scheduled that hadn't floated to ER holding. Oh, I say, but what about Nurse X? Reply: Oh, she could never make it down here. She can barely function on the floor.
First question. What is fair about that? Someone that can "just barely function on the floor" is excused from floating? I'm not understanding this picture. Can someone help me out? So does this mean if I don't want to be required to float, all I have to do is act like an idiot?
Second thing.
It's about 1:30 and I haven't had lunch. By this time I had sent 2 patients to the floor, sent one home, holding one for surgery, admitted 3 more to holding. S/w the nursing super about lunch relief and she said it was "different down there"...I could eat at the desk. Excuse me? I don't WANT to eat lunch at the desk with phones, docs, call lights, visitors, etc.! I will give her credit, tho'. She called dietary to have them send me a sandwich and chips not realizing I had brought my lunch. Needless to say, I DID eat at the desk - no choice. Nibble would be a better word.
So here again...rule changes.
You know, it really wasn't a bad day. Exceedinly busy, but I got to know some of the ER staff, they warmed up to me, and me to them, next trip down will be much more pleasant and far less stressful, but still...
Am I wrong to think there were a few double standards in play yesterday?
I don't see it as "selective enforcement" of policy or unfair if they don't float someone who can barely function on the floor. Even if you're the boarder nurse in the ED, it's a new environment and a manager would be negligent to float someone that she is so sure would not be able to handle it. Maybe that other nurse should be able to handle it, but the reality is that she cannot and you can't make the patients suffer for it.
Specializes in ICU/ER/Med-Surg/Case Management/Manageme.
OK, NoMoreStudying, I agree the manager should not require a person that is unqualified to go to a unit where he/she is not competent to function. Yes it would be negligent to do so for the patient, the hospital and the floated nurse.
However.
It is selective enforcement of policy if you have written a policy stating ALL nurses will float, etc., yet certain nurses do not float because they "can't handle it."
Don't you suppose that type of policy enforcement could make other nurses start screaming out..."I can't handle it!" And even if the manager wants to insist they can handle it, who's to say they don't float off and screw things up so badly that they are never asked to float again.
Beyond that, tho', this sort of thing sets management up for criticism and accusations of unfairness. That isn't what I intend to do, by the way, as I rather enjoyed the day for the most part and would willingly return. However, the point is this other nurse is a RN just like me. She has worked in this hospital several years compared to my several months. She should be as qualified as me to go to an ER holding area, and if she isn't she should be expected to start some sort of qualification process. That is, if we are going to have a policy stating that ALL nurses float.
OK, so let's turn this around a bit. Let's say you don't have children and it is Christmas. Policy states all nurses rotate holidays...work 2 of the 3 major holidays. Well, this year, it is your turn to be off on Christmas Eve/Day. You worked last year. But when scheduling is done, you are told that you will have to work Chirstmas Eve/Day because YOU don't have children at home. Do you think that's fair? Would you construe that as being "selective" scheduling?
OK, so let's turn this around a bit. Let's say you don't have children and it is Christmas. Policy states all nurses rotate holidays...work 2 of the 3 major holidays. Well, this year, it is your turn to be off on Christmas Eve/Day. You worked last year. But when scheduling is done, you are told that you will have to work Chirstmas Eve/Day because YOU don't have children at home. Do you think that's fair? Would you construe that as being "selective" scheduling?
This is a subject that has been discussed at great length on a number of threads. Let's slap the lid right back on this can 'o wormies. Thanks.
OK, so let's turn this around a bit. Let's say you don't have children and it is Christmas. Policy states all nurses rotate holidays...work 2 of the 3 major holidays. Well, this year, it is your turn to be off on Christmas Eve/Day. You worked last year. But when scheduling is done, you are told that you will have to work Chirstmas Eve/Day because YOU don't have children at home. Do you think that's fair? Would you construe that as being "selective" scheduling?
First, having children at home and celebrating a holiday aren't even related. It's not a skill or an ability to spend the holiday w/ or w/o you family.
But back to a legitimate argument, I do agree that there should be some sort of evaluation and real protocol for floating. However in your situation, the way things actually are or seem to be, I wouldn't send someone down if I wasn't comfortable with him/her.
I do think that most any experienced nurse could float down as a boarder nurse as long as she is told where things are and briefly oriented, at a bare minimum. It's definitely not sufficient, but you did survive and so would most experienced nurses, I think.
Also, a policy that requires all staff to float implies that they cannot deny the request. It does not require managers to rotate floating or spread the duty about to all staff memebers, b/c it is ultimately left to the judgement of the person actually doing the assignments as to who is most fit. Unlike the holiday example, which is more of a tally card concept.
Specializes in ICU/ER/Med-Surg/Case Management/Manageme.
I would love to debate the issue with you, NMS, as I feel you've failed to understand the issue, but the moderator has asked that the lid be slapped on this can 'o worms. I'll honor her request.
With that, adios! Anyway, I'm going to the movie on this cold afternoon. :)
First off, as an ER nurse, THANK YOU for coming to an ED to care for those folks. I worked the floors for a lot of years, but ED is totally different. Once they are admitted, different "rules" take over. You should have gotten a least of tour of the ER so you can find supplies, but sometimes I can't even find stuff bacause its gotten moved yet again. The other night we had 16 admissions on the board, and we only have 20 beds (plus some stretchers in the hallways). Having someone help out with the holdovers at least lets me get to the ones in the waiting room.
Yes, we eat at the desk a lot. We also wash a lot:lol2:. There isn't always someone to cover meals, we run a lot (I work nights). Some have called that being a "martyr nurse", because it just can't happen without us (gasp). That isn't always true, there really are times we can't get away without endangering patients. We also get paid no lunch on those shifts. I'm pleased to hear she sent you food, she may not have been able to come cover for you, did you ask if someone from your floor could have come down?
As far as the other one not floating, seems like a reality item rather than a fairness one. No it isn't fair. But it sounds like it was the right thing to do.
NoMoreStudying
58 Posts
I don't see it as "selective enforcement" of policy or unfair if they don't float someone who can barely function on the floor. Even if you're the boarder nurse in the ED, it's a new environment and a manager would be negligent to float someone that she is so sure would not be able to handle it. Maybe that other nurse should be able to handle it, but the reality is that she cannot and you can't make the patients suffer for it.