Float ICU RN to Med-Surg?

MomRN0913 · Aug 16, 2011

I'm an ICu nurse who started off her career as a new grad floating. floating sucks, yes. I did not get an orientation to each floor. Instead I got the crappiest assignments and all the admissions.

Then I went to ICU. We float there too, more often than not. Not to med-surg, just to tele or ER holding, because if they don't want to "waste" the expertise I guess, so if a med/surg spot needs floating, tele will go to med/surg and ICU will go to tele.

It's a different culture, med/surg than ICU, but it's within the scope of our practice. ICU nurses want to do their own 15 min checks on every patient. They want to have vitals all the time.... this makes it harder for us to do those assignments, yes, but it is a safe assignment. Like the others said, it wasn't comfortable for you.

My best float ever. Being pulled from ICU to the nursery to feed babies and change their diapers. My nurse manager was ****** at the supervisors when she found out about this, but I had crazy stage 4 guy on a vent trying to get OOB. I almost ran downstairs to the nursery.....

delabeaux, MSN · Aug 16, 2011

I'm an ICu nurse who started off her career as a new grad floating. floating sucks, yes. I did not get an orientation to each floor. Instead I got the crappiest assignments and all the admissions.
Then I went to ICU. We float there too, more often than not. Not to med-surg, just to tele or ER holding, because if they don't want to "waste" the expertise I guess, so if a med/surg spot needs floating, tele will go to med/surg and ICU will go to tele.
It's a different culture, med/surg than ICU, but it's within the scope of our practice. ICU nurses want to do their own 15 min checks on every patient. They want to have vitals all the time.... this makes it harder for us to do those assignments, yes, but it is a safe assignment. Like the others said, it wasn't comfortable for you.
My best float ever. Being pulled from ICU to the nursery to feed babies and change their diapers. My nurse manager was ****** at the supervisors when she found out about this, but I had crazy stage 4 guy on a vent trying to get OOB. I almost ran downstairs to the nursery.....

At the hospital I work at... ICU nurses NEVER, EVER, EVER get floated. All other nurses are game to go anywhere else except NICU and Women's care has their own team, no one else goes there. We have a dedicated ICU 'outreach' nurse to assist with nurse escorts for cardiac drips during transports to radiology etc, EMS runs with insulin drips etc. It is interesting to see the difference in hospitals across the US. We have resource as well that will float to ICU... speaking of getting dumped on, our resource makes a few more dollars per hour and they always get dumped on. For example, I see a 5'1" 110#, 9.5 months pregnant nurse escorting a pt. who is on 1:1 to radiology, a 6'4" 350+# EtOH withdrawal male who is in 4pts and violent. I said, 'You're a resource nurse aren't you"... yep. No other petite, pregnant nurse would get such a patient!

Biffbradford · Aug 16, 2011

Once they floated me, CVICU nurse, to an oncology floor. -> Totally lost. Had to look up every single drug. :uhoh3:

MomRN0913 · Aug 17, 2011

At the hospital I work at... ICU nurses NEVER, EVER, EVER get floated. All other nurses are game to go anywhere else except NICU and Women's care has their own team, no one else goes there. We have a dedicated ICU 'outreach' nurse to assist with nurse escorts for cardiac drips during transports to radiology etc, EMS runs with insulin drips etc. It is interesting to see the difference in hospitals across the US. We have resource as well that will float to ICU... speaking of getting dumped on, our resource makes a few more dollars per hour and they always get dumped on. For example, I see a 5'1" 110#, 9.5 months pregnant nurse escorting a pt. who is on 1:1 to radiology, a 6'4" 350+# EtOH withdrawal male who is in 4pts and violent. I said, 'You're a resource nurse aren't you"... yep. No other petite, pregnant nurse would get such a patient!

And where is this magical hospital? I want to work ICU there.

delabeaux, MSN · Aug 17, 2011

And where is this magical hospital? I want to work ICU there.

Magnet for 15 years, ANA award-winning, Malcolm-Baldridge recipient, Malcolm Baldrige National Quality Award, Magnet Hospital, Best Places to Work in Healthcare, LEED Gold certification, Peak Performance Award, Top 100 Hospital, Avatar Best Overall Performer, Beacon Award, Most Wired and Most Wireless, Top 500 User of Innovative Information Technology, Robert Wood Johnson Foundation, Quality Respiratory Care Recognition... Day patient ratios (non-icu) 4 pts per nurse. Never, ever more than that. Night pt. ratios (11pm-7am) 5pts per nurse.

We get 6,000 applications a month for ~75 open positions. I am among several applicants that applied for YEARS before getting in.

~Mi Vida Loca~RN, ASN, RN · Aug 30, 2011

Magnet for 15 years, ANA award-winning, Malcolm-Baldridge recipient, Malcolm Baldrige National Quality Award, Magnet Hospital, Best Places to Work in Healthcare, LEED Gold certification, Peak Performance Award, Top 100 Hospital, Avatar Best Overall Performer, Beacon Award, Most Wired and Most Wireless, Top 500 User of Innovative Information Technology, Robert Wood Johnson Foundation, Quality Respiratory Care Recognition... Day patient ratios (non-icu) 4 pts per nurse. Never, ever more than that. Night pt. ratios (11pm-7am) 5pts per nurse.
We get 6,000 applications a month for ~75 open positions. I am among several applicants that applied for YEARS before getting in.

I have worked with nurses that got more patients then that at that very same hospital, just because the website says that, doesn't make it so.

wooh, BSN, RN · Aug 30, 2011

^^Yeah that. ^^We had tv commercials bragging that our ratios were just over half what they really are. We get down to tv commercial levels, they send people home.

delabeaux, MSN · Aug 30, 2011

I have worked with nurses that got more patients then that at that very same hospital, just because the website says that, doesn't make it so.

I've yet to see it... I mean, I'm sure you CC clinicals for 1 sem??? were great but in 6 years... and 10 for my significant other who is an RN there too... we've yet to see it and my sig other floats.

I would like you to reply with where and when, it'll be interesting to look in to.

~Mi Vida Loca~RN, ASN, RN · Aug 31, 2011

I spent more then 1 semester there. I also did my Senior Practicum there as a Float. I live in a cul de sac of about 8 houses and 4 of my neighbors work for PVHS. I have lived here for 5 years and talked with them the whole time during school and graduating and so on. Not to mention I know a great many other people that work there and a lot of my friends from school are now working there.

In fact I felt like quiet the dummy when we were taking on our 6th patient in my Practicum (took 5 from the day nurse) and I said "I thought the ratios were 4 for days and 5 for nights" 4 nurses busted out laughing at me that what the website says varies greatly from reality.

Sure when Census was low it was not uncommon to see the nurses within those ratios, but when a few more patients were coming they would rather "bend" the ratio number and give everyone an extra patient then call in another nurse.

Hopefully when you get your job there as an RN as you seem confident you will, that you aren't only hired into a census managed position. That is another way they are really starting to screw the seasoned nurses and new nurses. The seasoned nurses are now stuck if they want to keep their hours. If they want to go to another unit they will end up having to take a census managed position and will lose their guaranteed hours.

New nurses are only being guaranteed a minimum amount of hrs because it's census based. They are getting out of school needing to pay back student loans and not really understanding what goes into a census managed position. They are being guaranteed their benefits but a lot of good it does when they only end up working 12-16 hrs for the week from census being low.

Like I said in another thread. I used to be the first one that would rant and rave about PVHS and how badly I wanted to work there when I moved here. After doing clinicals in school and seeing the direction the last year has taken with PVHS, and talking to my neighbors, I started off my job search trying to get a job at NCMC and got a New Grad job within a week through them. I couldn't be happier. My neighbors laugh at me now because they "told" me that PVHS wasn't what it was cracked up to be behind the scenes.

delabeaux, MSN · Aug 31, 2011

I spent more then 1 semester there. I also did my Senior Practicum there as a Float. I live in a cul de sac of about 8 houses and 4 of my neighbors work for PVHS. I have lived here for 5 years and talked with them the whole time during school and graduating and so on. Not to mention I know a great many other people that work there and a lot of my friends from school are now working there.
In fact I felt like quiet the dummy when we were taking on our 6th patient in my Practicum (took 5 from the day nurse) and I said "I thought the ratios were 4 for days and 5 for nights" 4 nurses busted out laughing at me that what the website says varies greatly from reality.
Sure when Census was low it was not uncommon to see the nurses within those ratios, but when a few more patients were coming they would rather "bend" the ratio number and give everyone an extra patient then call in another nurse.
Hopefully when you get your job there as an RN as you seem confident you will, that you aren't only hired into a census managed position. That is another way they are really starting to screw the seasoned nurses and new nurses. The seasoned nurses are now stuck if they want to keep their hours. If they want to go to another unit they will end up having to take a census managed position and will lose their guaranteed hours.
New nurses are only being guaranteed a minimum amount of hrs because it's census based. They are getting out of school needing to pay back student loans and not really understanding what goes into a census managed position. They are being guaranteed their benefits but a lot of good it does when they only end up working 12-16 hrs for the week from census being low.
Like I said in another thread. I used to be the first one that would rant and rave about PVHS and how badly I wanted to work there when I moved here. After doing clinicals in school and seeing the direction the last year has taken with PVHS, and talking to my neighbors, I started off my job search trying to get a job at NCMC and got a New Grad job within a week through them. I couldn't be happier. My neighbors laugh at me now because they "told" me that PVHS wasn't what it was cracked up to be behind the scenes.

Interesting... I was aware of the new census based nursing. Not sure what I think about that, I've heard many say it's becoming the norm. This does make me want to ask around to see who has had 5+ during the day. Thanks for the reply!

~Mi Vida Loca~RN, ASN, RN · Sep 1, 2011

Interesting... I was aware of the new census based nursing. Not sure what I think about that, I've heard many say it's becoming the norm. This does make me want to ask around to see who has had 5+ during the day. Thanks for the reply!

I would definitely look into it. (the census based stuff) before locking down a job. It would really suck to get a job and start having all your student loans to pay and stuff (if you have any but generally speaking) and you end up working 12-16 hrs a week. Or 16 (I think that was the minimum) I mean it adds up. With new grad pay and night differential I make about 350 pre-tax a shift. Getting called off for one shift each week, still leaving me 24 hrs, for the week will take off 700 bucks from my paycheck. Check the heavier floors, (Med-Surg and Medical) especially. That is where I saw it most. Not to mention the floor would be packed and the CNA's were overwhelmed and couldn't handle the patient load either. My second semester I didn't remember it like that. But I was limited on what I could do. My Sr. Practicum I was being the nurse and man was it a world of difference then what I thought the floors were like 2nd semester.

caroladybelle, BSN, RN · Sep 1, 2011

Speaking as a traveler, this is why you have ask these questions in your interview and address these issues in your contract. If it isn't specified to the contrary, expect to float, to float frequently, and to get very little orientation to those areas. And you have very little recourse if it has not been addressed in your contract.

At one major for-profit facility, it used to be common practice to overhire the longer contract tele/step-down travelers. They got lured in by the attractive ratios/conditions on monitor floors, only to find that they got floated to the more poorly staffed medsurg areas, for days/weeks on end that few travelers would take assignments in.

Second, to those that think that travelers make huge amounts of money, that is simply not true in many cases. These days, if you have the desirable amount of experience needed, you really won't make that much more, especially when you figure in limited benefits, not to mention inconvenience, lack of stable employment, etc. Barring strikebreaking which many of us refuse to do, pay rates are not all that high. Sure the facility pays a lot, but only a percentage goes to the nurse.

To the OP, why are you worried if it was "fair" or not. You did not want/feel safe doing what the facility required, and it cancelled you because you did not fulfill it's requirements. If it wasn't in your contract, move on and deal with it, and learn to specify these issues ahead of time. If you truly feel like this was an unsafe move, and the facility insisted, why would you want to be working there anyway.

I really get tired of the (is it fair) focus. "Fair" does not always count, many of our pts are in the hospital for issues that are not fair. Fair means little - one needs to learn from it and move on.