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Question

Floated mid-shift regularly

Dear Nurse Beth,

In the middle of the shift we are starting to be asked to change floors/ assignments. It's not easy to take an assignment, create a plan, then be told to go to another floor, but we have done it. Today I was told I needed to change my assignment and go to another floor in the middle of the med pass. I had given 5 patients medications and I had 10 more to administer meds because the supervisor told us there needed to be at least 1 head nurse on the unit on each floor. All 4 nurses are RNs, all 4 nurses have been in charge on each unit. There is no policy for a head nurse to be stationed on each floor. Does a nurse have to change assignments and floors in the middle of a med pass? 

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    Dear Changing Floors,

    I apologise, I'm not sure I follow the reason behind the request to interrupt your patient assignment and float you to another floor because a head nurse is needed if all 4 RNs are qualified charge nurses. It could be they are trying to meet some regulation (or their interpretation of some regulation) they just became aware of, and haven't shared all the information with you.

    I do feel I'm missing something, but regardless, this is a terrible idea. You are so right about the importance of taking an assignment and planning your day. There can be no continuity of care, and it has the potential to harm patients. If this keeps happening during med pass, there will be med errors.

    This is treating nurses as interchangeable widgets and not as professionals.

    It's hard to offer a solution without knowing what the problem is they are trying to solve. It's puzzling that a head nurse problem exists mid-shift that wasn't apparent at the beginning of the shift. Could you try to find out more from your supervisor and propose that the desired staffing is assigned before the shift starts?

    Unfortunately, there's no law that prevents an employer from doing this. I hope this is resolved soon.

    Best wishes,

    Nurse Beth

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    To me, it seems the problem here is the mid-shift switch. Like if you need me on another unit, just send me there at the shift beginning and let me start doing my thing there! Don't switch me mid-shift!

    OP is NOT a widget and shouldn't have to be just moved about. Beth, I would venture that the nsg TPTB didn't realize the other unit was short or needed assist UNTIL LATE, so they made their call late.

    As a LTC supervsr, I saw & dealt with that more times than I'd like to acknowledge. But I'd bet staffing was really short and Central Staffing had to cover the immed schedule. So someone prob wheeled & dealed with other staff , like "Mary, if you cover 7am for Thursday, I'll take you off the sched & replace you for Friday". Want to guess if the switch was ever successfully completed?!?! So on Friday, nobody realizes the other unit is short because Mary NEVER showed, altho her name WAS there on the sched. Hence the late call to pull the writer. Had to happen - no better option.

    Another possibility was that an agency nurse failed to show up (Note: I am not picking on them). But with these crazy times to cover staffing needs, so very much could fall thru the gaps. 

    Just my take on the writer's complaint Not sure what that's all about re HN, CN & RNs, but there must have been some logic. 

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