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floating between departments ie med/surg to nicu

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by mcl10109 mcl10109 (New) New

Hi I'm a nurse with a small dilemma and was hoping for some assistance. I graduated 3 years ago and like many new graduates are told to do so I went into med surg to develop my "nursing skills". Well after I begged and pleaded I was able to secure transfer to a NICU position and was safe there until my training time was over. Now every so often (we're talking about every 5 - 6 months) when the census goes down I'm expected to be able to go back to med surg and perform as well as the nurses that work that floor regularly I've spoken to my bosses using the chain of command and so far the response I've gotten is a nurse is a nurse is a nurse. I'm so frustrated. I love taking care of my patients, just the patient load, ancillary assistance available really don't compare to the the other floors that I work on and there really isn't enough time to be checking at least 5 out of every twenty medicines that you have to give per patient in the am. I feel that I can adequately take care of peds, gyn, mom/baby and level 2 nicu and think that med surg is too far a stretch or am I just overreacting and my bosses are right a nurse is a nurse is a nurse???

Please Help Any reply is appreciated

Thank You

BrnEyedGirl, BSN, MSN, RN, APRN

Specializes in Cardiac, ER. Has 18 years experience.

We have float clusters,...NICU and med/surge are NOT in the same cluster! I agree with you,...as an ER nurse I wouldn't be comfortable in NICU! A nurse is a nurse,..as a new grad! We can all go on to learn whatever specialty we want,......perhaps they should put you with a preceptor when you float! :)

see now that's the thing I have precepted for that floor like three years ago and I go there sparsely like every 5 or 6 months maybe 1 2 or 3 days and that's it, I would really rather not go back but I keep getting told that when the Adult units need me I "have to" go back because I have been trained. I understand that but the pace is too fast for me and I'm not a regular and still am expected to perform like a regular on that floor "ugh"

Pepper The Cat, BSN, RN

Specializes in Gerontology. Has 35 years experience.

Our float policy (which is seldom used - we don't float much) is that float nurses don't take assingments. They help out as necessary. Perhaps you can suggest that next time you are float. Say you don't want an assingement but will help out where-ever necessary. So you may do a drsg here, an admission there, and so forth. The nurses on the floor get help, but you don't feel overwhelmed.

MichelleB34

Specializes in Med-Surg/Pediatrics, Maternity. Has 13 years experience.

I can relate to your dilemma. After 11 1/2 years of med-surg I switched to maternity in August of 2008. Several times in the first 2 to 3 months I was mandated to float to my old floor because I could take an assignment. The more time that passes the harder it is to go down and pick up a full assignment. I can do it but it's harder because I am out of the routine. I don't think a nurse is a nurse. I think when nurses are expected to take an assignment on another unit it should be in a related specialty and maybe the assignment should be a little easier because it's not your floor. I have not always felt this way but I think switching to a different area of nursing has given me a new perspective. As someone else suggested maybe you could work as helping hands when you float to that floor. I have done this the last couple of times I floated and it has made it easier. Good luck.

I could try to offer this up but unfortunately they staff with me included in their numbers, I'm now trying to learn mom baby but at least it's not a far cry from my main floor, where I want to be. I beat myself up after the last horrible day I had and have tried to think up how else I could have handled it, I have come up nothing short of just realizing I am a good nurse and it's a far stretch to be going to all those different units and still be expected to be able to take on med/surg patients. I'm going to try to say NO when asked to float there, of course I feel I don't have any choice in the matter and have been told so many times.

Thank you very much for all your suggestions and well wishes :loveya:

Riseupandnurse

Specializes in Medical Surgical. Has 15 years experience.

A nurse is a nurse. So is a doctor a doctor? Or an administrator an administrator? My husband was the head of lab services and he said he got tired of hearing how a med-surg nurse shouldn't be floated to the nursery or ICU with no training. So one day the phone rang early one morning and I told him it was the hospital CEO saying the head pharmacist and his assistant were both out sick and he had to run the pharmacy for a couple of days. Well, I lied just to see him turn white. Priceless.

I feel your pain. I work at Neuro ICU and when our census are low they float us to MICU, CCU, and SICU. I just hate it. It is overwhelming because I am not used to many drains and procedures. I am also a new grad and when I get floated I spend the whole shift very nervous. Managament can care less about it. My sugestion is to get some experience and move on to another institution, this is because most hospitals have the policy that if you were trainned to work a specific place you can always be floated there... I am sorry !!! Many people don't get it that if you have a specific trainning you should stick with the area you were trainned for! OBGY doctors do NOT operate brain turmors !!!! Bad managers are bad managers!!!!

cjcsoon2bnp, MSN, RN, NP

Specializes in Emergency Nursing.

If you feel like you are not able to safely practice as a med/surg nurse because your specialty is NICU then you need to say that to management and tell them that you will not be floated to med/surg. floors because you do not feel safe to practice in that capacity. If you feel confident being floated to X, Y and Z floors but not where they are sending you then you need to express that too them because you can bet that if a mistake happens it will be your license on the line and they will put the full blame on you. Good luck and let us know how it goes!

!Chris :specs:

twinmommy+2, ADN, BSN, MSN

Specializes in ED. Has 16 years experience.

I would be worried about taking care of people with infections of any type and then working with the nicu babies. Yikes!:twocents:

Ahhphoey

Specializes in ICU, M/S,Nurse Supervisor, CNS. Has 16 years experience.

Floating can be hard regardless of the unit because you are placed in an unfamiliar environment with unfamiliar nurses and routines. NICU is definitely a far cry from Med-Surg and seeing as you don't regularly work med-surg, you should not be expected to take a full assignment. At one hospital I used to work at in ICU, we could float to any of the other floors (there was no peds or L&D), but could only take 4 patients. The hospital I am at now has ICU nurses float to either the other ICU or step-down only, though occasionally to ER and PACU but only to task or to care for ICU overflow patients that may be waiting there for a room. You just have to speak up for yourself and don't take on something you can't handle because in the end, it's your license on the line.

coffee4metech

Specializes in OR.

Use this situation to become more well rounded and take everything in stride, develop your skills in both departments and use it to your advantage. I would love to have a change of scenery every once in a while. And don't complain to management about it because they will probably take action against you so be careful and be greatful you have a job .

NurseLoveJoy88, ASN, RN

Specializes in LTC. Has 6 years experience.

Use this situation to become more well rounded and take everything in stride, develop your skills in both departments and use it to your advantage. I would love to have a change of scenery every once in a while. And don't complain to management about it because they will probably take action against you so be careful and be greatful you have a job .

I agree with the OP very much. As an aide it may be easy for you to say " I would love to have a change of scenery" but as a nurse its different then a change of scenery. Unless you have years and years of experience under your belt floating can be very difficult. When she floats to med surg she's dealing with a whole different set of diseases, medications, nursing implications, medical diagnoses and etc. I'm just a student and with a new clinical rotation every 7 weeks can drive me up the wall. BTW Can't wait to become an L and D nurse !

coffee4metech

Specializes in OR.

I am not just an Aide , but also a nursing student like yourself and maybe for you its overwhelming but not for everybody .I myself like to be well rounded and gain experience for my professional growth and development and use a situation like this to my advantage !!!

maxthecat

Has 27 years experience.

A lot depends on how closely allied to your home unit the department you're being floated to is. For example, if I work NICU and I am floated to Mother/Baby, I will be familiar with the doctors, with the expected diagnoses and routines, the equipment used, etc. If, however, I am floated to a Med/Surg floor I have a whole new set of doctors whose protocols I don't know, tests and equipment I am not familiar with, etc., not to mention not knowing where equipment is located, charting protocols which are entirely different, etc. Yes, I can learn these but a float assignment is not the time. My patients have to wait while I have to ask already overwhelmed staff about these things. Not an efficient system.

I think there was a time when nurses could be expected to float anywhere and function but those days are long gone. There are no longer 4-5 "walkie-talkies" that can be given to a float. Every patient is high acuity or they wouldn't be in the hospital. And medicine changes so fast that just because you learned something in nursing school two years ago doesn't mean that's the standard of care today. If I'm a patient, you can bet I want a nurse who regularly works in this area taking care of me, not a float from NICU. Just as I don't want a med-surg nurse taking care of my premie.

Floating as a tech or learning new units as a nursing student has one big difference from floating as a nurse in charge of care for patient--as a tech or student I don't have a license (and livelihood) to lose. So while I applaud anyone who is interested in learning as much as possible, just be sure you aren't learning it at the potential expense of the patient.

icyounurse, BSN, RN

Specializes in MICU, SICU, PACU, Travel nursing.

I am not just an Aide , but also a nursing student like yourself and maybe for you its overwhelming but not for everybody .I myself like to be well rounded and gain experience for my professional growth and development and use a situation like this to my advantage !!!

I think the difference between floating as a tech or student (no offense here) is the level of responsibility. I think the concern from nurses about floating is that if, for example, say a med-surg nurse was floated to Neuro ICU, has no NICU experience. And then given a patient with a ventriculostomy drain even though the regular NICU nurses all took a course on how to properly monitor/care for said drain and float has never even seen one. Well say there is a complication with the drain- do you think the patient and family are going to say, well I am glad the float was trying to grow professionally- No they are going to sue and you may lose your license and livelihood. And for those of you that say "this would never happen" I have seen it happen.

I just mean that different nursing specialties can have very specific training and it is not always safe for someone else to perform the same care simply because they have the same degree.

FYI- I have no problem with floating as it is my job and I am in the float pool:specs:

But it is what I signed up for, after I had 5 years of varied travel/staff experience in different areas. Also I am paid more because I float. As a staff nurse, there is little incentive for the nurse to do it.

Daytonite, BSN, RN

Specializes in med/surg, telemetry, IV therapy, mgmt. Has 40 years experience.

Floating from NICU to med/surg after having worked on med/surg. . .you're over-reacting. I was a supervisor. I would float you to the med-surg unit too if it was your turn to float and the med/surg unit needed help.

Roy Fokker, BSN, RN

Specializes in ER/Trauma.

Would you have a dermatologist treat chest pain patients in the ER? How about a radiologist doing primary care? Would you have a nephrologist read CT scans?

After all, a doctor is a doctor is a doctor, right?

cheers,

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