floating to other departments

[smbmlt]

Ive been an L&D nurse for 3 years now, we have been told to float to other departments, (ICU,ER,PEDS,MED-Surg) when we are slow. Our minimal limit is 4 RN's. We were asked recently to work in the ICU and take patients. We didn't refuse, but we informed our supervisor that our competency for this floor would lack in patient care and cause more harm than good for the patient. Being already on a specialty floor, does anyone know if we required to float with our experince being little to the environment?

[Riseupandnurse]

I am so sorry for you; that's more of "a nurse is a nurse is a nurse" thinking. You ask if you're required to float? Yes and no. Your hospital can require you to do this and fire you if you refuse. However, the state Nurse Practice Acts are clear that it is up to the individual nurse to ascertain his or her own competence. If you accept an assignment it means you are agreeing you have the training and experience to give minimally competent care. If something goes wrong, then, it's on the nurse. If you get pulled to ICU, for instance, and are given a patient on dopamine and a vent, you are in effect saying you know what to do about those things. The only way out of it is to make it clear to the facility you cannot accept the assignment BEFORE you listen to report (so it's not patient abandonment) or, if it's a case where you judge the patient is still better off with you than with nobody at all because there is no alternative, to accept the assignment under protest and get written confirmation that management is aware that this is the situation. Can you still get fired? Sure, but unfortunately you may have to pick your poison, so to speak. Personally, I think all facilities should do meaningful cross-training before subjecting a nurse, the other nurses on the zone, and most of all the patients, to these circumstances.

[babyktchr, BSN, RN]

I cannot believe a hospital would float an L&D nurse to ICU????? Do ICU nurses float to L&D??? ICU requires specific skills and not just anyone can work there....just as not just anyone can float to do labor. The mentality that a nurse is a nurse is a nurse is so outdated. OMG...even med/surg nursing is a specialty these days. Nursing administration MUST realize, despite nursing shortages, you cannot just put a nurse anywhere and expect her to perform safely. Its just bad news all the way around. I cannot believe that anyone would work in a specialized area such as ICU without proper traning. The liability is enormous.

The facility I work in has the above mentioned mentality. They do, however, draw the line at putting the properly trained nurses in ICU or PCU.....though they do try. I did get pulled to PCU once (I have worked ICU before, but eons ago) and I had a patient on a cardizem drip. What would his reaction be if he knew his nurse worked in labor and delivery?????????

[elizabells, BSN, RN]

My large peds hospital has groupings of floors that can float to each other... to my recollection, no one from L&D has ever floated to our NICU, and none of us have been floated there, though we've gone to every other floor but OR and ER.

[smbmlt]

I have never had anyone from another department help us when we get SROM's and deliveries out the yang...no other employees are trained to take care of preg. moms. except us. The hospital cant stand that sometimes we are looking at the walls with nothing to do, but then again, we are open door to anybody.

[snowfreeze, BSN, RN]

The last travel job I had was rural nursing, I was the ICU/tele nurse in a 24 bed facility. All the patients were basically in the same unit, L&D at one end, ICU in the middle with the potential for any bed being tele and med/surg and rehab at the other end. I did have to care for a mom and 20 hr old baby one night as the L&D nurse called off sick and no one else was considered qualified. I had not checked a fundus since nursing school and forgot how much those little ones can squirm. Fortunately the tech working that night was quite familar with newborns and new moms. She did get quite a giggle watching me trying to change his diaper.. now that I think of it, I am sure it was humerous. We had poop everywhere when I was done.

Back to the original question, normally you don't get pulled to an unfamilar unit for patient safety reasons.

[classicdame, MSN, EdD]

Your state Board may have rules on this as it is of great concern to nurses everywhere. Texas has a Safe Harbor act to protect nurses who are put into situations where the nurse may feel the patient is at risk. Remember, the Board is there to protect the public, not you, but you can use that to your advantage. It is more important to protect your license than your job. That said, you don't want to abandon the patients either. Very sticky - so I would talk to the Board and make any written complaints, grievances that are available to you. Next choice would be to leave the hospital entirely. Have you talked to your CNO?

[mpccrn, BSN, RN]

no one likes to be pulled to other departments. i'm an ICU nurse and have been pulled to places like NICU as well as med-surg, medical and the ER. as an ICU nurse, i'm competent to take care of ANYTHING that rolls through the doors, alive or dead. it's the way it is. did i always feel comfortable? no, not always but it keeps me on my toes and on the top of my game. go with a good attitude and the people you're working with will recognize it and be more likely to ask if you're doing ok. NO ONE is on the floor alone.....ever......whether we are working in our own department or somewhere else......we all get a little help from our friends! i'm not saying it's an ideal thing but the reality is, sometimes you have to do what you have to do. Sick people need a nurse.....if you're unsure....ask. your patient will appreciate it and you'll get reminded of something you might have forgotten long ago!

[nurserynurse55]

No, No. I work in NICU, and the only unit that I float to is special care nursery.

[smbmlt]

so, if you were to be placed on L&D and sometimes we are so busy that no one is able to help, how could you read a strip?place a FSE? circulate during c/s?put mom's on our monitor with the TOCO/US?complete pt care during a crash?

[suanna]

If I hear one more time "you know you work for the hospital not your unit" as the excuse to float nurses all over the hospital. We are fortunate to have the rules of floating spelled out in our union contract but it is still one of the most difficult facits of the job. I have been doing this 22+ years and still feel like I'm doing substandard care when I float to another floor. I feel like my patients are being short changed when the other patients on the floor get a nurse that knows where things are kept, who to call, whats allowed, while my patients are stuck with me. One night I restarted 6-7 IVs on my post-op patients on the floor that went bad only to be told by the dayshift nurse that it was doctor approved unit policy to d/c the IV if it went bad on patients that were tollerating PO and could switch to po meds/fluids.