Floating of ICU RNs

cowboyRN · Nov 22, 2006

In the last 6yrs, I have floated out once. I have picked up extra shifts on other units. I work a small unit, 6 bed with a mix of ICU/SAC patients and we are always full.

Colorado Kid · Dec 14, 2006

It is just common courtesy to help out where it is needed, since when do the skills on the floor exceed those in the unit! The charting might be different, but the patient care is the same. Quit whining and do the work you are paid for!:pumpiron:

Colorado Kid · Dec 14, 2006

I'm glad I don't have to work with johnboy!:smiley_ab

ginger58, ASN, RN · Dec 15, 2006

Our critical care nurses only float within critical care areas. ER nurses aren't floated. We have about seven med-surg floors and we're only required to float to a M-S floor as a M-S nurse.

Pediatric Critical Care Columnist · Dec 15, 2006

Our PICU is almost an extension of the float pool. Whenever we have even one extra nurse, regardless of how bad things have been in the unit recently, no matter how sick the patients we currently have are, no matter how burnt out people are, no matter how many empty beds we have that could potentially fill up, we are expected to float. Any staffing problem in our children's hospital-within-a-hospital becomes PICU's problem, one way or another. We go all over the place; so far we're retricted to the peds floors, but I sense that it could change a heart beat. We are also supposed to take turns, but that gets turfed whenever we have a high-acuity unit - the most junior staff gets sent in that case. Our casuals do NOT float, because they can cancel themselves: if they arrive and find out they're being floated, they go home. WIth our last round of collective bargaining, the emplyer successfully had the wording of the contract changed to state that we are employed by the health region, not by the hospital or the unit. That means that we're interchangeable widgets. Except that PICU can float to anybody and nobody can float to PICU. The adult ICUs do not float their staff anywhere, and ER doesn't either.

In my previous unit, in another city, we floated all over the hospital but weren't restricted to peds. I was sent to antepartum one night because there was only one of their nurses on, and she was going to need a break. I was stunned to find out that they routinely took a two hour break (nap) in the middle of the night and I was going to be completely alone with these women, one who had recurring antepartum hemorrhage and another who had already had one microprem (that I had cared for in the nursery... another story) now at 22 weeks and with hourglass membranes... I had a chat with the supervisor and told her that if either of these women even sneezed, I was calling a code, because I sure as heck didn't know what to do with them! Got through that night unscathed.

When I interviewed for the job I have now, I asked about floating. I was told that it had been an issue in the past, but that there was an agreement in place that meant PICU only floated to NICU, and nobody floated without a four hour orientation (when they sent me to NICU I got, "There's the med room, there's the respiratory desk, there's the staff bathroom and here are your patients." but that was a lot more than I got when I went to the palliative care ward...). There was also a PI-NICU float pool of six nurses who were crosstrained and would go to the unit with the biggest need. That lasted about as long as that particular patient care manager. Once she moved on to a better job, the whole thing came off the spool. The PI-NICU pool has shrunk to three; they've created a new pool of about a dozen nurses that is supposed to ease the staffing issues of our step-down unit and our PICU... but there's usually a note at the desk telling us that the pool nurses have been scheduled for the stepdown unit and are NOT to be pulled. It seems that PICU can work severely short (and frequently does), but no other unit should be expected to. I haven't floated for a long time... Labour Day 2005... so I'm suspecting my turn is coming. Yeehaw.

RNforLongTime · Dec 15, 2006

In my small community hospital where I work in the 6 bed ICU/CCU, we float to any area of the hospital. but we don't take a pt assignment. Which basically means that we act as their nursing assistant for the shift. Answering bells, baths, etc. Usually the floor nurses are sitting on their hind ends at the desk reading a magazine.

When we are slammed in ICU-we very RARELY if EVER get help from the other floors. Theres been times where I've worked ALONE in my unit with a vent patient!!! They put the other RN on call! And I've been told to put up and shut up so to speak. So, I will begin the job hunt again here really soon! I get so tired of the political/money issues having to work as a staff nurse. Sick and tired of it. Am seriously thinking of going agency!

cowboyRN · Dec 18, 2006

So, I will begin the job hunt again here really soon! I get so tired of the political/money issues having to work as a staff nurse. Sick and tired of it. Am seriously thinking of going agency!

If getting dumped on really bothers you, you might want to rethink going agency. As an agency nurse you can count on the worst assignments.

coffeeaddict, LPN, LVN · Dec 19, 2006

I work a 12 bed ICU, we take alot of ACU overflow pt, occ. float to the rest of the hospital, but can't take a assignment. We end up doing all of the admits, sometimes helping with med passes, and often working as a aide. Most of the other ICU nurses hate to float, 1/2 of them are rude to the floors. Some have been permenently kicked off of the ACU. I started working in ICU about 6 months ago, previously worked M/S, and ACU, I also know a someone on almost all floors. So when I have to float I am treated well. But I always try to tell the floors "Ok here I am, what can I do to help you." instead of " I am only here to do the admit, I will sit here untill they get here." I always have fun floating, most of my shifts, 8 hrs out of 12 are getting caught up with my friends from the floors, I rarelly have anyone giving me busy work with them sitting. If they dont need help they tell me. If they do need help I try to help with anything they might need. Even if it is something they would normaly have a aide, of unit secretary do.

golfingrn · Dec 22, 2006

We have a 16 bed ICU and when we have a call in or short shift we cover our own. NO ONE is every pulled to us. We are being pulled to the ER on a frequent basis - called a "CRITICAL PULL" - to justify shorting us a nurse to cover another unit. This week we were told that to cover the ER due to inexperience and shortage an ICU nurse would be pulled each shift to the ER. Also if a patient goes bad on the floor an ICU nurse would stay at the bedside until an ICU bed opened up - no longer would the patient be taken to the ER to wait on an ICU bed. Once again our "management team" has taken a very stable and for the most part very happy group of staff and slammed them. Oh and the inexperience nurses in the ER - we have no education department - cut - experienced nurses - transferred to the ICU(5 including myself) in the last two years-management-in their offices...

perfectbluebuildings, BSN, RN · Dec 30, 2006

In our hospital, floor nurses, ICU nurses, ER nurses, all float to ANY unit in the hospital. I am not saying it is a great policy, but the floor nurses definitely do a lot more floating than the ICU nurses... and do have to take teams there too. Your policies where ICU nurses have to go to floors to take teams but floor nurses don't have to take ICU teams, makes little sense in terms of usefulness or fairness. I like the idea of floor nurses floating to the different floors, and ICU/ER nurses floating among themselves. (See my recent post in the PICU forum). Thanks for listening.