Floating non-ICU RN's to ICU!!?

TheCommuter, BSN, RN · Nov 3, 2014

has anyone else dealt with this?! Do any others think this is wrong?

I have never dealt with this because the small specialty hospital where I'm employed does not have an ICU.

However, I would feel uncomfortable floating to the ICU because I'd be entering a foreign world. Although there are some tasks I could safely perform, I know nothing about arterial lines, Swan Ganz catheters, titrating drips, and other procedures that are routine to ICU nurses. And frankly, I am not accustomed to the increased acuity level.

BSNbeauty, BSN, RN · Nov 3, 2014

You have a right to refuse an assignment you don't feel comfortable with. When you do, don't use the word refuse. Instead use the word negotiate. This comes along as less defensive and proves that you are actually willing to be a team player. I used to be a CVICU and there were assignments I was not comfortable with due to lack of training and exp. I negotiated my assignment and made sure that I documented everything just in case it would come back to bite me.

You are doing right the thing. If anything were to happen you would be thrown under the bus in a heartbeat.

nurse4ever08 · Nov 3, 2014

I would refuse as well. Tell them to orient me in ICU and then I would be happy to do it

Here.I.Stand, BSN, RN · Nov 3, 2014

Oh...my. No.

I can see if the pt in the ICU was *truly* a stepdown or floor pt, as in has transfer orders but no beds available, letting a PC nurse take care of those pts. But it is completely unsafe and inappropriate to assign an RN to that pt who is not trained for the pt's level of care. If it was, why were we experienced RNs given orientation and classroom training upon our hire into the ICU? My ICU hires many RNs from various floors within our hospital. If it is appropriate to give critically ill/injured pts to floats (ETA--from other floors or untrained members of the float pool. Our float pool has many qualified RNs because we have trained them), it should be appropriate to throw these new RNs right in. After all, they've had the same general RN orientation, and know the same EHR system as the rest of us in the ICU have. But it's not, so they don't.

For this same reason, I would not float to NICU. If they tried to float me to the PICU (staffing has floated adult ICU nurses there on occasion), and the very least I would would make it clear that 1) I will not take a pt under age 15-16, 2) I am not PALS certified so I will be of limited help during a code, 3) I am not to be left alone or even with 1 other RN in the vicinity because of point #2. I would not float to psych or L&D or procedure rooms for that matter (my hospital does not do this.)

You're absolutely right.

blondy2061h, MSN, RN · Nov 3, 2014

My hospital will float non-ICU nurses to ICU if there is no choice at all. It's a last resort. If there are floor status patients, they take them. If not, they don't get their own assignment and help with checking blood products, turning and positioning, bathing, any dressing changes they might feel comfortable with, and just overall being another set of hands and eyes.

Keri29 · Nov 3, 2014

My hospital will float non-ICU nurses to ICU if there is no choice at all. It's a last resort. If there are floor status patients, they take them. If not, they don't get their own assignment and help with checking blood products, turning and positioning, bathing, any dressing changes they might feel comfortable with, and just overall being another set of hands and eyes.

I think being a helper/extra set of hands doing things all nurses should be able to do is a totally different story than being asked to take a team of ICU patients. I would feel comfortable helping out, but not being responsible for a team...

Keri29 · Nov 3, 2014

Do you think there is anything I could do to bring this to the attebtion of hospital supervisors?

RNsRWe, ASN, RN · Nov 3, 2014

No, they shouldn't. At worst, an RN who is not prepared to handle an ICU assignment can go as 'extra hands' (without an assignment, but able to help as an RN for whoever needs help). Have seen this done many times. Eventually, that RN is deemed 'floatable' to get an actual assignment, but.....it comes after time and prep work.

When I worked med-surg, it always boggled me that if ICU was slow, and we were slammed, they'd send an ICU nurse to take on a "typical" m/s assignment, and it usually buried them. NOT a criticism of ICU nurses by ANY stretch, just an observation that when you're used to dealing with two patients (and get to know them intimately) having 7 patients (typical evening assignement), trying to keep up on all their assessments, meds, etc, can cripple the float. Unfair for the float (who is buried) and unfair to the RN who gets to pick up their assignment (and starts out the shift buried)!

dudette10, MSN, RN · Nov 3, 2014

You were right to refuse. I am often dumbfounded at what house supervisors try to get away with.

Only a month off orientation as a new grad, they tried to float me to ICU. They said it was my turn, and I would get "more stable" patients. I called the manager of my unit, and she tried to persuade me. I stood my ground.

tarotale · Nov 3, 2014

Do you hear that sound? Yap it's the sound of lawyers grinding their sickle. Good luck to hospital admin.

blondy2061h, MSN, RN · Nov 3, 2014

Does you hospital have an assignment protest form? If they ever make you take ICU patients, be all over that.