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

icuRNmaggie, BSN, RN · Feb 15, 2015

Non ICU nurses who are floated to my units are asked to help with tasks. Turning, bathing, changing linen, taking and charting temps, emptying foleys, FSBS EKGs, answering call lights etc. Nobody likes to be out of their element and we don't want to make it harder for them or scare them away.

ixchel · Feb 15, 2015

Hello fellow nurses! I'm having a hard time understanding why it's okay for my hospital to float med/surge, med/tele, and PCU nurses to ICU to care for ICU patients!? I work for a float pool so all I do is float, to 4 different hospitals. I get called and told that I'm going to a certain ICU but I will be caring for overflow PCU pts (I'm a PCU RN). I get to ICU and they try to give me all ICU pts. I refuse because #1 I'm not a qualified ICU nurse, I don't know their protocols, charting requirements, etc, #2 if my loved one were in the ICU and I found out a nurse not qualified in ICU was caring for him/her I would be LIVID!!!, #3 the safety of the patient!!, and #4 I'm protecting my license! If God forbid something happened to the pt I was caring for and I had to go to court, no one would be backing me up saying "oh well we made her take ICU pts", I would be the one in trouble! I've refused every time and every time it causes a big issue! I personally think the hospital is just trying to get away with paying a PCU nurse instead of an agency ICU nurse...just trying to save the $$$. ï˜’ has anyone else dealt with this?! Do any others think this is wrong? I'm curious for your opinions! Thanks!!! ï˜Š

I'm struggling to completely understand your pov. I'm a PCU nurse and we've been short in our ICU for ages, so they float PCU nurses there all the time, and they send a med/surg nurse to cover us if it's needed. We ask for help when it's needed, and if we feel in over our heads, we say so. I'm a new grad nurse with only about 9 months experience, so the very first time I was floated to ICU, I said straight out - I want to be an asset to you, not a drain of your time and energy, so do you mind giving me a crash course in all that I need to do? They were wonderful, supportive, and attentive when I had questions. I will say, though, they don't give PCU nurses vented patients, but even if they did, we have RT on the floor at all times. We are also a non specialized ICU, so we get it all.

Eta: after reading more comments, I wonder if maybe it's the environment that makes the difference. Also, jumping in with the mindset that you can learn from this experience. I'm not saying I don't get nervous, and I will always, always say something if I think I'm in over my head, but I think going in with a different mindset might be helpful. If this is going to be an ongoing trend in your facility, dive in. The more you learn each shift, the less intimidating it will be in the future. I honestly feel myself falling in love with our ICU. I have a whole lot to learn over there, but I love it and enjoy being pulled. Open your mind, and don't be afraid to ask for guidance. In time, it'll be less scary.

Bluebolt · Feb 19, 2015

I've worked in a few different ICU's in a few different states. I've noticed that most facilities do not float anyone untrained in the ICU to the Unit. If someone with previous experience in the ICU is working somewhere else presently and is willing to float for that shift they are still given the easiest patients who are preparing for transfer soon. One small hospital

I'm not saying I blame them for it. They have not been trained in critical care, drip titrations, high acuity patients, vents, PA catheters, CVP and Arterial monitoring, Q1hr vitals and strict I&O on everyone. Not to mention the family dynamic for a nurse in critical care takes on a much more involved role than floor nursing. We would get complaints that the nurse didn't spend much time explaining the pathophysiology (in layman's terms of course), what the plan for the day was, general pleasantries, etc. When you're used to having 7 patients and constant streams of various people streaming in and out of your patients rooms you probably don't approach things in the same manner. Families let back during short visitation times are vulnerable and expect to be coddled, they expect you to make yourself available for long periods of time to answer lots of questions. They ask hard questions sometimes and they expect you to know the hard answers. Ultimately they need to test you out and see if their loved one is safe in your care and if you're competent and caring enough to keep their heart beating. These are all things unique to the ICU and aren't learned through a few times floating to the unit. It takes at least a year of full time ICU practice to even get "okay" at these things.

It's unsafe and unwise to float people into the ICU to take an assignment. You should tell your manager you don't feel comfortable doing it with no ICU experience. You can even feel free to use some of my points to display the risk of patient and family dissatisfaction. That always seems to get managements attention.

HazelLPN, LPN · Feb 21, 2015

We did receive float nurses from the floor in the ICUs. If there was a patient assignment that they felt comfortable with, sometimes they would take a full assignment. If we didn't have easy assignments, they were not expected to take an assignment on their own, but they certainly could help out and there was quite a bit that they were able to do to help the regular staff. Sometimes we would pair a floor nurse with an ICU nurse and they would take an expanded assignment...three patients on 1:2 care for example. There were also times that we would take nurses who didn't take any assignment but simply served as an extra pair of hands to do whatever was needed.