Floating...

[KimmieKoo72]

I've been an LPN for almost 2 years now and I work on a rehab floor in a hospital.. down there we function alot differently.. I'm not you're regular, "med-surg" working the floor kind of nurse. On my floor the LPN is basically a helping hand to the RN with meds and patient care... We are not responsible for doctor's orders, we aren't even permitted to take them... We do not take report on new admissions, nor the paperwork for admissions or discharges.. I was floated this past week due to low census on my floor.. I was sent to a very busy surgical floor. Up here the LPNs are almost autonomous.. Much different from what I am used too. I spoke with the nursing supervisor prior to my shift to explain the situation and how I felt.. she assured me that she would explain this to the charge nurse on the surgical floor I was being floated too... Everything started out okay, but as the day went on the charge nurse was being really hard on me.. She wanted me to take admissions, discharge patients, take report for an admission.. and I was not comfortable with any of this. I have never been trained how to do any of the paper work for any of this... not to mention I have never done it before.

I just really felt like an idiot. I tried to explain my feelings to the charge nurse, and also explain that the LPNs on my floor do not do any of this, I'm not used to it, never been trained... it was like she didn't care.

I feel that if the nurses are to float that it should be a madatory part of hospital orientation that they are oriented to each floor.. and the admission/discharge procedures should be universal through the whole hospital.

What would some of you do in that situation? Would you muddle through it.. or would you speak up... I didn't want to do something that I wasn't sure how to do... just lookin for some input!!

[pink2blue1]

I'm and LVN in California...I work on a Surgical floor and I do always have my own assignment. The Charge nurse covers my piggy backs and pushes as we do not do them in CA. I take orders, take admits, take report etc.

When I am floated I am expected to know what to do. I ALWAYS inform the Charge nurse up front that I am an LVN and I always tell them if I have never been to a certain area. Most of the time people are good.

If I was put into a situation like that though, I would go straight to the house supervisor and tell them that I am WAY out of my comfort zone. I do think that if they expect nurses (RN or LVN/LPN) to float out of their home unit, they SHOULD be oriented to all areas they are expected to float to. That is the safe thing to do.

[systoly]

Going to work in an unfamiliar area usually produces apprehension, tension and discomfort. In a situation like this, a quality charge nurse will realize that you cannot be expected to be as effective as regulars and that you should have some mentoring throughout the shift. However, it doesn't sound like the expectations were unsafe or too unreasonable. Sure, it would have been nice to have orientation, but when you work a unit infrequently you'll always be somewhat unfamiliar. My suggestion is to take it as a learning experience. It never hurts to be familiar with discharges and admissions, it just makes you more valuable.

[BerryHappy]

Muddle, trip and stumble. That's how it is EVERY time I float. I am starting to think that I would rather just work on the floor that is ALWAYS short staffed than float to that floor. At least then I get comfortable with their routines. IMHO floating should be reserved for the MOST experienced nurses anyway. Good luck!

[lpnflorida]

It is scarey and unnerving to float to another unit. I can fully understand your duress. I think you did what you could which was to tell them what you did and did not feel comfortable with.

I am curious did you admit the new patient? If you did, how did you feel afterwards?

The paperwork for most admissions is pretty self explanatory. After filling that out it is simply then charting your assessment of the patient. Discharge can be more difficult when you do not know the patient well.

Floating gets a bit easier after you have done it a few times. I have survived it by doing the following:

I always remind them what unit I come from

I let them know briefly how many years I have been working.

I ask to be buddied up with a regular staff member of the floor whom I can use for a resource as the need arises.

I save any complaints I have, and mull them over only in my head. What I feel at the beginning of the shift which most often translates to overwhelmed, often changes to the end of the shift when I feel satisfaction for a job well done.

It is a good opportunity to network with other units. I have received many offers to come work other units if I ever choose to leave where I currently work.

Always remember to put your best foot forward when working other units.

[Butterflybee]

We are in the same situation. Over time, Ive come to realize that this situation will ultimately be used to my advantage. At first I was apprehensive and nervous. I always ask questions regardless of any perceived irritation on their part. If Im really not sure, I will go slow... double check myself and still... ask questions. The other nurses at my facility have come to realize that because of my floating I may not be as familiar with certain things so they will take the time to show me. This willingness to help came over time. Perhaps as they got to see how I work, Ive become 'accepted' because initially getting help wasnt this smooth. Floating at first was a nightmare, now Im one of only a few that are familiar with just about all of the patients in my facility. It would be easier to be on one wing because you get to know your patients day in and day out and pretty much you know what to expect as routine on your shift but I appreciate this experience as it has built up my confidence. As a float nurse, when you get to work, you never know where you will be, who you will have and what is needed/ it takes more time to prepare and just to get started. When we change jobs (if we do), this floating will have come in handy. Hang in there.

[pagandeva2000, LPN]

I don't think you are wrong for reacting the way that you did because you were new to the floor and unfamiliar with their practice, but I would also check with the BON to be sure that you are, in fact, able to do admissions and discharges. Even if it was allowed, they should have taken exception to the fact that you were a float and unfamiliar with what their procedures were and should have assigned this to someone else. I have noticed that some RNs are actually unaware of the scope of practice for LPNs and assume that we are able to do more; the LPNs are either not cognizant of their state scope is or do whatever just not to make waves. An RN cannot assign you to do something that is not within your scope of practice or outside of hospital policy. If something happened the RN would be in trouble, but the LPN moreso because the BON states that you are responsible for knowing the scope of practice in your state. Scary and hairy, I know...but I have had to carry copies of state policy with me when I go to other areas to show them if necessary.

I have heard the excuses of "Well, LPNs here do it..." and my theory is "everything is okay until something happens". If, in fact, this is within the scope of practice in your state, then, I would certainly take any learning as a chance to grow. If, in fact, this is allowed by the BON and I floated there, then, I would probably muddle through as much as I can. It is not fair at all that you didn't receive an orientation of the basic job description of an LPN in your facility. I am wondering if some of it may not be allowed in your state, but that RN decided to dump as much as she could on you because she, herself was overwhelmed.