Forced to float?

fergus51 · Sep 5, 2001

I don't want anyone who doesn't feel confident in my area. I think the worst thing in the world was being a student and asking my instructor (ICU nurse for 1 years) for guidance with a baby that was REALLY difficult to breastfeed. She had absolutely no idea what to do. I think it's a very different body of knowledge and unless you are knowledgeable you shouldn't work there.

bbnurse · Sep 6, 2001

SusyK-- Your story about the ER and the pt. who was 40% effaced got me laughing all over again about a patient we had recently. ER called to say EMS was bringing a "drop In"patient (without any physician) red lighting it with contractions q2". We started getting ready when they called back to tell us that EMS stated she was really active and would need to deliver in the ER so would we please bring a warmer. We grabbed the warmer and packs and shove that unwieldy thing as rapidly as possible to the ER. We set it up, turn it on and grab gloves when EMS calls again to tell us the baby is coming and they are 5 " out...

There are now 3 ER docs, 2 OB nurses, 4 ER nurses/staff all lined up outside the doors, in gloves awaiting the arrival of this pt and possibly her newborn of uncertain gestational age. ER staff is all discussing what to do and who would do what. We are pacing, sterile little hands up in the air everywhere in the driveway when the ambulance roars in, doors pop open and there is screaming and panicked looking EMS jumping out. It all goes in slow motion now as they all hover over her and run to the ER area where the warmer is set up. One ER doctor tries to check the screaming woman and says he feels no cervix. The OB doc walks in now, assesses the situation---mind you, people are milling around and talking and EMS is shouting report and are sooooo relieved that she held that baby in til they are through with the transport. He checks her and the ER doctor is telling him we have this and that all ready. He looks at us and winks when he says, Well, I think we have time to go on to OB for this. ER starts her IV and we push that warmer back to OB and EMS brings the patient to us. When we get her, not only was she not ruptured, she was not dilated at all. She was drug seeking, tired of being pregnant and had voided all over herself. ER called to see about the pt. that they were so wired for and were so shocked that we sent her home 2 hours later, undelivered. EMS has yet to live that down. We just giggle when we get those panic calls now and ER has trouble getting us to take them seriously when they call to ask for our help. :OH WELL!!! Get some experience in OB and maybe that will help you find that cervix.

I know this is off the topic, but couldn't resist the story.

Have a great day. I smile with anticipation.

prmenrs, RN · Sep 6, 2001

I had an EXCELLENT preparation in the basics--i.e., med-surg. 33 years ago!!! Jami, you mean to tell me nothing's changed?? Hmmmm.

valene · Sep 9, 2001

Our OB department is now closed. I created a contingency staffing plan which I presented to administration. Now our nurses and nursing assistants do not get floated in times of low census. The nurses all agreed to sign up for a total of 12 hours every two week schedule for on call availability (no on call pay).

Now if we get busy there is a nurse readily available to come in and help. ( the obligatory time to get to work is 40 min)

When the census is low those nurses who have worked overtime are offered to be called off first, thus getting their time back. Has worked well so far. The med surg floors now do not depend on us and are forced to do their staffing without us. It was quite unfair to the med/surg nurse who had ob help instead of what he or she really needed which was another assigned med/surg nurse with her. (ob nurse called back as soon as pt comes in labor)

dachsygirl3 · Sep 10, 2001

Originally posted by fiestynurse
CEN35--Your comment about not wanting to "look at prego crotches" all day is offensive. Be careful how you refer to female patients and female anatomy.

I was a maternal-child health nurse for many years and got floated all over the hospital. It never got easier, only harder. Some of my floating experiences were awful! I agree with fergus51, that med-surg has become a very specialized area and is no longer considered to be the "foundation" of nursing. Floating, was at the top of my list of reasons why I left bedside nursing a few years ago.

Jami--I think you will find when you become a L&D nurse, that it is
a nursing speciality that is like no other. There is so much to learn and I know you will throw yourself into it wholeheartedly. Every CEU class will be geared towards fine tuning your L&D skills. Mark my words, there will come a day, after many years of working as a L&D nurse, that you will walk on a med-surg floor and feel that you are in foreign land. It's not so much the med-surg skills, but the whole med-surg routine and environment.

I really think that hospitals need to have very specific floating policies that are geared toward safety and respect for nurses and what we do. A nurse is a nurse just isn't true. I have always like the idea of sister units, where 3 somewhat related units are grouped together and floating is closed to the staff on those 3 units. So, you are not randomly floating all over the hospital, but just to your 2 sister units. That way you become somewhat familar with atleast 2 other units in the hospital besides your own.

dachsygirl3 · Sep 11, 2001

I have primarily been in Ob since the early 80's. However I havw mostly worked in facilities that were small/rural and we had to work all areas of OB & assisted on other units when census was low. BUt, i was never asked to take an assignment if I was not comfortable until I came to FL. I have left 2 hosp. in the Tampa area because I was TOLD I had to float. In 1 facility,( which I might add no longer has OB,) I was floated to M/S by the supv. & when I arrived, I was told I would be helping with meds. I was then directed to a LPn who handed me numerous UNLABLED syringes & told these meds needed to be pushed via a central line,( hadn't seen one of those in ages.) I refused to give anything I didn't draw up myself, & refused to give anything via central line. What did I get, but "a reprimand" from the supv. Needless to say i pushed this whole issue to admin. & stood my ground. I did not stay there long. The next place I left in the area was at a large teaching facility when I was told it was my turn to float to a sister unit, peds. I know my limits & taking care of peds pts. is beyond it. Of course I called the house supv. & told him I felt it was an unsafe assignment, & his response was as follows; you are an RN, you are trained." And I might add I had not been oriented to peds not that it would have made a difference. Of course I did the correct documntation & things were supposedly changed. However I do not feel it is necessarily safe to float to some sister units. Perhaps staff should be given choices in the large facilities as to which sister units they will float to. May I ask this, do you feel you would want your child who is a pt. in PICU to be taken care of by a RN who has worked in LD/PP/NSY for15+ yrs. I think not. I don't!

debbyed · Sep 11, 2001

First off I'll state that our hospital doesn't have L/D so when that "Popping Peach"(no disrespect intended) shows up at the ER door we have the pleasure in the ER. Are we trained for it? Not exactally, We have the required inservices but since we only get a few a year that are too close to delivering to transfer we are not proficent. Hey, we all do the best we can.

Our hospital has made some advances in taking the fear and frustration out of floating.

1. There is a resource nurse who has received orientation in all areas of the hospital who can respond in emergencies. Yes she/he makes bigger bucks, but she/he deserves it. You know, like when the staff member decides to have an MI prior to the end of her shift.

2. We also have SWOT (Staff without territories) nurses who are either Med/Surg trained, or Critical Care/ER trained who are unassigned until 2 hours prior to their shift start. They fill those Call-out holes. They are also higher on the pay scale.

3. In addition there are pull territories.

Med/Surg can be pulled to other med/Surg units and to PCU(progressive Care).

PCU nurses can be pulled to Med/Surg or CCU. CCU nurses can be pulled to PCU or ED,

And ED nurses can be pulled to CCU and PACU (Post-op) {not that that ever happens, we're never overstafffed}

4. In the event a nurse has a preferrence they can be cross-trained at the expense of the hospital. We have several Med/Surg nurses that like to come down and do Fast track in the ER once in a while.

Since these programs were started about 5 years ago, there has been much less frustration on the part of the nurses when they are pulled. Each department also has specific guidelines regarding what a Pulled Nurse can be expected to do.

By-The -Way this program was developed by nurses, for nurses at the request of nurses.