Shortages in CC areas has lead to lots of floating between units. Some nurses float every day away from their home unit. Nobody's happy.
The newest practice is management has stopped pretending it's a float situation, and just forced the senior nurses to transfer. Whether they want to or not. Of course there's no orientation. A nurse is a nurse is a nurse after all.
I'm old enough to know there's not much you can do except quit. Or is there?
No way in hades I would work in CC with no orientation. That is a sentinel event waiting to happen. As for whoever is asserting that a nurse is a nurse....call an Amber Alert because some villiage is missing their idiot.
To be clear I'm not saying most floor nurses are not capable. They are. With proper training!!
Heck I had ICU experience, and at my current job I still got critical care classes and a month of orientation.
As for your original question, personally I chose my hospital specifically for a level 1 trauma SICU. They couldn't pay me enough to work on our floors, and MICU just isn't my thing. I would possibly consider the burn unit, but that's it. My notice would be in like white on rice. It stinks because for some that's easier said than done, though.
I would contact your hospital's risk management dept, maybe your BON, and definitely your liability insurance for advice. I suggest those entities because of the very real public safety concerns that go with failing to train ICU RNs.
I could do all three of your suggestions, but the first two would probably mean I'd lose my job. Not much of a loss, but right now I don't have a replacement. I need to actively look for another job. See what's available and what I can get. If I stay, I thought about changing shifts. Or even putting in a transfer to a unit that has openings and is not CC. It might not be a unit I'd usually like, but at least the choice would be mine.
I would never and have never been the pissed off disgruntled employee, at least not visibly, I don't wait til they say good riddance you bitter old witch. I've only left when they still liked me. I have been the bitter pissed off ex wife who stayed too long and I was so ugly about it, it's not something I ever want to repeat and for some reason I've found it easier to avoid that in my work life than my past personal life.
I was the ticked off employee for about 5 seconds. Then I pulled myself together, put out applications and got call backs pretty quick. I thought wow, I guess I'm the one with power here. I can change things up too.
Luckily I am not a tantrum thrower and did not come across as disgruntled :)
I could do all three of your suggestions, but the first two would probably mean I'd lose my job. Not much of a loss, but right now I don't have a replacement. I need to actively look for another job. See what's available and what I can get. If I stay, I thought about changing shifts. Or even putting in a transfer to a unit that has openings and is not CC. It might not be a unit I'd usually like, but at least the choice would be mine.
Wow...when I did critical care there was a lengthy orientation. Even with hospital experience, it's its own animal. I remember they would float tele nurses there to take care of a "soft ICU" on bipap. I felt bad for them because they didn't want to be there. But we helped them, they weren't thrown under the bus. Still though, I feel if it's a different department and you are being forced to transfer I'd be out. Unless they provide you with a good orientation and you want to be there it's dangerous for your career.
The State won't really care about the forced transfers, but they will generally expect that nurses forced to transfer are properly trained for the competencies they will be using on their new unit. Personally, I wouldn't hesitate to speak with your Health department or BON and just say "so I was wondering if you guys would have any problem if I was transferred to a unit and expected to do tasks that I haven't been trained to do? I have a feeling they might look into that further.
I could do all three of your suggestions, but the first two would probably mean I'd lose my job. Not much of a loss, but right now I don't have a replacement. I need to actively look for another job. See what's available and what I can get. If I stay, I thought about changing shifts. Or even putting in a transfer to a unit that has openings and is not CC. It might not be a unit I'd usually like, but at least the choice would be mine.
I transitioned to floor nursing after critical care/ICU and let me tell you - that is a totally different world ! I am not sure you want to put yourself through that given that you are sort of close to retirement. Comparing the two I find that critical care/ ICU was by far easier (perhaps that is just me).
Most large teaching and non teaching hospitals in my area now also float critical care nurses to similar floors. They get patients they can take care off because they are similar to their pat population or they receive training. In some hospitals the cc nurses also have to float to IMC at times or step down - which all of them hate...
Personally, I discovered that I actually enjoyed floating because it broadened my horizon. I have worked in different CC areas and got the hang of floating quickly. Here are some suggestions while you look for something else (doesn't hurt to look around):
Because you are not "the expert" just be up front about it. Simply tell the nurses on your float unit that while you are an expert in your subspecialty you may need their expertise. Be positive and come ready with a smile - I know that it does not sound enticing when you float and actually hate it - but it will work 100% in your favor. Floors and units do not like nurses who complain or floating or up front about disliking an area - that will just lead to you getting worse assignments and less help next time you come.
If you get there upbeat and positive say also stuff like " I do not mind helping you guys out - shortage is terrible" or "It is great to learn new things" ----- even if you do not really feel like it, try to convince yourself. A positive attitude will help you to get through floating much easier...
I floated to a floor everybody disliked like nothing else and people were very verbal about it. That only led to nurses getting the worst float assignment ever with no CNA to find....
In the meantime you can look around to see what else in out there in your area. BTW - if you are close to retirement you are a more expensive employee and finding a job that will pay that much could be hard to find.
I agree with everyone who says that being moved to critical care without orientation is awful. I hope your hospital is at least relatively low acuity and they ship the really bad stuff out if staff isn't going to be trained on really critical patients before being thrown in.
Specializes in ED, Telemetry,Hospice, ICU, Supervisor.
Being floated to different units, when one is contracted to work in one specific unit, is a really pain in many cases.
It will all come down to you as an employee. I speak specifically of how much "crap" you are willing to take from managers. If you are being treated as a "chair" how much longer are you willing to let other people sit on you? As an employee, you have to voice your concerns in a direct manner that will not be misinterpreted as something else.
The Leadership Team requires that employees communicate their needs, so that they may come to an amicable resolution to the problem.
imintrouble, BSN, RN
2,406 Posts
I could do all three of your suggestions, but the first two would probably mean I'd lose my job. Not much of a loss, but right now I don't have a replacement. I need to actively look for another job. See what's available and what I can get. If I stay, I thought about changing shifts. Or even putting in a transfer to a unit that has openings and is not CC. It might not be a unit I'd usually like, but at least the choice would be mine.