Getting pulled...

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So I'm an ICU nurse in CT right now in the ICU. While being here I've found that they are using me as the official "pull" nurse to the progressive care unit. This unit takes up to 4-5 pts a piece, they are mostly off telemetry, vitals every 4 to 8 hours, everybody voids, techs dont keep up with accurate I/O's, always on the call light for petty wishes, no advanced medical equipment, no interesting challenging disease processes, etc.

So my problem is this is my worst nightmare unit. I went straight from graduation to the ICU for the very reason that I knew from clinicals I wanted no part of this type patient population. I find no professional development in it and personally dread going to the floor. I enjoy and take pride in what I do and that is the ICU.

Don't misunderstand, I'm not too good to ever help a PCU out on a rare occasion. I will put myself in a pull rotation schedule with all the other nurses in the ICU to help PCU out but this hospital uses me every time. Nobody else wants to go so I get sent every time. This has become a problem and I'm more like a traveler hired for the PCU who can float to the ICU if needed. I even took assignment on two critical patients, did assessments, gave meds, talked with families and they told me 3 hours into my shift they were calling in an on call ICU nurse to take over my patients so they could pull me to PCU. This felt like an insult and a slap in my face. Instead of sending the nurse who was coming in with no patients they were going to make me give up my patients to her and send me to pick up 4 new patients. Ridiculous.

The way you approach and think about PCU patients and ICU patients are different, I'm uncomfortable having patients off monitors and walking around the rooms, no IV drips, nothing.

So my question is has anybody else ran into this issue as a traveler? I of course understand you will be expected to be versatile, but to be pulled all the time?! Has anyone had any luck in putting in your contract that you don't float or you at least only float when it's your turn?

What have you done?

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I don't travel, but the travel nurses I've seen at my places of employment work under the circumstances that you describe. Regular, full-time staff always has priority over travelers, per diems, registry, part timers, etc.

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Specializes in ICU/PACU.

I've been in this situation. I also started off in the ICU as a new grad and never worked step down or tele until I started traveling. In the past I have just stuck it out. i worked one job where I floated to all the tele floors 90% of the time and the hospital did this on purpose..they would hire ICU nurses because we can cover ICU and tele. It's a nightmare.

In the future you can refuse assignments that will float you. Ask in your telephone interview with the manager. I avoid submitting to any ICU float positions, because that usually means you will be floating to all ICUs and all step-downs, maybe tele too. It may limit your job prospects if you refuse to float though. Sometimes you get lucky and you're only floated once or twice a month.

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13 weeks and put it behind you.

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Specializes in L&D, Mother/Baby.

I've also heard that in cases like this, travelers are always the first to float in any situation. You're being paid to be flexible unless your contract says otherwise. Maybe while floating, take the time to focus on another aspect of the nursing process with these patients, like pt education (it's so nice to have real time to go through this) and discharge prep, which can enhance your knowledge and skills as well. Or like Ned said, buck up and get through it. It'll be over soon enough!

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Hmmm...PCU off tele doesn't sound like a PCU. Sounds more like med surg to me. In my experience, the travelers that they had at my old hospital were part of the "Supplemental Staffing Team," which meant they were always the first to float or get pulled. As someone else suggested, next time you can ask in the interview if you will be floated, and if so where. If you don't agree with it, then pass on the offer.

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Specializes in Psych.

On e of my ICU traveler friends has written into every contract that her schedule is to mimic regular staff schedules in terms of shifts assigned and floating. That way she's not scheduled every weekend and if regular staff don't float she doesn't either.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

I have seen travelers with no float in their contract. Mostly though...it is the traveler that floats. The regular staff belong in their unit. The traveler...temporary employee is the float.

13 weeks and out....((HUGS))

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When I interviewed they did mention that the staff floats to PCU in a rotation schedule but failed to mention I wouldn't be in this rotation schedule. As mentioned for a PCU I was shocked that patients may be off telemetry, have no cardiac drips, etc. Very boring in my opinion, but lots and lots of small tasks to do.

When I was a staff nurse I used to have the preconception that travel nurses get paid double what everyone else makes so it's only fair they float instead of staff. Actually the pay rate for staff is about the same as the traveler, we just liquidate all benefits, sick time, vacation days, insurance and get a flat rate paid. I know it's tempting to give all the admissions to the traveler, float them to places nobody likes, give them the hardest assignment, but is it right?

Ultimately I'm a nurse who traveled to help your unit be staffed well enough so you don't have to work in terrible conditions. All I expect is some appreciation and fair treatment. This hospital has asked me to stay much longer then my contract and even offered me a full time position but I have turned it down. After seeing the way they view "teamwork" I'm not interested.

Live and learn, I'll now know what specific questions to ask in interviews.

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Well put about liquidated benefits - and that is exactly the difference between a staff nurse and a staff per diem nurse at the same hospital and roughly accurate from the traveler perspective. However, from the hospital perspective, a traveler is around 30% more than a staff nurse - the agency margin. Depends on location and there are some other issues, but that is a good rule of thumb.

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Well, I can't fault you for finding one branch of nursing boring--I find some branches boring, too--but it does strike me that it doesn't sound like you have a good understanding of the patients and goals of the PCU and/or med-surg. I like eager1hasbegun's comment. I think you're trying to make it clear that this is just you personally finding it boring, but some of your post is perhaps inadvertently condescending--that you don't take pride in PCU work, that you describe it as "small tasks", that being sent to the PCU is an insult and a slap in the face. The professional development opportunities you say you don't find there are there to be found, if you look for them.

But lesson learned, as you say, and now you know what to ask. A warning, in my permanent positions people would have resented the hell out of any traveler who had limited floating written into his/her contract.

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Specializes in retired LTC.

But lesson learned, as you say, and now you know what to ask. A warning, in my permanent positions people would have resented the hell out of any traveler who had limited floating written into his/her contract.

And if there is a union, you may still be the one who is the usual 'first one' to be floated. To do otherwise, could be a grievance issue for the regularly assigned staff.
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