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Discussion

Have you ever refused a pull?

Once again I was pulled somewhere I felt incompetent to be at. I hate when this happens and I am very much afraid that one of these days it is going to result in my having to refuse an assignment, which will likely get me fired. Has anyone ever refused a floating assignment on the basis of no cross-training/ no idea what to do to take care of patients you aren't trained for? And if you did, what happened?? :

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I was asked to float to Labor and Delivery one time while I was still working at the hospital and I said NO WAY!! I'd only seen those monitors and such during school and there was NO way I was going down there with no cross-training!!

The supervisor said 'Well, you tell me where YOU would like to float since we don't need you on your unit today!!' LOL I said 'You can send me over to psych or you can feel free to let me go home but I AIN'T going to L & D!'

I got sent to psych.:D

I once said that all the procedures I'd have to do would need supervision, as you must have that the first time you do any procedure. I wasn't sent off my OB unit!

I have never refused a pull to any unit. That does not mean I have not had some trepidation about going.

When I have gone to a unit I am unfamiliar with I ask to be buddied up with a core nurse of the unit. That way I have a resource person. I also when I arrive on the unit, let them know what department I am from, that clues them into the fact I may not be as familiar with their aspect of nursing as someone else might be. I find as long as I am upfront about my years of working, my home base, pretty much they will assign me patients who are within my capacity to take care of. That doesn't mean the caseload is an easy one. The best units base assignments on who are the nurses, their skills and match up with what the patients need.

As to the person who took a float to psych as opposed to labor and delivery.. I use to work psych, it was not easy and I fell pretty strongly no one should go there unless they knew psych very well. It is much more difficult and dangerous than it appears on the surface.

I went to labor and delivery twice, each time I was assigned to sit with a psych patient who happened to be in labor, my job to help keep the patient calm while their nurse monitored the contractions and did their physical assessments.Yes, I went into delivery with the same patients, again my role to be next to the patient to try and keep them calm.

When going to unfamiliar medical units, I had one time when sent to an ICU unit, my assignment was to do nothing more than watch and try and keep the patient still as they had just had a procedure done and needed to lie flat for 4 hours. I did not mind the assignment. They were short, they were appreciative of having someone with the patient at all times. After four hours, I then went to another unit, again as assignments had already been made I just helped every nurse on the floor with whatever they needed.

Yes, I refused to go to the PICU. I bargained with the supervisor to go to the ER instead and have someone with actually pediatric experience to go to the PICU.

if you were being reassigned d/t over staffing in your unit it is one thing if you were being reassigned because of the critical shortage in another unit you are putting patients in danger

even if you are not qualified for at risk patients you can do nursing duties that will free a pair of hands for others to stepin the more critical parts

be flexible and cooperate with others as much as possible,,the day may come when you will appreciate someone being there for you

Nurses have the right to refuse any assignment they feel to be unsafe, including moving to a unit to which they have not been adequately orientated. Facilities that "pull" should be responsible to train nurses for other areas prior to those "pulls". It is your license. If you accept an assignment you do not feel trained to take, you are saying that you do feel trained to take it, and only you will be responsible. Clearly these methods did not come to fruition with the protection of nurses in mind. We have to do that ourselves.

I refused to go to the cardiac cath lab. I was only there one time and I NEVER had orientation. Nothing happened and one of my coworkers who was familiar with our set up went. We have all adult patients at the hospital I work at now.

At another hospital, I worked house supervisior (and staff nurse) and I would help ANY unit in our hospital. Peds, OB, ER, med surg didn't matter...I was pretty comfortable where ever.

Nurses have the right to refuse any assignment they feel to be unsafe, including moving to a unit to which they have not been adequately orientated. Facilities that "pull" should be responsible to train nurses for other areas prior to those "pulls". It is your license. If you accept an assignment you do not feel trained to take, you are saying that you do feel trained to take it, and only you will be responsible. Clearly these methods did not come to fruition with the protection of nurses in mind. We have to do that ourselves.

:yeah: Couldn't agree more. If we are refusing it is for patient safety.

Once again I am thankful I work for a unionized nursing unit. As part of our contract we are only allowed to be pulled to areas we are cross trained in or that have similar patient populations. If we are pulled to a "foreign" unit we are to task only without primary patient care responsibility. It sounds like common sense but when have hospital administrators ever been accused of having common sense when it comes to nursing assignments. Also, in the contract, they cannot bring in an agency nurse to work my unit to float me out to a unit the agency nurse won't work. No one floats if there is a per diem or agency nurse on the unit. A hospital across town is famous for this and we have inherited a number of thier critical care staff who were tired of being pulled to the med/surg floor when a critical care agency nurse was called in to take thier assignment in ICU.

Yes I have. When I was asked to float to an area that I knew absolutely nothing about (OB). The liability was too high. We ended up doing a double pull. They pulled a nurse from another area that was familiar with OB and I just took her spot where she worked.

I am an ER RN of long duration. Pulling me from ER to the floor would place patients, other nurses, and the doctors at risk. I would be totally lost on a floor.

Gees, don't ya hate when that happens. I used to float alot off my unit. I would let the staff know what unit i came from and not that familiar with routine care of the patients on their floor. But i was never afraid to ask questions or for help. They were really good about that.

If i went to l/d i would just care for the post partum--which was okay.

It seems that nursing supervisors just want you to go whereever, they never think about our license, they just want to fill the staffing shortage--sucks though.

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