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Hospitals That Hurt Good Staff's Morale

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I currently work for a facility that financially is not doing well. We can't get certain supplies due to suppliers not being paid. Many nurses have quit. I work in the ICU at this facility and they have turned us into a float pool. The problem with that is we constantly get pulled from our ICU to staff the medsurg floors. When this happens we are given the worst patients and all the discharges so that we have to take all the new admits. On top of this, we lose our ICU differential so we get paid less when we go to a floor that we didn't want to work on, to begin with.  We have pointed this out to management who say there is nothing they can do about it. They started having a shortage of nurses in ICU due to everyone quitting because of how we are being treated. When this happened we were told we can not use any of our vacation time unless we find someone to fill the spot that we want off from. We also received letters saying the hospital would not be matching our retirement this year. Our charge nurses have to take patients in the unit just like everyone else, but the charge nurses on the floor are not required to take patients no matter how short they are on nurses. As an ICU nurse at this facility, I have been put in many situations that were unsafe for the patient. They will triple us up with patients for one nurse, sometimes it being 2 or 3 vent patients at once, so they can pull one of our nurses to a medsurg floor. 

The doctors at this facility are never on the same page with each other. They do NOT listen to the nurses at all. When we tell them that a patient is not ready to leave ICU they send them anyway and then go to management when the patient gets worse and say that the nurse didn't take good care of them. 

I'm just curious if any other facility has issues like this? Is this normal for every facility? Would you work at a facility that has this many issues? What are your thoughts on being pulled from an ICU to a medsurg floor?

Edited by rnsteph87

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Daisy4RN has 20 years experience and specializes in Travel, Home Health, Med-Surg.

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I think that most hospitals work in this manner. The last place I worked (med-surg) was pulling our nurses to go to other floors and having ICU nurses work the med-surg floors. At times a med-surg nurse would even float to ICU. It is sometimes done because of pt acuity, nurse ability etc. but usually because admin thinks that nurses are a one size fits all.  Most hospital admins do not ever listen to nurses concerns. Most people I know don't like floating because units are very specialized and not safe for patients or staff. I would check your policies and see what they say but there is probably not much you can do about it. 

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1 Article; 147 Posts; 1,017 Profile Views

1 hour ago, rnsteph87 said:

Would you work at a facility that has this many issues? What are your thoughts on being pulled from an ICU to a medsurg floor?

No, I would start looking for a better job. If you have the time to search thoroughly for a better job and can move if need be, you'll find a better one. When exploring your options, ask potential employers if you'll have to work other floors than the unit for which you're hired. If you can't find a better facility to work at (I'd be surprised), then maybe you'd rather get a travel job. At least with a travel job, if the work environment is less than desirable it will only be temporary, and you can specify in your contract that you will only work your ICU unit.

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Orca has 25 years experience as a ASN, RN and specializes in Corrections, psychiatry, rehab, LTC.

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I have done hospital work, and I never encountered situations like the ones you are describing. It sounds to me as if the place is about to collapse financially, and you will have to look for a job at that point. Better to get ahead of the game now than wait until the roof caves in, and suddenly a bunch of people are dumped into the job market at once.

Good luck on your search.

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TriciaJ has 39 years experience as a RN and specializes in Psych, Corrections, Med-Surg, Ambulatory.

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I agree that most hospitals try to have one-size-fits-all staffing policies, but your hospital sounds especially bad.  I think Orca is on the right track; this ship is sinking and you have to decide if you're willing to go down with it.

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Thanks, guys. I really wanted input to make sure I wasn't wrong in my thoughts. I actually quit. I have a job in a CVR unit at a much bigger hospital. I start on February 18th. 

I got further confirmation that this was the right move when I took a patient to this hospital yesterday. I have been a paramedic in this community for 8 years. We have 2 hospitals to choose from. I took in an 80 something-year-old male who was in afib with RVR. He also had a friction rub with muffled heart sounds. I advised the hospital of this enroute and again once at the hospital. A nurse friend of mine called me last night and said that he agreed with me totally on diagnosis, but the doctor gave him metoprolol and gave him 5 liters of fluid and sent him to ICU where he coded while rolling through the doors. This gentleman was maybe 90 pounds. My thoughts are he had fluid around his heart and 5 liters of fluid increased pressure from the inside cause arrest. I can't fathom giving 5 liters of fluid to this particular patient.  Stuff like this happens constantly there though. 

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TriciaJ has 39 years experience as a RN and specializes in Psych, Corrections, Med-Surg, Ambulatory.

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Five litres of fluid?  WTH?  Glad you're out of there.

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gonzo1 has 15 years experience as a ASN, RN and specializes in CEN, ED, ICU, PSYCH, PP.

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Good luck with your new spot.  You sure did the right thing.  So sad for the patients that will be going there till it closes.

 

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Ruby Vee has 40 years experience as a BSN and specializes in CCU, SICU, CVSICU, Precepting & Teaching.

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On 2/5/2019 at 3:26 PM, rnsteph87 said:

I currently work for a facility that financially is not doing well. We can't get certain supplies due to suppliers not being paid. Many nurses have quit. I work in the ICU at this facility and they have turned us into a float pool. The problem with that is we constantly get pulled from our ICU to staff the medsurg floors. When this happens we are given the worst patients and all the discharges so that we have to take all the new admits. On top of this, we lose our ICU differential so we get paid less when we go to a floor that we didn't want to work on, to begin with.  We have pointed this out to management who say there is nothing they can do about it. They started having a shortage of nurses in ICU due to everyone quitting because of how we are being treated. When this happened we were told we can not use any of our vacation time unless we find someone to fill the spot that we want off from. We also received letters saying the hospital would not be matching our retirement this year. Our charge nurses have to take patients in the unit just like everyone else, but the charge nurses on the floor are not required to take patients no matter how short they are on nurses. As an ICU nurse at this facility, I have been put in many situations that were unsafe for the patient. They will triple us up with patients for one nurse, sometimes it being 2 or 3 vent patients at once, so they can pull one of our nurses to a medsurg floor. 

The doctors at this facility are never on the same page with each other. They do NOT listen to the nurses at all. When we tell them that a patient is not ready to leave ICU they send them anyway and then go to management when the patient gets worse and say that the nurse didn't take good care of them. 

I'm just curious if any other facility has issues like this? Is this normal for every facility? Would you work at a facility that has this many issues? What are your thoughts on being pulled from an ICU to a medsurg floor?

I realize that this post is over a month old, but dang!  This is unusual.  It sounds as if you're in a smaller, community hospital.  This sort of thing did happen when I was a traveler and took an assignment at a smaller, community hospital.  It is almost exactly the opposite of what I encountered working in large, inner city teaching hospitals as I've done for most of my career.

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Here.I.Stand has 16 years experience as a BSN, RN and specializes in SICU, trauma, neuro.

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Dang... I’m glad you have an exit plan!  It’s in our union contract that ICU nurses don’t staff the floors; after all the floor nurses aren’t able to float to the ICUs when WE are short.  

We do float to stepdown units, but that I don’t mind... they have max 3 patients (APPROPRIATE stepdown ratio!) and the alternative would be loss of hours by mandatory cancellation.  

Personally I don’t agree with ICU differentials.... but it would be maddening to not receive it if that is part of my compensation plan.  

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You can see the signs.  When this type of thing happens nurses must vacate asap!!

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