I don't want to be the ONLY nurse in ICU!

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want to put out a question to see if I can get any feedback or information. I work in a small rural hospital that has a 6 bed ICU. Actual ICU cases are few and far between, so they aren't well-staffed. As a trained ICU nurse, I work in another department, but I am being pressured to float to the ICU as the SOLE PRACTITIONER in the unit. No secretary, no aide, no other nurse but myself. I would be responsible for the phones, the paperwork, the telemetry monitors, EVERYTHING! The DON's rationale is that the M/S nursing station is only steps away. I am used to working in large ICU's with complex patients, but there's always been other nurses around and ancillary personnel. I feel very uncomfortable and have stated that this is not a safe environment for a solo practitioner, to no avail. I've looked at the AACN standards of practice but have been unable to find anything specific to address the issue.

I have told the DON that I would be happy to float to the ICU anytime as part of a team, with another nurse there-not alone. I frequently float to the ER, so floating isn't the issue. Staffing is, and I feel trapped. Any suggestions?

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Specializes in Critical care.

Absolutely unsafe. If my PACU is holding even one med-surg patient, we call in an ACP to sit with the RN. What if something happened? Who would run to call a code while you did CPR?

Look at it from your personal safety. You shouldn't be left alone with a patient who may try to hurt you. Or a crazy patient who could make up lies about your care or professionalism. There should be a second witness for things that could go on.

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Thanks-I never even looked at the personal safety aspect.

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Specializes in LTC, MDS, Education.

This happened to me in 1979 as a traveller. It was a real mess because after the first admission (simple MI ), then came a blind man on a dopamine drip, and a gunshot wound to abdomen. I was certified for CCU only. The hospital had only 60 or so beds. I got no support and would leave at 10:30 or later each morning. Finally broke the contract after they moved me into a trailer with no running water and a door that wouldn't close. Took me 2 years before I got up the courage to travel again. BUT, on days they had 2 nurses and a ward clerk.....go figure! :confused:

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It seems the hospital would be more concerned about the liability issues with this as well. I also work in a rural area with a 9 bed unit. In my unit, one pt or nine, we have at least two nurses...b/c what if they were to code. Could be very interesting tryin to defend their rationale..."well your honor, we were trying to save some money..."

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Specializes in Emergency, LTC, Med/Surg.

In the Rural Hospital that I work at, there are 4 CCU beds. The nurses that work there don't have a HUC for support either. The CCU is located right in the middle of the Med/Surg Floor, so the NA/R's and LPN's float into that area to help the CCU nurses out when they need it. There is a HUC that works on Med/Surg Station which is right behind the CCU station, so sometimes the HUC will assist the CCU nurse with calling the MD.

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Specializes in Cardiothoracic Transplant Telemetry.

My understanding is that there is a requirement that any unit has to have at least 2 nurses on duty. One of our units was quarantined for Noro recently, and the night before we reopened we were down to 2 long term patients. And yes, there were 2 nurses on the floor.

I don't think that they can get around it by saying that the med surg unit is just around the corner. They are separate units, so I think that they are required to have 2 nurses available, even if there is only one patient

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Specializes in School Nursing, Pedi., Critical Care.

Like my momma used to tell me.... If you have to ask, you probably shouldn't do it!

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Specializes in ICU.

You stick to your guns on this one! It is absolutely unsafe for you and the patients for all the reasons stated above. If you don't stand up, nobody will. Best of luck, and be brave!

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Specializes in Oncology.

We have a 4 bed unit that takes overflow from our patients. Even if we only have one patient there, there's a minimum of two staff members, just because it's unsafe and unfair to only have one person staffing a unit.

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Specializes in Management, Emergency, Psych, Med Surg.

This would be a very risky position to be in. Every ICU that I have worked in always had a minimum staffing standard of at least 2 people being on at one time, no matter what the census. How can you call a code and perform CPR by yourself? You are setting yourself up for liability. Just tell them no unless you can get at least a CNA in there with you.

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Specializes in ICU.

How close is the other unit??? It does seem unsafe to me! Atleast you need a tech or something!

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