ICU nurses- floating to floor

Ok. So I was searching through the posts and now I realize I should have been more specific in my interview...and put in will only float to other ICUs in my contract!!

Man. Lesson learned. It just hasn't happened to me in 2 years of traveling. And it's a different situation than say a floor nurse floating to an ICU - I mean of course that is wrong. But technically I am adequately skilled/trained to care for these patients - just not 4 at a time, but it's just a shock when you are so used to taking care of 1-2 patients ( usually 1 most of the time actually in my case! ) to 4 patients. And they were so busy. I have an all new respect for floor nurses. I'm just trying to figure out how to organize myself so I can do a better job next time. I know I'll do better next time, unless they find something wrong I did today and fire me?! I don't know. Still freaking out here. Scary day. Everything was so different, the charting, the routines, didn't know where anything was and I was just a mess the whole day.

OK, don't freak out! I worked on the floor prior to working ICU, and yes, the priorities are very different. If you are unable to get around having to float to the floor, I'll give you a few pointers:

Unlike ICU, you don't need to know every single detail of the patients hospital story. Dates of extubation, dates of MRSA diagnosis, etc, are irrelevant when now your patient's priority is to get ambulating, eating, and going home. Pertinent dates, such as surgery dates are still important, though!

Your goal is discharge, either to home or a SNF, or wherever. So, your big interventions are getting PT/OT to work with your patient, getting their IV meds changed to PO, d/cing catheters, making poopies, and things like this.

Giving meds usually takes some time in the AM, so if you organize your day by getting report, reading charts--first day and the last 2 days of progress notes, diet and activity orders, grabbing one of their meds, and heading into that patients room for the assessment as well as morning meds. And grab the meds for the next patient, and go in an assess. And so on.

If your patient is there for pneumonia (and no real health history), you can save time by using a focused assessment, instead of a full head-to-toe. Listen to lungs, take a temp, promote turn cough deep breathe, and have your CNA's check vitals, give meals to your patients, etc. Sounds like your cutting corners, which in a way you are, but if your patient doesn't have a neuro deficit, you don't need to do a full neuro exam!

Anyway, hope this helps.

Try to relax!! They can't make you resign!

Thanks for the advice Becky, I really appreciate it! Things have been going great, no floating to the floor since. But I know it'll probably happen again and hopefully I'll be better prepared to handle it. Thanks again.

Hi I worked the floors for 4 years before jumping to the ICU. Just keep in mind the pts are not as sick as the ICU ones. Trust your gut though if you have a feeling that the patient doesn't look right. Deligate to your CAs when you can.

Unlike ICU too the response time to a call light can be 5-10 minutes. (Especially if you have 3 call lights going off at once). Hope this helps.

I work in a step down unit and our ratios are 6 to7. If you only had 4 that was great !!! please tell me where that hospital is !!!! The best advise i can give is to stay out of south florida. Especially palm beach county. They expect travelers to float almost every day. The travelers are there to make the staff happy.

In California, I believe the ratio is 1:4 on the floors & tele units. I've worked @ 3 hospitals here and that's how it is..but I'm not an expert on the floor or tele units.

I haven't floated again. But I did speak with my recruiter who was upset that this happened. She told me facilities are not suppose to do this, when they book an ICU nurse..it's for the ICU, not the floor. So next time call her or my clinical liason if they try to do this again.

I'm at a hospital in LA and was under the impression when I signed that floating to tele was possible, but that it would be rare. This hospital can't staff it's tele units so it purposely overstaffs it's ICU float pool to cover. Or that's the rumor. The first month I spent more time on tele than in an ICU. Needless to say I turned down the extention.