ICU RNs floated to floors?

kmac315 · Apr 7, 2015

I don't get why this would be wrong. You should know how to take care of them. I have worked in NICU for 30+ years and they float us to Post Partum and L and D! I have never taken care of a baby who had had a baby! I think they will try to float anyone anywhere.

jamisaurus · Apr 7, 2015

It's not that we don't know how to take care of them, of course we do. But when you're getting floated once a month or more to a med surg floor or even the ER, it gets old. I went into nursing and accepted an ICU job because i LOVE ICU nursing, and it sucks to get floated away from your home base to a new floor where you don't know anyone and people are rude. Med surg never floats to us in a bind, because they can't manage our patients.

It's not my problem, as a staff RN to float to the floor if they have a critical hole. They can call in their managers, like we do. Every now and then I would because I like helping out but to not get the option upsets me.

michlynn, BSN, RN · Apr 9, 2015

I can't help but be kind of offended by this post. No one likes to float to other floors but we do it because the hospital is essentially a TEAM. I work on a tele/step down unit and when we're running 8 patients on night shift with step down patients I would be extremely grateful if someone, ANYONE, would come take a 3 patient assignment so my mind could be at ease that at least the patients were getting appropriate care. We get floated to ICU units all the time to "care-pair" which basically makes us glorified PCT's that can pass meds. Do you think I want to do that? No, I don't. But I do it anyways because clearly that unit needs more help than mine at the moment.

1sttime · Apr 11, 2015

When I worked ICU I would float to other med/surg units. I was amazed at how much faster I was able to care for the med/surg patients with ICU experience- I think this had to do with the fact that as an ICU nurse I would always get tasks done as soon as possible to make sure I had time for the unexpected.

The other benefit of this was getting to know the nurses that worked the med/surg floors- I was also able to be a resource for those nurses who had more complex patients. I also was able to help recognize when a patient was in trouble and needed to be sent to the unit.

We would have times in the unit when we were short staffed and had patients waiting to go to the floor- so we would have a med/surg nurse come and work in the unit to care for 2 floor patients. As I had floated to the med/surg units there was already rapport built with the med/surg nurse. This also helped us recruit med/surg nurses to the ICU.

To me floating was always a win win situation- the more I was exposed to the more skills I had. The partnership between the unit and the floors was also great- it was a continuum of patient care.

loriangel14, RN · Apr 11, 2015

You have a great attitude. Good post.

New ICU RN · Apr 12, 2015

One of the reasons I am leaving my current hospital is because of the low census time we have to take. I was told that I would never get low census but over the last year I have hit my maximum low census and more (24+ hours a month). When I complain to my boss they low census someone on med/surg and float me from ICU. It is annoying because I didn't sign on to float but my manager says if I want my full time hours, that's how I get them.

jamisaurus · Apr 14, 2015

Thanks everyone for your feedback!! Sounds like we're definitely not the only hospital Doing it and I'll try to lose the "woe is me" attitude. It'll always suck being away from home base, though. I love my vents and lines and gtts ðŸ˜š

calivianya, BSN, RN · Apr 14, 2015

My first hospital was like that. It was a smaller (400-ish beds) community hospital. The 900+ bed facility I work at now doesn't float anyone. We have a corporate staffing office float pool that covers holes at all facilities within the market area. There are critical care floats, med/surg floats, maternity floats, and psych floats. If you are not working as float staff you do not have to float. I have never been called off either because we are always short. It's sort of the best of both worlds... never floating and never missing a shift. Although, being tripled because we are three people short, even with six float staff working with us, does suck.

Bluebolt · Apr 15, 2015

As a travel nurse I've worked in a lot of different ICU's and have seen different hospitals management of staffing for RN's. Telemetry and Med Surg nurses get floated laterally to other med Surg and telemetry floors very often, even without being in the float pool. ICU nurses are at risk for being floated at most facilities. When I was a staff nurse for a few years we had a closed ICU so that meant you couldn't be forced to float, you had the option of going home and using your PTO if the census was low. While traveling I've noticed that the norm is actually to pull ICU staff into the stepdown area's and ED's, sometimes even to a med/surg environment. Although they aren't supposed to give you more than 3-4 patients at a time ever.

I really enjoy hospitals that have entire float pool staff specific to ICU's, Telemetry floors, and Med/Surg floors. I work in the ICU float pool right now as a travel nurse and have seen how this enables the staff nurses to not be required to float. If I was a staff nurse I would work for a hospital that doesn't require you to float, like the one I'm currently at. It's just not fair to staff nurses to force them to get out of their comfort zone, learn a new hospital floor with new door codes, new supply rooms, new patient populations, new MD's, new RN's/Staff, new charting requirements, new policies, etc and they get no extra compensation for this. The float pool staff or travel nurses put up with all this because we are compensated to do so. As a traveler who currently works the float pool I can tell you the job deserves the extra pay. I would never agree to it if I was getting staff nurse compensation.

A previous poster had mentioned the ability to grow your skills, learn new nurses, create camaraderie between med/surg depts and the ICU. All these things are true and an extremely optimistic view of the situation. I guess if you are forced to squeeze water from a rock you can do it! If you are floated for whatever reason, I suggest you meditate on the positive things and work to make the experience as pleasant as possible. Although when your shift is done consider how often you float, how much it makes you uncomfortable, if you find it fair to not receive extra compensation, etc. Whatever answers to your questions you find, you may look into working for a hospital with a closed unit that doesn't require floating from the staff nurses.

Another aspect of floating to area's you don't normally work in is the possibility of being unsafe. So last week I was floated to an observation/med surg floor environment. I am in the ICU float pool so this area is outside of my area/background of nursing. I've never managed more than 3 patients before and it's always been in the SDU or ICU. In 9 hours I had taken report on 8 different patients and had transferred and given report on 4 different patients who I moved out. This was completely out of my comfort zone and felt very unsafe. Med Surg nurses have a very specific skill that ICU nurse do not have, rapid patient turnover and task management. These patients were all fully alert and oriented talking to me, requesting things, families in the room distracting me, getting out of their beds, no monitors in the room, no MD's around to consult with me, tons of PO meds, multiple admission paperwork.... it was what I imagine Hell to be. It was really too busy and chaotic to really get to know the patient and do the proper assessment and reassessment, study the labs and radiology reports, look over the physicians notes, etc. I wasn't even the one checking the every 4 hour vital signs, it was a tech who I didn't trust was using proper technique.

I said all that to paint a picture of why being an RN does not mean you are competent and safe in any RN role without proper training and experience. I grow tired of the perspective management has that if you're an ICU Nurse it means you can do ANYTHING, float ANYWHERE. That is not true and I learned that the hard way in that experience. ICU nurses can float to ICU's, Med/Surg nurses can float to med surg. Until nurses stand up for themselves and realize that management doesn't care about you and your license they will continue to put you in whatever situation they need. It saves them money from hiring float pool staff!

Esparkee · Apr 16, 2015

In my experience, CCRNs often have difficulty w time mgt taking a full med-surg load. But my opinion is based from very intermittent floating where a CCRN would not have the repetition or consistency needed to manage 8-10 med-surg patients, not the inability to.

Bluebolt · Apr 16, 2015

In my experience, CCRNs often have difficulty w time mgt taking a full med-surg load. But my opinion is based from very intermittent floating where a CCRN would not have the repetition or consistency needed to manage 8-10 med-surg patients, not the inability to.

I believe what you were trying to say is CCRN's don't have the experience or training to take on more than 3 patients. If that was your point, I agree. As far as the inability to take them on, that is a gray area. I am licensed to take charge of up to 7 patients at a time before it's blatantly obvious in a courtroom the assignment is unsafe, for any RN. Although the caveat to that is if you have no background or training in taking more than 3 patients at a time, in court you will have no leg to stand on. You must protect your own license and the judge will not care if "someone told you" to float to an area you have no background or training in and take a patient assignment that could be unsafe.

All that needs to happen is one of your patients is off the monitor and walking around the room falls and hits their head, bleeds out, whatever, and you're hauled into court for questioning. Or an even more common and more likely scenario, while juggling meds for many more patients then you're used to you have a med error, happens all the time. You will have no defense, good luck to you.

Please be smart, you worked hard for your license, don't just let some management who is filling holes in their poorly made schedule jeopardize that for you.

Cafelattee · Apr 16, 2015

get over the idea that a ICU nurse is any better than a floor nurse period. I worked floor and step down and was pulled to SICU for a couple of years before actually going to SICU. The SICU nurses when pulled to the floor were always behind. They thought sitting at the desk and reading through the chart backwards and forwards made them better nurses yet they had no organizational skills for the 11 patients they were assigned at night on the med-surg or the 7 patients on the step down. They were total disasters. Yet when being pulled to the unit it was a damn vacation from the floor which is why I ultimate left for the floor to work SICU, CVSU and whatever unit. I then went back to house float for 8 years. I could of just been a unit float but I actually like the challenge of floor nursing. I would walk in to a floor assignment as charge nurse with every chart needing signed off and multiple blood, central line stuff the LPN was not allowed to do. There were usually no other RN on the assignment. I would be in charge of 54 patients as a only RN. I wouldn't of been able to do without some very experienced LPN many nights. I can tell you find a ICU only trained nurse and watch her/him cry and go say I'm quitting with that type of assignments.

Also a good med-surg nurse prevent codes and knows when the patients needs drips and more monitoring. They have ultimate observations skills cause they don't have a 24/7 camera monitor on their patients. The longer and more skill they prevent patients from getting worse. When I work the floor its my job to keep them from going unstable. When I see signs they are going unstable I started calling doctors and convincing them this patients needs intervention or they will code.

Don't put down the floor nurse.

Just keeping it real since I've been in this game since 1992