ICU RNs floated to floors?

ArmaniX, MSN, APRN · Apr 16, 2015

Why is it impossible for one type of nurse to not be pinned up against another type? Instead of pointing out the skills of a med surg versus icu nurse we focus on their weaknesses. It is NOT a competition, yet with the way the majority of posts in this thread are written you'd think someone was throwing dirt on the other. A nurse is a nurse, we all take care of patients in varying capacities and have different skill sets.

OhioCCRN, MSN, NP · Apr 16, 2015

I'd hate it. I love my vented sedated people and the floor brings back bad memories

VANurse2010 · Apr 17, 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.

Oh, but it is your problem; you are seriously mistaken if you don't think hospitals in general see it that way.

jamisaurus · Apr 17, 2015

Nowhere did I ever say ICU nurses were better? Everyone needs each other. I can't manage 6 patients time wise and you can't manage my vent and gtts. I don't want my post to be twisted around that way because that is NOT the point I was trying to convey.

VANurse2010 · Apr 18, 2015

Nowhere did I ever say ICU nurses were better? Everyone needs each other. I can't manage 6 patients time wise and you can't manage my vent and gtts. I don't want my post to be twisted around that way because that is NOT the point I was trying to convey.

I guess it varies depending on the ICU, but are you *really* managing the vent? As in changing the settings and modulating the mode, I/E ratio, PEEP, and Fi02? I realize that's not what you really meant, but I snicker a bit when ICU nurses talk about managing vents - because 9/10 times they really don't. Pressors, inotropes, etc. are another matter entirely!

Salutations · Apr 27, 2015

There was a time that I was being floated every other week to either tele or the ED, which was very frustrating. It's been several months since I was floated to tele, and when I was floated there last week, the cobwebs were firmly in place!

It all comes down to the fact that you're comfortable at home, and may even have personality traits that led you there. I have some OCD/control traits, but am not very organized (Read: I like to know as much as possible about my patients and advocate for treatments and alterations in plans, but am terrible at managing 7 patients or dealing with the revolving door of the ED). The nurse who relieved me when I floated to tele was floating from the ED. She was exceptionally upset "I hate this place!" to which I responded "you hate this floor, or this hospital?" It was intended as a joke to lighten the mood, but actually upset her further. It's 12 hours, and if you can lean on the people you're working with while providing safe patient care, I think it'll make you a more rounded nurse to float every now and then. (My mantra whenever I float!)

AnthonyD · Apr 27, 2015

I guess it varies depending on the ICU, but are you *really* managing the vent? As in changing the settings and modulating the mode, I/E ratio, PEEP, and Fi02? I realize that's not what you really meant, but I snicker a bit when ICU nurses talk about managing vents - because 9/10 times they really don't. Pressors, inotropes, etc. are another matter entirely!

Even if not managing the ventilator itself, care or "management" of a ventilated patient does often require more time and attention.

I do basically agree with this: "I can't manage 6 patients time wise and you can't manage my vent and gtts."

jamisaurus · Apr 28, 2015

I guess it varies depending on the ICU, but are you *really* managing the vent? As in changing the settings and modulating the mode, I/E ratio, PEEP, and Fi02? I realize that's not what you really meant, but I snicker a bit when ICU nurses talk about managing vents - because 9/10 times they really don't. Pressors, inotropes, etc. are another matter entirely!

I interpret ABGs and call the physician, all while knowing what he'll want changed. Increase in rate, increase in TV, lower FiO2. Do I myself physically do it? Usually not.

Do I interpret when the ventilator alarms and fix it? YES. Someone who doesn't regularly come into contact with vents won't know peak pressure needs suction or a bite block, or that not pulling volumes means your ETT could have got pulled out, etc etc. it's not fair to act like ICU RNs just sit there and do nothing with the vents, because that's not true.

OhioCCRN, MSN, NP · Apr 30, 2015

I interpret ABGs and call the physician, all while knowing what he'll want changed. Increase in rate, increase in TV, lower FiO2. Do I myself physically do it? Usually not.
Do I interpret when the ventilator alarms and fix it? YES. Someone who doesn't regularly come into contact with vents won't know peak pressure needs suction or a bite block, or that not pulling volumes means your ETT could have got pulled out, etc etc. it's not fair to act like ICU RNs just sit there and do nothing with the vents, because that's not true.

I agree completely with this statement. I used to think ICU nurses did nothing when I was in medsurg but after I transferred I realized how truly overwhelming the job can be. Don't get me wrong I love it and especially the patient on every gtt circling the drain (adrenaline) so to say that a floor RN can handle an ICU patient is simply not true. Unless it's a completely low acuity ICU where they transfer their sickest patients to a tertiary center.

VANurse2010 · May 4, 2015

I interpret ABGs and call the physician, all while knowing what he'll want changed. Increase in rate, increase in TV, lower FiO2. Do I myself physically do it? Usually not.
Do I interpret when the ventilator alarms and fix it? YES. Someone who doesn't regularly come into contact with vents won't know peak pressure needs suction or a bite block, or that not pulling volumes means your ETT could have got pulled out, etc etc. it's not fair to act like ICU RNs just sit there and do nothing with the vents, because that's not true.

I didn't say that, but our role in managing vents isn't exactly rocket science.

mimi397 · Jan 6, 2016

Can anyone tell me if they are being compensated when pulled to ICU? I'm on a step down unit and due to low census, my floor is continually getting pulled to the ICU. I don't mind every once in a while but since Thanksgiving it's every weekend. It's a situation that is creating very low morale, people are frustrated and pissed because we don't have a say. Supposedly my floor is the only floor able to be pulled to ICU and with new nurses that aren't off of orientation, there are only a select few that can be pulled. So week after week the same people are pulled. I don't know what the current pay is for ICU but I would imagine it's more than what I'm making. I believe that if we were compensated, maybe it wouldn't be so frowned upon. I'm trying to stay positive but if I wanted an ICU position, I would have applied for it. I don't mind once in a while but the constant is really upsetting. Anyone have any insight??

MYSTICOOKIEBEAR · Jan 6, 2016

For us we float there just to resource pretty much as a glorified patient care tech that can also pass meds