Is there a line floating?

[applesxoranges]

So a place that I know about likes to float their ICU nurses. Apparently they are now floating them to specialty units such as OB, psych, and ER along with the standard stepdown and med-surg. Is there a line when it comes to floating? If the nurse is not specifically crosstrained in the charting style and does not have previous OB or psych experience, should they be forced to go to the specialty units to take on patients? One nurse was told that four post c-section patients were the same as med-surg patients (I do not think that they got the babies since four patients + babies seem like a lot, but I may be wrong and I do not know how many days post-op they were). The nurse supposedly was yelled at for trying to report it as unsafe since she never received crosstraining as an OB nurse nor did she have previous experience.

I would flip out if I was sent to work in OB or psych. Those two are specialty units.

[calivianya, BSN, RN]

My facility will float anyone anywhere. I have been fortunate as an ICU nurse to only float to the other ICU, stepdown, and an oncology med/surg floor, but some of my coworkers have been floated to L&D, postpartum, the ED, and other units with no previous experience in those areas.

I even thought floating me to the oncology unit was pretty stupid. I am not chemo certified and several of my patients were receiving chemo. It was a lot of work for the oncology nurses to handle my patients' medications, too, on top of having a full patient load themselves. Some of those nurses were hanging meds on 12/13 patients, since they had seven or so of their own in addition to having to hang everyone else's chemo. Very poor planning...

[elkpark]

Now, if you took a med-surg nurse and sent him/her to OB, that nurse was expected to be 'helping hands': NOT an assignment. After all, it was NOT something they were competent in, newborn care and postpartum care of obviously detailed specialty areas that unless you WORK in them, simply having passed the NCLEX umpteen years before will not sufficiently prepare you for such an assignment. I would not want someone who had only a nursing school education HOW many years ago as the basis for an unassisted float and assignment out of their comfort zone, such as OB or peds. And PSYCH? Seriously, no. Never.

(If this is in response to my post above, I was not suggesting that every nurse is equally competent to practice in every area by virtue of having completed nursing school at some previous time in their lives; I was just responding to malestunurse, who was talking about legal "scope of practice" issues from the perspective of someone in a country where people do specialize in school and licensure, and pointing out that that, specifically, is not the case in the US.)

[FurBabyMom, MSN, RN]

Ah. How I don't miss the floor. :)

I worked neuro stepdown with med/surg and tele patients thrown in (they had this bright idea to do neurosciences care and have everyone not ICU status on the same unit). It was quite a continuum of patients, but I was only floated twice in a year. Both times to a med/surg unit with the same amount (or maybe 1 more) patient and MUCH lower acuity. Both of my float days were pretty awesome because the nurses on the other units were a much better team than the ones I worked with routinely. Also, having way easier patients helped.

It also helped we were generally short staffed...and people got floated to us. Well, I mean, kind of. Floating an inpatient rehab nurse to neuro med/surg and stepdown? Maybe not the best option. They got all of our easy patients on those days (our charge nurses were merciful - to the floaters and unit staff).

[RNsRWe, ASN, RN]

(If this is in response to my post above, I was not suggesting that every nurse is equally competent to practice in every area by virtue of having completed nursing school at some previous time in their lives; I was just responding to malestunurse, who was talking about legal "scope of practice" issues from the perspective of someone in a country where people do specialize in school and licensure, and pointing out that that, specifically, is not the case in the US.)

Thank you for clarifying....I did get the impression you believed that since all US nurses had the same basic general education, they should all be competent to go wherever. DID strike me as odd, based on other posts of yours I've read! :)

Maybe one day hospitals will realize employees are not interchangeable from one specialty to another simply because they share the common license of "RN"

[FLAlleycat]

The hospital in which I worked labor and delivery for ten years started having a slump in pts. So, administration, in its infinite wisdom, converted some of our postpartum rooms into orthopedic rooms. At first, they said med-surg nurses would care for these pts. That lasted a couple of months. Then they "trained" the postpartum nurses (1-2 days) and med-surg nurses went back to their floor. I reported to work one night and told to go to the ortho pts. I had no orientation. I didn't know how to set up those machines or to assist pts out of bed safely. I got out of it that night because of the lack of orientation but was told I WILL DO ortho pts. Got a new job the next day. To me, the hospital was really stupid to take such a risk, not to mention mixing OB pts with med-surg pts. Then when ratings on our floor started to plummet, admin got on our asses. We used to lead the hospital in pt satisfaction. Gee, could it be because we "acted" like we didn't know how to use the machines? Dumb hospital administration! But, at least they never did float any nurses to L&D.

[~PedsRN~, BSN, RN]

My hospital made the PICU and NICU closed units. I don't have to float there and they don't have to float to my floor. Bad news is when they are short, there's no help. As a result they work funky call schedules, etc.

[blondy2061h, MSN, RN]

One of the pediatric outpatient clinics at my facility was really short. I got floated there. I work inpatient adult BMT. No peds experience. No outpatient experience. I told them I'd help with what I could and not take my own assignment. I did what I was comfortable with- answering phones, starting IV's, vitals, medication education. Just me being there was a help. I wouldn't have done it if I was expected to carry my own assignment independently.

[nrsang97, BSN, RN]

We only float nurses among like units. ICU to CCU, Med surg to med surg or inpatient rehab, Telemetry to step down. That is how it is everywhere around here. No one floats to the ER or psych or OB.

Floating a nurse to an area where they have no experience is dangerous.

[Twinmom06, ASN, APN]

our hospital floats med surg to med surge (telemetry also). We have a critical care float pool. If a med/surg nurse is ACLS certified they will float to stepdown but NOT ICU. Med surge float pool also floats to mom/baby but will only take care of moms until NRP certfied.

[poppycat, ADN, BSN]

I went straight into Peds when I graduated (1978). About 8 months after I started working, I came to work one night & was told I was floating to ICU (adult). I called the house supervisor & told her that I would go but I would only do CNA work because I had no adult or ICU experience. Surprisingly, she was ok with that. I was not about to take an ICU assignment where I'd be responsible for vents, drips, or anything else I had no training in.

My last hospital job was in NICU. The policy for floating was that we could float to Peds, PICU, or newborn nursery but not to adult world. A lot of the NICU nurses weren't comfortable with that because they had been in NICU their entire careers. It didn't bother me because by then I had many years of Peds & PICU experience.

[FlowerChild2005]

I think if a specific nurse said she'd like to float thats ok.But most ICU nurses I know float between Icu and the telemetry unit.Med Surg staffs the entire hospital including the physician offices if need be.So our med surg nurses are mandated to float to telemetry, and OB, and outpatient nursing

[86toronado, BSN, RN]

I've worked in float pool, and was expected to float anywhere except ICU, ED, and OB. That said, since I had PALS, I suspect I could have been asked to float to OB if it had been necessary. And I did regularly float to ICU, and took "step-down" paints, even though I knew they weren't really... Not that safe, but I never complained.