Med Surg floating to ICU

UM Review RN, ASN, RN · Jun 6, 2005

I feel the same way. Patients in ICU are still ICU patients and anything can happen. I've been refusing to float there, because legally I'm responsible, even though I know diddly about critical care.

Tweety, BSN, RN · Jun 6, 2005

I've floated to ICU a couple of times, and got nonvented "stable" patients that were waiting to be transferred or seen by the doctor. I was o.k. with that.

In ICU there are no "easy" patients. They all need the close monitoring that only a trained and experienced ICU can provide.

I would be uncomfortable if I were in your situation.

Perhaps you should make out an incident report, so risk management is aware.

suzanne4, RN · Jun 6, 2005

If you are not monitor certified then they should not be floating you to an ICU. Simple as that. You should not need to be responsible for a patient that is on a monitor.

Get your risk management department involved in this.

Morguein · Jun 6, 2005

That's a very DANGEROUS practice in my opinion and should be against the law. That's like sending an ICU nurse over to Labor and Delivery. We wouldn't know what the heck to do. ICU requires weeks to months of special training (depending on if you're a new grad or an experienced nurse from another dept). If they don't give you the training prior to throwing you in there, they're creating a dangerous situation for you and your patient. I would refuse to go if I were you.

mattsmom81 · Jun 6, 2005

I have seen facilities take advantage of good hearted float nurses in this way. You must be very clear about what you are comfortable with when they float you to areas outside your expertise.

Trouble is, once you start doing it (floating to ICU) the nurses get used to seeing you, the supervisors get used to you going...and voila...they start thinking you're an ICU nurse. Recipe for trouble.

lsyorke, RN · Jun 7, 2005

That's pretty much was has happened. All of our nurses housewide are monitor certified, but the reality is that with the use of a central monitoring system, we don't use it much. I guess I've been one of those "goodhearted" nurses who they've pushed to far.

pricklypear · Jun 7, 2005

We get regular floats in our unit frequently. Our unit is sort of unique in that we OFTEN have several patients who don't need to be in ICU due to bed shortages, or doctor preference. There are usually plenty of "easy" patients to assign a float. We try really hard to make it a good experience for floats, because we want them to come back! We have some nurses in the float pool who have specifically cross-trained in our unit. They got about 3 days with another nurse to learn documentation and stuff. That made it a little easier for them to adjust because we do things a little differently than they do on the floors. Out of our hospital float pool these nurses volunteered to do this. I find it very hard to understand why people think just because you are "float pool" you should be able to go anywhere and be happy about it.

To the OP, it you've had a bad experience (like a patient with a higher acuity than you're comfortable with) refuse to go until/unless you come to some kind of understanding with regard to assignments. I would suggest you get it in writing. (Like no titrated drips, no vents, stable VS, basic equipment, no admits, etc...) That way, if they try to screw you, you can pull out your agreement. And if they don't have any patients that fit your criteria, too bad, they'll have to call in one of their own. It's YOUR licence! There are some places that don't care if you're in over your head, as long as the numbers look good.

lsyorke, RN · Jun 7, 2005

Yup, bad experience this week. The nurses in the unit are usually pretty good about picking the "waiting for transfer" patients, but this one day has me looking at the whole thing in a new light.Thanks for the input guys.

meownsmile, BSN, RN · Jun 7, 2005

I have floated to ICU from my med/surg floor a couple times now. Although im not really comfortable with it, i will not take a vented patient, i will not be responsible for their monitoring and they know it. I have taken patients on monitors but one of the other nurses is responsible for all charting regarding cardiac monitors. As far as i see it i can monitor UD bags, IV's, give some iv pain meds, i can do a couple assessments,etc etc, but i wont do the things im not comfortable with. Im an extra hand, and thats it.

PJMommy · Jun 7, 2005

Sorry but this sounds like a recipe for disaster. The patient is your responsibility so the do-everything-but-the-monitor stuff leaves you hanging dry to be sc**wed. If something is missed on the monitoring and the patient suffers, trust me...it will be your license and not the nurse who is doing your monitoring charting.

Personally, I wouldn't accept a patient assignment unless I were comfortable with ALL the responsibilities that go along with this patient.

Our ICU takes the med/surg float from time to time but, honestly, I sometimes think it is harder on our ICU nurses than just taking an extra patient would be. We end up giving up the "easier" patients to floats and everyone has to pick up the slack with the hard, critical patients. In the meantime, we spend more time in the float's patient's rooms - helping out, answering questions, putting out fires, etc.

I have floated to ICU from my med/surg floor a couple times now. Although im not really comfortable with it, i will not take a vented patient, i will not be responsible for their monitoring and they know it. I have taken patients on monitors but one of the other nurses is responsible for all charting regarding cardiac monitors. As far as i see it i can monitor UD bags, IV's, give some iv pain meds, i can do a couple assessments,etc etc, but i wont do the things im not comfortable with. Im an extra hand, and thats it.

UM Review RN, ASN, RN · Jun 7, 2005

i can monitor UD bags

At the risk of proving how little I know about ICU, I have to ask. What's a UD bag? :uhoh21: