Floating of ICU RNs

Specialties MICU

Published

Would like to hear from other RNs about floating in their hospitals. Is there a lot of floating to other short staffed areas like ER and Telemetry by ICU RNs? Is this a problem or are there any good solutions out there regarding situations where rapidly changing patient census is a problem for adequate staffing? Where I work in a ICU in a 120 bed hospital in a rural area, there is so much floating of ICU RNs that it has become a morale issue where RNs dread to come to work for fear of being floated again. We recognize that administration has to deal with changing pt census and short staffing especially as these two areas, ER and Telemetry, seem to burn their RNS quickly but I am looking for other ways to deal with it than burning out our ICU RNS due to floating. Anybody know of any help for this situation? We have an RN nursing pool but as soon as they know they may have to float to ER or Telemetry, they quit. We have an unusually busy ER with many indigent patients.

Specializes in NICU, Infection Control.

I tried to find it, no luck tonight. I'll get back to you.

Specializes in NICU, Infection Control.

Go up to the general nursing discussion, and find the thread I started asking who knew where this was.

One was florenceproject.com, the other was on allnurses.com. You can see the entire address on that thread.

We are not yet unionized..almost, several times, but it has always fallen through at the last minute every time we have organized.

It's the volume of pts, the volume of paperwork, meds, procedures, interruptions from all those family members as well as freq. calls from a group of pts mostly that I drown in. The oncology stuff I turn right over to the staff/charge nurses. Neuro is comfortable to me; ortho I hate, but I can set up the devices then double check with the charge or staff. (I'm just so slow at it, not doing it very often). A couple times ICU nurses have verbally objected and tried to make the sup.

aware. Man, did the higher-ups ever make a HUGE deal over it and practically put the nurses through 'cross-examination and trial' and make them feel small. One time somebody stood their ground, so then somebody begrudgingly volunteered to go. But I never heard about any paperwork to it. I'm going to check that out - thanks!

floating has been a big issue for my fellow icu nurses and i. we are often sent to the step down unit to charge as they have no staff for this unit. more times than not we are given agency or float pool nurses to work with. we are expected to charge a very busy unit and orient someone else at the same time to hospital procedure, charting, etc. in a unit that we ourselves are not even familiar with. this is an 8 bed unit and we are asked to charge and take 4 pts, and have only one other nurse on the unit besides ourselves. no secretery, no aid. even worse, we are often supplied with and lvn, who in our hospital, can not give ivp meds, therefore we must give them. we are also expected to read and document in the charting that we agree with the lvn's assessment, and make changes if we don't. it is like taking all the pt's ourselves! the acuity of this unit is often high. at any given time time you may have pt's that are on critical drips, q2 blood sugars or bp's, and some that should be over in the icu. it is very easy to feel overwhelmed.! anyone else in a similar situation? any suggestions?

the last part of your post gives one of the big reasons why nurses leave bedside care. you say you see pts in this area that should be in the unit well that is not uncommon by any means. i have witnessed it several times myself and it was one of my reasons for leaving the floors and going into the unit. i figured if i am going to take care of unit patients i might as well be in the unit and only have two patients.

(p.s. this is one of the reasons why i am amazed that there is a shortage in the units. maybe someone can enlighten me.)

OK this might be off the subject a bit, but just have to mention, with ____ advertising not only a 14% raise to all their RNS, they are also re-vamping their med surg floors so that one nurse gets only 4 pts max! Our nurses all want to leave and go over to _____. Our ICU nurses are jealous, because when we float to the med surg areas, we get up to 9 pts on dayshift (LVN has half, but we have to cover and do all IV pushes and meds, timeline/careplans, call docs etc.) I wouldn't mind floating half so much if I knew I'd only have 4 pts!

Specializes in ED, MED-SERG, CCU, ICU, IPR.

I know that I am going to get flogged for replying but...here goes.

I worked in a high acutiy ICU and was floated to a busy floor on day shift where I had never been before. Man oh man did I drown, big time.

The thing is, looking back, I think the manager wanted me to fail. They put me in a no - win situation. It was all down hill from there.

I went agency, learned to work in any situation but on my terms. Now, I am a critical care nurse again who can float to any floor and do well.

It worked for me, Maybe it can for you. Most of it is organizational skills. Work once a month on one of the floors and you will end up being very popular with the managers.

MicheleRN

Our ICU nurses float quite regularly. The order of floating is as follows

travelers first

casual pool next

overtime next, ( double time people get the choice not to float)

regular staff ( after a four hour orientation, and new hires are not allowed to float until six months after they are hired.)

These nurses float to MICU, Nuero ICU, then to the sac floors (sister units as they say, to make us feel like we are helping our own. But I say why can't they float here?, and we never go to the floors. If you float to the ER you get 2.00 dollars more per hour for out of area pay.)

In reality you very rarely get floated anywhere but the ICU's because of the short staffing.

Originally posted by PhantomRN

Oh yah forgot to comment on RUsincere2.

GET A D#%$ GRIP ON YOURSELF!!!!! Tell us how often- IF you are an ICU nurse- do you float to other areas? Why is it the units problem that other floors WON'T OR CAN'T- DUE TO CRUMMY CONDITIONS- staff appropriately?

Do NOT give me that team crap, there is not a nurse on this board who would not help out their fellow nurse. But floating to another floor frequently gets old.

We have one floor that we float to at least 3 times a week. Is that fair to us...NOOOO I think not. Because If we were not busy bailing out this floor some of the unit RNs could get some well deserved time off and just maybe this would HELP TO KEEP THEM FROM BURNING OUT AND QUITTING!!!

Do I sense a bit of Anger?!! I have to say I probably would feel the same way if I were routinely sent to the floor. I've been an ICU nurse for 10 years and have only been sent twice to the floor. I was completely lost (I am not ashamed to admit). It takes a completely different set of organizational skills to work there. And unfortunately, floor nurses where I work routinely have 8 - 12 pt assignments. I say send me to the floor when you start pulling them to take care of ICU patients!!!

I FIND MYSELF FORTUNATE. I WORK IN A BUSY CCU/ICU. IN 5 YEARS I WAS ASKED (YES ASKED) IF I WOULD FLOAT TO HELP OUT AN ONCOLOGY FLOOR. OUR HOSPITAL HAS JUST DEVELOPED A NEW PROGRAM. FLOORS THT ARE IN GREAT NEED FOR RN'S ARE REFERRED TO AS "CRITICAL NEED UNITS". YOU SIGN UP FOR THE DAYS YOU WANT IF ANY. ON TOP OF OUR REGULAR PAY, THEY ARE ADDING 10.50. THIS IS GOOD WAGES. IT HELPS OUT THE FLOORS THAT ARE DESPERATE AND I HAVE MET A LOT OF NEW PEOPLE AND AM LEARNING A LOT. OUR MANAGER HAS BEEN HERE FOR 32 YEARS. SHE IS AWESOME. NOW LET ME SAY I WORKED ACROSS TOWN AT ANOTHER HOSPITAL IN WHICH ALL OF US FLOATED ON A REGULAR BASIS. 2X A WEEK AT TIMES. GUESS WHAT. THIS HOSPITAL IS NOW IN A BIGGER CRUNCH. VETERANS OF 20-30 YEARS HAVE LEFT AND US WHO POOLED HAVE LEFT ALL TOGETHER. I AM A CRITICAL CARE NURSE. THIS IS WHAT I KNOW AND DO. MED SURG IS IN MY EYES A SPECIALTY FLOOR OF IT'S OWN. IT IS A DIFFERENT KIND OF NURSING. YOU HAVE TO DEVELOPE NEW AND DIFFERENT ORGINIZATIONAL SKILLS AND THE CHARTING AND AQUITY GRASPING IS DIFFERENT. THE WORSE THING FOR ME IS I FIND MYSELF SPENDING MORE TIME LOOKING UP DRUGS IN A BOOK BECAUSE I DON'T GIVE THESE DRUGS ON A REGULAR BASIS. I FLOATED TO 4 DIFFERENT UNITS WHILE I WORKED THERE. I WOULD NOT FEEL COMFORTABLE AS A PT IN A HOSPITAL THAT IS WORKING THAT MANY "NEW ORIENTIES". THAT'S WHAT WE ARE WHEN WE GO TO ANOTHER UNIT WHERE WE ARE NOT TRAINED OR ORIENTED.

Our policy just changed. Now the ICU nurses float only to Tele, Neuro Observation Unit, and Bone Marrow Transplant Unit. The 1st two arent' too bad, except you are the only RN in the NOU, with 8 crazy pts. and one NA to assist, and if you are lucky, an LVN too. BMT however is a nightmare. Four SICKSICK primary care pts., can be on vents and Swan'd, multiple antibx, CA or transplant drugs. And NO SECRETARY to do the orders, you do your own!!! It is just unbelievable. Also have to deal with distraught, demanding family. IT is way worse than ICU, and they can't keep any staff.

Our hospital is like a giant float pool. ICU goes to Tele, OB goes to pedi, etc. The kicker is they can send you out of the float district if it is a "bonafide emergency". What crap! They engage in little to no retention efforts and wonder why people leave in droves! Offer a differential for floating and maybe you would have a float pool. Our only saving grace right now is since we have so many agency people on they have to go first.

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