Floating of ICU RNs - page 3
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... Read More
May 31, '02Occupation: PICU Staff Nurse Joined: Feb '02; Posts: 121Originally posted by ccnurse
I work in a 300 bed hospital in the CCU. We used to have to float to the floors, but no more. The problem I had with floating to the floors is trying to treat them all like ICU pts. I am used to doing total pt care and am not used to having a CNA. I caught myself a million times doing thier job! Our manager is great and had the policy changed. We now float only to MICU, SICU, or ER. She said the same thing as above, "if the floor nurses can't float to the units, then why should my nurses float to the floors?"
I work in a PICU and nobody wants to float here when we get busy! I float at times to NICU, PEDS, or NURSERY but none of them float here unless their jod is in jeopardy. And then, I get to hear them complain all night.
But i start in a new job soon where the only place i have to float is other ICU's
Jun 24, '02Joined: Jun '02; Posts: 299; Likes: 4How about being asked to float from the unit to another floor, and having an agency nurse take your place in ICU. My organization was doing this on a regular basis. I have great respect for the agency nurses, but I do draw the line. I refuse to be pulled to a another floor so that an agency nurse can take my place. I have made it quite clear to my manager that I will quit or accept termination before I accept this situation. I have witnessed this occuring with other nurses who are not taking a strong stance, and they leave to go to the other floor almost in tears from where they are so frustrated. Smart management always take retention of existing staff into acccount. The quickest way to staffing your floor with all agency nurses is to continue with practices such as that mentioned above! But, I have not been confronted with this situation since making my views clear to management.Last edit by London88 on Jun 24, '02
Jun 25, '02Occupation: Sometimes burntout ICU RN Joined: Jun '01; Posts: 121; Likes: 20Our Per Diem nurses have that option, to refuse to go to certain floors. If we accept them to come and work in the unit for 12 hours, then at 3PM we end up overstaffed - and one of the 8-hour floors are short for 3-11....then one of us ICU 'regulars' gets to float from 3PM to the end of our shift at 7PM.
Also, you can be floated to one unit for 4 to 8 hours, then told to float again to some other unit for the rest of your shift. It Stinks!!!!
Nov 23, '03Joined: Mar '03; Posts: 486; Likes: 986We have floating "clusters" where critical care nurses can be floated to other critical care units, med nurses float to other med units, and surgical nurses float to surgical units. Everyone can float to ER but nobody floats to OR.
If the situation is very poor staffing, it is possible for a critical care nurse to be pulled to the floors or vice versa. We can always volunteer to float as well. Personally, I enjoy floating from time to tiime and volunteer to take other people's floats. I have made a lot of good friends all over the hospitall.
When a floor nurse volunteers or is mandated to the ICUs, she rarely takes her own assignment. Instead, we pair her with an ICU RN and they function at whatever level they are comfortable. We use them staffing wise as we would a nurse technicial or nurse asssistant II. They are usually assignmed 3 1:2 patients with a regular ICU RN. Its a good experience for most of them and often we get many who volunteer to float down here. A few gals are here so often that they not only take their own assignments but they are now on our call in list.
Jan 4, '06Occupation: Nurse Specialty: I got hurt and went to the ER once ; Joined: Oct '05; Posts: 86; Likes: 5Quote from ccnurseWhat is a floor nurse? How are they different than other nurses? A pediatric nurse works in peds, a ER nurse works in ER, an ICU nurse works in ICU... I'm in pre-nursing so forgive me if I have no clue where a floor nurse works.I work in a 300 bed hospital in the CCU. We used to have to float to the floors, but no more. The problem I had with floating to the floors is trying to treat them all like ICU pts. I am used to doing total pt care and am not used to having a CNA. I caught myself a million times doing thier job! Our manager is great and had the policy changed. We now float only to MICU, SICU, or ER. She said the same thing as above, "if the floor nurses can't float to the units, then why should my nurses float to the floors?"
Jan 5, '06Joined: Nov '05; Posts: 22; Likes: 24I here you loud and clear..I'm not an ICU nurse.but a floor nurse. Our unit staffs the hosp(We are a med-surg unit) Staffing waits to see our staffing per shift. No workload relief allowed..even though our pts are complex and heavy. You can't say no to being floated out or you will be reprimanded for insubordination. You will go to ICU/ER,MED or where ever they want you.I say we are the prostitutes of the hospital. Noone will come to our unit,workload's too heavy,pts too complex. And yes morale is low..people dread coming to work..oh well...what do you do. You try to have a positive attitude and take your turn.:chuckle
Jan 5, '06Occupation: Infantryman OIF, RN, EMT-B Specialty: SICU-MICU,Radiology,ER ; Joined: Nov '04; Posts: 210; Likes: 4This is one of the primary reasons I have decided to make nursing a secondary career. I have worked in the field as ICU and some ER for five years now and am sick of it.
The unit that is my home base isnt too bad as we rotate by number not senority, and primarly float to other ICUs or a BMT unit that has very good nurses on it. They always help us and as a result Ive told them Ill float there no problem.
I have an understanding with the agency I work with which is Ill only work ICU or radiology period, no acceptions. This does limit me some but thats the way I want it.
While working in CA for a year as staff I learned a lesson. That particular hospital overhired travel nurses for ICU then floated them to the floors. Of course, it was their policy to float travelers first. I took note.
One of the first questions I ask during a hiring process is when and where do the units nurses float.
Personaly I think its a shame how nurses are treated and let themselves be treated. Nowhere else have I seen it not construction nor the military.
Hopefully that wont be an issue for me in the near future-
Jan 6, '06Joined: Nov '05; Posts: 12I just have to get in on this one. I work in a 120 bed community hospital also. I have been pulled to the floors 2 times in the last 9 days. It should have been 3 times, but I complained to my boss and I think that she felt bad for me and didn't pull anyone last night. The ICU nurses are pulled 10 times more often in my hospital than floor nurses. We actually have float nurses that get paid 2 dollars more an hour and that was supposed to prevent so much pulling, but that hasn't helped. If a floor is short nurses then we are not allowed to take time off with or without pay, we have to go. We are considering many options. My boss is considering several options. They took one of our positions and gave that to the float pool. But we are still getting pulled. When a couple of nurses leave we are considering not replacing them and taking on call for 8-10 hours a week. That would be on call for our unit only. Also I work in a unionized hospital and we have considered going to the union and insisting on getting an extra 2 dollars and hour (same as the float nurses) every time we are pulled.
Jan 6, '06Occupation: RN Joined: Jun '02; Posts: 2,030; Likes: 5,933Quote from johnboyI have to disagree with the above posting. I'm sure the lawyers and jury wouldn't quite understand that i'm just "improving my triage skills" by floating to the floor where I've never worked before, no orientation as to what paperwork I'm expected to fill out, what signatures go where, what discharge instructions need to be given ("initial here, here, and here please!") Oh right! When does one get time to go in, sit down and chat with the patient you've taken care of when they've been on death's doorstep down in the ICU?
I know you're intentions were good in the above post, but not fully grounded in reality.
We also have an suburban, small 150-bed hospital. Many times the ICU nurses staff every unit except L&D. The TCU nurses will sometimes float to ICU, but will only take the "lighter" patients ready to transfer over to step-down. The ER nurses DO NOT float over to ICU ("they do their own
staffing"). Yeah, right. What really gets me is that floor nurses want "advanced skill" pay like the ICU nurses, yet "can't" float over to the ICU like we have to do for them. We're the ones that go everywhere, guess that means we're "flexible". Rolling my eyes right now!
The first order of business, for the un- unionized, is to unionize, and have a clause in the contract, to place different nursing units into "float groups", with similar specialties, such as OB and peds, ICU/CCU, etc together. If floated out of your specialty group, you do not take an assignment you are, what we called, "functional". You do not take an assignment, just help out with tasks, such as V/S, baths, hanging new IVs, medications, help with admission and discharge paperwork. etc. You get the picture. This way you can help out your fellow nurses by doing the things that we all know how to do. We had a nurse float to us from the telemetry unit once, and, even though she had no critical care experience, (and no, telemetry is not critical care), she was able to hang IVs, give meds, do chem sticks, baths, transfer paperwork, (no one get discharged from the ICU- they either get moderately better, or they go to the morgue) etc. This way she was ableto use her basic nursing skills to help in the ICU, without running the risk of being put in a situation of risking her license. It can be done. There is no good reason to force someone to work where they have no expertise. I would write an incident report (make a copy for yourself), and send it to risk management. outlining the risk that the hospital is taking by forcing nurses to float out of their area of expertise.
If you really want to be a BBuster with the hospital, I would find out which law firm defends the hospital, and voice my concerns to them. Better yet, after I voiced my concerns to the hospital, with a letter to management and administration (and again, send it registered mail with a return receipt), a few of you, make an appoinment with the law firm, preferably with the senior partner (who probably is the one who deals with the administration), and outline all of your concerns, including and communication that was made with management and administration, concerning this issue, and any "near misses", that occurred when a nurse was floated off of their unit. Provide him/her with the policy in writing, memorandums, notes in your boxes, any paperwork that was given to you. Just because the hospital initiatates a policy don't always believe that they have checked it out with thier attorneys.
This tells the hospital, and the law firm who defends them in court, that you are serious about this issue, and the if the $!&*$ hits the fan, that the hospital, not the nurse will take the heat, blame, and accountalbity. Make it clear, and I bet that the present policy will change. Practice defensive employment!!
Nurses have not done a good job of making the hospital the one who has to be accountable for any wrong doings, and failed/flawed policies. Also, get . $99 from NSO. JMHO.
Lindarn, RN, BSN, CCRN
Nov 17, '06Joined: Jun '00; Posts: 97; Likes: 9Have to agree. I myself had never worked the floor at my hospital prior to working in the ICU. I am used to the ICU's and am comfortable floating between the three units, but the floor and I am sick!! Literally. I am not comfortable doing this. No amount of short oritentation to a floor will make you qualified to work there that day. Another hospital I worked at was strictly floated among the units and to the ER. I can say we never made an issue of going to the ER. Someone actually usually volunteered to do this float. Someone else asked me to look at it as if my mother were up on the floor I am being floated to, well, that is my point!!! I would not want me...a nurse ill prepared for that floor, has no ideal where anything is, how to even call the RT for this floor.. to have to care for my mom. Although some do not want to admit it, each floor has their own specialty within themselves. Eventhough we can care for the acuity of the patient, it doesn't mean we will give that patient the best care in the setting they currently reside. WE can only give the best to our ability within our training, which on the floor we floated to, amounts to a hill of beans.
Nov 22, '06Joined: May '06; Posts: 22; Likes: 2In the last 6yrs, I have floated out once. I have picked up extra shifts on other units. I work a small unit, 6 bed with a mix of ICU/SAC patients and we are always full.
Dec 14, '06Joined: Dec '06; Posts: 7It is just common courtesy to help out where it is needed, since when do the skills on the floor exceed those in the unit! The charting might be different, but the patient care is the same. Quit whining and do the work you are paid for!umpiron:Last edit by Colorado Kid on Dec 14, '06