My poor co-worker!

[tryingtomakeit]

I really guess I would just like to hear some opinions about something that happened to one of my fellow nurses. I'll try to make it short.

One of the 7a - 7P L&D nurses came onto her shift to be floated to med-surg. Bear in mind that this young lady has never worked med-surg a day in her life.

We have been told recently that if we are floated, we may be asked to take a couple of low accuity patients so that if we are needed in our own area we can quickly hand then off to another nurse. None of us has had any orientation to med-surg, other than to occasionally help out as a "runner", and our L&D is staffed with a MAXIMUM of two nurses per shift. Only if there is a second nurse are we expected to take patients.

Back to my co-worker ... She came in at 7a and was to be floated. She was already upset that she would have to take patients because she had very rarely been over there to work at all, but she held her head up and went anyway. When she got there, she started taking report. After two patients, the offgoing nurse continued. The L&D nurse stated that she was only supposed to have two patients. The offgoing supervisor told her that she was going to take a full load - that the med-surg manager had approved it through the CNO.

My co-worker became upset and told the nurse supervisor that she had to go to the restroom (she didn't want anyone to see her crying). After coming out of the restroom, she told the supervisor that she would be right back, that she really needed to speak to the L&D nurse manager, who's office is just down the hall from med-surg.

When she got there, the NM wasn't in yet, and she ran into the CNO, who told her that she needed to wait for the L&D NM to get there so they could talk about the situation. The nurse was still visibly upset, so she thought they were just going to maybe work out a compromise of some sort.

When the L&D NM got there, she was taken into the CNO's office, told that she had abandoned her patients, and escorted off the property by security with the NM telling her that she was going to report her to the BON.

The other nurses were still taking report and hadn't even been on the floor to see their pt's yet, and she had told the supervisor that she would be right back, which she had every intention of doing.

That night, another L&D nurse was pulled and was given a full load also - without any form of orientation. I guess I'm just wondering if I have lost perspective of the whole incident and was wondering how you guys feel about it.

Thanks so much!

[Bridget O'Malley]

Your co-worker was treated horribly. I'd be bringing the big guns in on this situation as cisco recommends myself.

Now I'm going to threadjack and give a different perspective. At my hospital, L&D nurses are told at their orientation that they may be expected to float to a med/surg floor that specializes in gyn and male urinary problems. They are given monthly competencies specific to that unit.

And yet, every time a L&D nurse comes over to act as an aide (they are never given patient assignments) they refuse to give meds such as Toradol and Zantac because they are not familiar with them. They refuse to assist in caring for men because "We only deal with women's parts in L&D" and will not go into a room unless it is strictly post-op in case they get "called back to the babies". Why these nurses can't look up meds they are not familiar with like the rest of the nursing population; take care of an infected foot of a diabetic (as though everyone who delivers a baby and her multitude of visitors is 100% healthy); and apply an ice pack to a scrotal injury is beyond me.

I love my L&D nurses, really. They took wonderful care of my babies and deal with as much family BS as any ER nurse. But at my hospital (don't know about any others), I just wish they'd stay in babyland or think of ways in which they CAN help instead of reasons why they can't.

Now back to the original post--

[floatRN]

In my hospital, L&D nurses are never given an assignment when they float. They help out with tasks they are comfortable with. Mostly, doing admission histories, giving pain meds, answering call lights etc. It is still helpful to have the extra set of hands on the floor even if they can't take an assignment.

[UM Review RN, ASN, RN]

Were the situation reversed, with me taking a full load on an L&D floor --- omg, perish the thought!! --- as soon as I found out that I'd be taking an assignment, I would've been refusing and let the chips fall where they may.

The problem is that this situation has not been resolved in a good way. As sympathetic as you are feeling toward your friend's plight, you need to understand that next time, it could be you. You have to choose whether you'll either be floated or fired.

That's why I think you should quit before you get mired in the situation and someone gets hurt.

Good luck to your team and please keep us updated. We're rooting for you.

[tryingtomakeit, RN]

Your co-worker was treated horribly. I'd be bringing the big guns in on this situation as cisco recommends myself.

Now I'm going to threadjack and give a different perspective. At my hospital, L&D nurses are told at their orientation that they may be expected to float to a med/surg floor that specializes in gyn and male urinary problems. They are given monthly competencies specific to that unit.

And yet, every time a L&D nurse comes over to act as an aide (they are never given patient assignments) they refuse to give meds such as Toradol and Zantac because they are not familiar with them. They refuse to assist in caring for men because "We only deal with women's parts in L&D" and will not go into a room unless it is strictly post-op in case they get "called back to the babies". Why these nurses can't look up meds they are not familiar with like the rest of the nursing population; take care of an infected foot of a diabetic (as though everyone who delivers a baby and her multitude of visitors is 100% healthy); and apply an ice pack to a scrotal injury is beyond me.

I love my L&D nurses, really. They took wonderful care of my babies and deal with as much family BS as any ER nurse. But at my hospital (don't know about any others), I just wish they'd stay in babyland or think of ways in which they CAN help instead of reasons why they can't.

Now back to the original post--

I can understand that being really frustrating, but this is the thing that is so frustrating to us where I work. We do go to med-surg from time to time. It just so happened that this girl had only ever been floated over there once before, and it was to clerk. She knew next to nothing and is a relatively new grad to boot! I have passed meds for the nurses over there, emptied foleys, hung IV's EVERYTHING. I am comfortable with that. I can do those things. I dont even mind taking a small patient load and still help the other nurses because I have been over there enough that I do feel as though I have had some form of orientation, but let me tell you what happened the last night I worked ...

I was in L&D alone and my partner was helping out in post partum, we have no problems with this because we are just down the hall from each other and can still tell what is going on in our area. But, at any rate, I had a patient who came in, 31 weeks, bleeding like a stuck pig! All I had to do was yell down the hall to my partner and by the time the Dr got there, we had her IV started, labs drawn and ordered, had taken them to the lab, had her abd shaved, and the C/S room partially opened. As it was, by the time we were taking her off the monitor to go to the OR, her baby was having HUGE late decells. If I had been alone to call the Dr, take orders, and do all the other things I mentioned, that baby could have been dead. Not to mention if I had to wait for my partner to give report, then come to me - minus the time it would have taken us to contact med-surg, then have them find her down the hall.

Believe me, I know your frustration, because we can't even get the same people we are being MADE to help give us the time of day when we need help. They say, "that is a specialty area and I can't be made to do that". When in reality we would never DREAM of giving them patients. All was ask is for help with call lights and answering phones, things like that. It can be very frustrating on both ends.

Another thing that we are finding very frustrating is that when we are slow, they will pull us over there even when THEY are slow. The other night they were complaining that there were two of us in L&D with only two patients. They only had four patients each! Grrrrrrrrrrrrrrrrrrr!

Please don't think for a minute that I am flaming you for your comment, because I'm not. I guess I just really wanted to say that sometimes I realize that it gets frustrating for ALL of us, no matter where we are.

[whiskeygirl, LPN]

It sounds terribly unfair to do this to anyone. I am so sorry for her. Had I been her co-worker I would most likely be quickly searching for a new job for myself.

[BBFRN, BSN, PhD]

Personally, I find it outrageous that they think it's OK to float a L&D nurse to Med/Surg.

I hope all this poor nurse's coworkers plan on backing her up here, by also contacting the BON, JCAHO, state nurse's association, etc themselves. I think if more nurses did this when things like this happened, there might be different outcomes than if the nurse was left alone to defend her actions.

Don't just walk- tell people why you're walking.

[imenid37]

So where does patient safety fall in all of this? That CNO is a clown who is trying to flex his/her muscles. I'd say go get an attorney. Preferably a nurse attorney. You only abandon paitients if you had accepted the assignment from what I learned. I worked on a post-op OHS floor for three years. I left 17 years ago. My cardiac and med-surg experience has cobwebs all over it. Folks had L/D in nursing school too. We NEVER EVER EVER would give them a labour patient. If there would be a staffing crisis for us, we would have our manager, assistant manager, or educator (me) or all three take a patient. I often do have patients or float around our unit, as does the assistant manager. The hospital wants to save $. I hoped they have saved enough for the lawsuit and publicity they deserve pulling this cr*p. I hope someone has the gonads to address this type of practice in the next National Patient Safety Goals. As we ALL know the pulling of staff to an unfamiliar unit is an accident waiting to happen. I wonder if the CNO would have wanted to have the L/D nurse be his/her nurse or his/her parent/child's nurse. If I were placing my bets now, I'd say I'd soon be very rich!

[imenid37]

Your co-worker was treated horribly. I'd be bringing the big guns in on this situation as cisco recommends myself.

Now I'm going to threadjack and give a different perspective. At my hospital, L&D nurses are told at their orientation that they may be expected to float to a med/surg floor that specializes in gyn and male urinary problems. They are given monthly competencies specific to that unit.

And yet, every time a L&D nurse comes over to act as an aide (they are never given patient assignments) they refuse to give meds such as Toradol and Zantac because they are not familiar with them. They refuse to assist in caring for men because "We only deal with women's parts in L&D" and will not go into a room unless it is strictly post-op in case they get "called back to the babies". Why these nurses can't look up meds they are not familiar with like the rest of the nursing population; take care of an infected foot of a diabetic (as though everyone who delivers a baby and her multitude of visitors is 100% healthy); and apply an ice pack to a scrotal injury is beyond me.

I love my L&D nurses, really. They took wonderful care of my babies and deal with as much family BS as any ER nurse. But at my hospital (don't know about any others), I just wish they'd stay in babyland or think of ways in which they CAN help instead of reasons why they can't.

Now back to the original post--

When I have been pulled, I am a great nursing assistant. I have done that job, Oh so many years ago. I don't give an entire team of meds like they do on the med-surg floors EVER. Yes, you should be careful. Again, it is an accident waiting to happen because it is unfamiliar territory. Do the L/D nurses get a formal orientation to your unit? Is there a list of approved tasks for them to do? If not, they should do basic nursing care, like nursing assistants. They could assess some GYN patients if they are pretty basic, but really they are not a substitute staff nurse for the unit. They should be functioning as a helper giving basic nursing care because there is no one available that is regular staff for the unit to work and take a full load. It means that the regular staff have been called and asked to work, etc. It doesn't mean the nursing supv. thinks L/D is "not busy" and she/he doesn't want them "sitting around" so they are pulled to cover a sick call on med-surg when the supv. didn't bother to call regular staff. I f there are tons of confused patients and med-surg has regular staffing, i think it is fine to get a nurse from L/D to do things like take vitals, waatch confused patients, help w/ moving or hygiene, but not take an assignment. It doesn't mean that a nurse from L/D is pulled to med-surg so the med-surg nurses can put up Christmas decorations. That happened to me several years ago. They were wonderful and friendly, but they were pinning snowflakes to the ceiling and telling me they were "surprised" I wasn't going to hand out a team of meds or do an admission. They also had a helper from Critical Care. It is not so much those nurses who I was pulled to work with that I fault, it is the supervisor. She saw them hanging up decorations knowing she had pulled me and the Critical care nurse. She wouldn't dream of pulling a nurse from the med-surg unit to take a labout patient. med-surg is very busy. The hospitals need to pay the med-surg nurses OT, premium time, or whatever to get staffing up to snuff when you are very short. The hospitals owe it to the patients to provide safe and appropriate nursing care to them.

[angel337, MSN, RN]

this is one reason why i am not fond of the float position. hospitals think a nurse is a nurse, which just isn't true. there is no way i could float to L&D, when all i have ever known is ER. i have known nurses that just take a chance that they can get by with basic knowledge and sure enough a disaster always happens like in this case. i feel sorry for your coworker. she will need a good lawyer.

[GardenDove]

That's totally bogus. She hadn't taken report yet so she hadn't abandoned her patients. I'm so sick of management like that.

One time I was floated over to OB to be the "NICU" nurse, since they needed someone to watch a baby because they were so busy. It was a twin that was a little puny. My hospital doesn't really have a NICU, just a couple of those incubator things with a hooded O2 thingie. I got report from another ICU nurse float, and also oriented to the apparatus, charting, and the whole shebang, right in front of the Dad! LOL, I tried to emphasize my "ICU status" to the Dad to impress him so he wouldn't be scared $hitless by a total newbie watching his kid. I pulled it off, he was really grateful and nice.

I was behind a glass and could signal to a nurse who knew what in the h*ll was going on fortunately. I've done it a couple of times since, one time I assisted with a fullterm spontaneous pneumothorax babe that needed a needle decompression before transport to a larger hospital. LOL, I'm a bigtime NICU nurse.

Back to the OP, your friend should definately fight this injustice, it's outrageous.

[Jolie, BSN]

Your co-worker was treated horribly. I'd be bringing the big guns in on this situation as cisco recommends myself.

Now I'm going to threadjack and give a different perspective. At my hospital, L&D nurses are told at their orientation that they may be expected to float to a med/surg floor that specializes in gyn and male urinary problems. They are given monthly competencies specific to that unit....Why these nurses can't look up meds they are not familiar with like the rest of the nursing population; take care of an infected foot of a diabetic...is beyond me.

Simple. Because it is a violation of accepted standards of infection control.

[tryingtomakeit, RN]

I just wanted you guys to know how much I appreciate your support - you have no idea how much it means to me right now.

I am very grateful that, at least for right now, we are all hanging in there together. There have been three people who have left in just the past week with this situation being their deciding factor.

I really do love my job and it is sad to me that something like this is pushing me away from a place that I love so much. The Drs there are WONDERFUL - they are trying very hard to take up for us and my co-workers are second to none. I am looking at going PRN on a very limited basis until I can see if this is going to pass. I am hoping that with everyone leaving (there are more looking for jobs), that they will see the light and then maybe I can come back full time. I plan on telliing them why I am going PRN - I just can't handle the stress.

Thanks again for all your support. I will keep you guys posted.