My unit is being changed a 2nd time in less than a year, and I don’t want to stay...

[Golgiapparatus]

Hi everyone,

I'm coming up on 2 years this mid-November of being an RN on nights in acute care. I've been on the same med-surg floor this entire time. When I first started on my floor, it was a true med-surg floor: we'd get acute GI bleeds, IVDUs with cellulitis/osteomyelitis/endocarditis, COPD/asthma/PNA, dementia with behavioral disturbance, etc. But, we realized mixing our dementia and IVDU population was not safe. We had 2 instances where an IVDU patient assaulted a dementia patient because they were annoyed of their aggressive or wandering behaviors. Therefore, this past March, we officially changed into a geropsych/medical floor. We mainly have dementia patients as well as patients who have been in the hospital for months because of placement challengers. We still get medical patients too but in fewer numbers compared to the geropsych patients. Now, I have been told by management that they want to change our unit again, to only have long length of stay patients. Our nurse-patient ratio will change from 1:5 to 1:10 because all the patients will be medically stable, just awaiting placement. This is not the type of nursing I'm interested in. I like being a medical nurse. I've been told that because we are not a telemetry floor I will have difficulty getting hired on a telemetry floor since I'm "inexperienced". Am I better off going to a clinic if this is the case? Should I look for jobs outside my current hospital if they won't take me on a new floor because of my lack of tele experience? I have been a charge on my floor since last February as well. Thanks for any input.

[PeakRN]

It depends what the market looks like but it sounds like you have 2 years of well rounded med/surg experience. I doubt you will have that hard of a time getting a tele job; I have the suspicion that they are trying to keep staff on a floor that they have basically turned into a LTAC.

Nobody has experience in Tele/ICU/Peds/ED/OR/L&D etcetera until they work in one, so I wouldn't worry too much about that.

[RRTNurse]

Sounds like fear. Overcome it and go get what it is you think you want. Know that a Tele floor can be hectic too. Although a 1:10 ratio is plain nuts, unless federal standards are passed people can expect this will only get worse. Hospital administrators are looking to squeeze every penny to keep margins the same. Turnover will get worse, as well as care. Need regulations unfortunately to keep stupid from ruining another market. 1:10? Yeah I'd bounce and without burning any bridges let them know the census is your reason for leaving as a patient load that size is unsafe. Put it in writing as well so that if something does happen proof will exist that they were informed by staff.

[K_NM_rn]

So there is a tele floor in your current facility? I think you already have an advantage in being a current employee, even if you don't have that specific experience. I would think an internal transfer would be more desirable for managers than a completely new hire. If there are openings, go ahead and apply! Or go talk to the manager of the tele unit.