NOT an ICU nurse but assigned by SUP

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Hello! I am a med/ surg tele nurse and was just hired last December 2018 in this floor. So, the assigned house supervisor called in and so our ICU nurse became the house supervisor for this night. When I came to get reports I was told that I will be in ICU. There is only 1 patient there and she is being treated for CHF exacerbation. She pretty much stable and with only occasional VPC's but she has afib and LBBB all the time on the monitor.

So I am not sure if I should have declined the assignment since I am not an ICU nurse. I started to question my assignment (in my head) when I went to med/ surg floor to say hi to my fellow nurses. But I felt they are KINDA indifferent and asked me right away " You are not an ICU nurse right?" "The patient was not downgraded from ICU why are you there?". I just told them well I just accepted the assignment otherwise I might be put on call shift. I appreciate them but I don't know if I did wrong accepting the assignment.

A little background about me: I have a nursing experience as a PICU nurse (2 years) not in USA tho. But here in USA I worked in skilled nursing fulltime and per diem NICU nurse.

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Yeah, you should have declined the assignment, or else insisted that the patient get downgrade orders before assuming care if they really thought giving him to a nurse who's not trained in intensive care is appropriate. And definitely don't justify working beyond your scope by saying its either that or being put on call - that's not any kind of justification.

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Specializes in oncology, MS/tele/stepdown.

I've taken patients in ICU but only those who were downgraded and waiting on a MS or tele bed. If the patient was a true ICU patient, that was inappropriate. If the patient was a tele patient, it was fine. If the patient was still listed as an ICU patient but should have been a tele patient, the ICU nurse/house sup should have addressed that for you with the doc. I would ask your manager what to do in that scenario should it happen again, so you know how to handle it.

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Specializes in Adult and pediatric emergency and critical care.

We often float floor nurses to the ICU, but they are given the least sick assignments and with interventions that are floor appropriate.

I'd be more concerned that there was only one patient, and you had them. This makes me think that you we by yourself. No unit should ever have fewer than two nurses. You also shouldn't be in a unit that you are not familiar with.

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7 hours ago, Swellz said:

would ask your manager what to do in that scenario should it happen again, so you know how to handle it.

Thank you very much! I will do that. ☺️

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7 hours ago, Cowboyardee said:

Yeah, you should have declined the assignment, or else insisted that the patient get downgrade orders before assuming care if they really thought giving him to a nurse who's not trained in intensive care is appropriate. And definitely don't justify working beyond your scope by saying its either that or being put on call - that's not any kind of justification.

Thank you for being straight forward and sounded like a big brother after telling my day from work. ?

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9 hours ago, Cowboyardee said:

And definitely don't justify working beyond your scope by saying its either that or being put on call - that's not any kind of justification.

??

Yes. It's either that you felt adequately prepared to handle the patient, or you didn't.

But if you didn't, then you don't accept just so that you won't be put on call.

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Specializes in Neuro ICU and Med Surg.

If you haven't had ICU training then you shouldn't have accepted a patient that was on ICU status. I would have declined the assignment.

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Specializes in Psychiatry, Community, Nurse Manager, hospice.

I think it depends whether you determine that you have the skills to care for the patient or not.

If you have the skills to care for that patient, then you can accept the assignment. Your judgment should be respected on that.

If you don't have the skills to take care of the patient then it doesn't matter if someone writes up a downgrade.

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I would not have done it, even if I felt I could take care of the patient. If the patient was tele, the patient should have been on your floor. Don't do it again. If things go south, it's is on you and the hospital will throw you under the bus. Not only that but did your pay change for the day? Why do more than what is necessary? This is what is hurting nurses in the end. They may try to make this a regular thing on your floor. ICU unit=ICU patient= ICU responsibilty.

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Specializes in ICU/community health/school nursing.

We never drill for this - how to decline an assignment. Now you know. Next time you can handle it in a different way, if needed.

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Specializes in clinic, ortho/neuro, trauma, college.

I remember getting to work and realizing it was my turn to float to another floor. Well, the floor they were trying to float me to was the STICU!!! I had zero ICU experience. My fellow nurses were split. I had many who supported my outrage, but just as many who were questioning why I didn't want to go. One even asked me, how do you expect to learn if you don't challenge yourself? I was dumbfounded. Who wants to learn by being thrown into the fire?

I didn't care that they would supposedly give me the two patients with the least acuity: it was a completely different ball game. Luckily, another nurse who had floated there before agreed to go in my place when it became clear I would not be doing this. Totally unsafe, for me and my patients!

OP, I hope things worked out for you! It blows my mind that nurses are being put in this position.

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