My poor co-worker!

imenid37 · Mar 10, 2007

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

I didn't see the thing about the diabetic foot in the original post. YUK!. I agree that violates infection control as Jolie says. I have been questioned about why I couldn't go into a C.diff room. Our tech was pulled to sit w/ a C.diff. pt. and then had to shower and change clothes when she needed to return to OB to prepare for a delivery. It goes on and on. Time to sing a new tune for nursng admins. NO PULLING. I was so sick of this on nights, I was going to seriously look for another job until I took the position I have now. Why can't nursing supervisors, admin, etc. believe us when we say that we don't have med-surg skills? When a nurse is pulled to your unit and says I can't give that med, why do you make her feel like she is doing something wrong? She doesn't want to make a mistake and cause trouble for herself and the patient. Go to your admin or manager and tell them you need someone who can assume full responsibility for the patients and do the tasks. For the sake of patient safety, that means someone w/ the correct skills NOT a make-do from somewhere else!

Monthly comps? People have time to do them??? Wow!

UM Review RN, ASN, RN · Mar 10, 2007

One time I was floated over to OB to be the "NICU" nurse, .

See, I just get myself in trouble because I'll say, "You want to send me where without any orientation? ICU? CCU? OB? I'm not an ICU/CCU /OB nurse, I haven't the skills or the training. I'll float where I have the skills, but I can't float where you want me to."

They used to say things like, "Well, this is really a Tele patient, so it won't be hard."

To which I'd respond, "Fine, bring 'em over and give us all a full assignment."

Or they'd say, "It'll be OK, the ICU nurses will 'cover' you." To which I would respond, "You mean that they'll do things that I will be responsible for, to the patient that I'm assigned to? So if something happens to the patient and family sues, then I have to justify what was done to my patient by someone else that I signed off? No thanks."

It never ceases to amaze me that I have to tell helpful visitors that no, they are not qualified to pull Mother up in bed because of the potential liability to the hospital, yet they can take me, float me to a critical care area that normally it would take a very competitive, hours-long panel interview and 8 weeks of orientation, plus more time in preceptorship--and allow me to float with no training and no orientation and be legally responsible as an agent of the same hospital for keeping someone alive.

All to save a few bucks in Agency fees, they'll take that crapshoot with someone's life?

Not to mention that they're messing with my livelihood, my license? :angryfire

I'd better get offa my soapbox now because this is a subject that heats me up pretty quickly. Nurses have enough problems to deal with and floating to units in which they have no skills and no expertise should not be added to the burden.

TrudyRN · Mar 10, 2007

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!

1. She might need a lawyer. She DOES need one if they are going after her license.

2. She needs to write a letter to her boss, the CNO, whatever managers there are, and to the hospital president, medical director, whoever, detailing the events and the broken promises. Ask the lawyer if it is advisable to actually send the letter. It might be good to send if it can settle things at the immediate, lowest level and gets her job back - if she wants it.

3. I think she should sue the living piss out of her boss, the hospital, the people who lied to her. A lawyer will help her figure out a charge to make against them.

4. You and your coworkers will, hopefully, stand by her by writing down your own belief that a float from your unit would take only 2 patients and everything else you said, all the broken promises and lies. If you all stand together, they aren't going to fire any of you. If you break ranks, she'll be crucified.

TrudyRN · Mar 10, 2007

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

Jolie, what are you talking about? :uhoh21: :uhoh3:

TrudyRN · Mar 10, 2007

:yeahthat: Thank you, that's EXACTLY everything I wanted to say, but was COMPLETELY SPEECHLESS for a minute after reading that post! Whoa! Are they kidding! Perhaps she would like to contact her local newspaper, as well!

Yes. She does need to go on the offensive. JCAHO, CMS, the public all need to know what is happening at that hospital and how she has been victimized by the cheap b-st-rds and gutless ignorami (nurse managers, CNO) who run the place.

:angryfire :angryfire :angryfire :angryfire :angryfire :angryfire :angryfire :angryfire :angryfire :madface: :madface: :madface: :nono: :nono: :nono:

Jolie, BSN · Mar 10, 2007

Jolie, what are you talking about? :uhoh21:

Originally Posted by Bridget O'Malley

Why these nurses can't...take care of an infected foot of a diabetic (as though everyone who delivers a baby and her multitude of visitors is 100% healthy);...is beyond me.

If a nurse cares for patients with active infections, he/she must scrub, shower, and change clothes before returning to OB. This is not feasible, given that an emergency on OB would require the nurse's immediate return.

subee, MSN, CRNA · Mar 11, 2007

Originally Posted by Bridget O'Malley
Why these nurses can't...take care of an infected foot of a diabetic (as though everyone who delivers a baby and her multitude of visitors is 100% healthy);...is beyond me.
If a nurse cares for patients with active infections, he/she must scrub, shower, and change clothes before returning to OB. This is not feasible, given that an emergency on OB would require the nurse's immediate return.

That doesn't seem logical to me. Okay, if the nurse were going to care for an infant, that's one thing since she's basically caring for an immuno-comprimised patient. However, that nurse who takes care of the diabetic foot shouldn't carry any bugs to the other patients on her floor- who are actually SICK!. That's why we have infection control procedures. If she has to go back to L & D, at least she is going back to a healthy population (assuming no babies involved when she gets back) and that's nothing that a good hand scrub can't take care of, if good infection control procedures were followed. Okay, that's my argument based on science. If you don't work med-surg frequently, you shouldn't be in med-surg. Its a specialty like any other and doesn't deserve to have a nurse who can't promise her attention for the entire shift.

GardenDove · Mar 11, 2007

Our OB floats never take pts with open infections, or RSV babies, or anything else that they could transmit back to moms and babes.

SmilingBluEyes · Mar 11, 2007

When I floated to any area (including med-surg, ICU/CCU and ED), I never was allowed to take a pt load on my own. I was required to help the various teams/nurses by giving meds, changes linens/diapers, starting IVs and doing general "go-fer" work. This was because, at any point, OB could get busy, and I was then required to report back to OB. If I had taken a pt load of my own, it would create a very big problem for the remaining nurses when I had to leave.

To require OB nurses to take independent pt loads without a contingency that allows them to return to OB immediately and seamlessly, if needed, is just plain dangerous and stupid. Also, if they are not oriented to a particular unit, this is dangerous for everyone involved, including the patient, other nurses and the hospital risk-wise. I am amazed places get away with this.

Also, we sometimes did not really know who was infectious with what. Sometimes, I found out a week or two later, a patient I took care of, was indeed infected with TB. I found that unsettling and unnerving, just like anyone, not just for my own wellbeing, but those of my OB and newborn patients. I do know, if we returned to OB, we had to change into new scrubs and shower, if at all possible, to mitigate certain risks.

Anyhow that is how it worked where I have been. Where I am not, OB does not float; however we are required to take low-census call-offs if census is down, and be on call for the duration of the shift, should we be needed. I like it this way, much better. I truly would rather be "low census'ed" than float.

jrbl77, RN · Mar 11, 2007

i find this all very interesting. i have been a med surg nurse for 29 yrs and have ben pulled to every unit in my hopsital, with basically no choice other than being suspeneded. our psych unit and icu are now closed units and rns do not have to go there. i was pulled once to sit with a new mom after delivery because they needed a nurse. the problem with pulling from one speciality to another is lack of experience, if the pulled nurse gets a light load- the rest of the nurses usually end up working 2 times harder. the answer that i see is to have closed units and self staff. be willing to cover your own unit when short and when over staffed either take a day off with out pay- use vacation time or be trained and willing to float to another unit. i was pulled to a tele unit a few years ago and it was the worst experience of my long nursing career. but you know - a nurse is a nurse is a nurse. all of this is probaly the reason that i have let med surg nursing and now work in a different setting. i loved med surg nursing

SmilingBluEyes · Mar 11, 2007

This is basically how it's done where I work, jrbl. No one is required to float to our unit, either. But they can, if they want. Some nurses wanting out of med surg float to OB to get experience and exposure, and we have had more than one or two eventually come to work in our unit. Med surg nurses tend to make excellent OB nurses!

magz53 · Mar 16, 2007

I would also rather be "called off" to be on-call when our census is low. Sometimes we are not given that option if the house is full as they count on us to staff the units. Funny there are call ins on the med surg units when we are "slow". mmmmmmm Creates a lot of hostility between the units as we cover our own call ins and staff our own unit. Nurses who get floated to us ( rarely) basically answer call lights and the telephone and are not required to do any OB care. This may belong on another thread but a couple of years of med surg is a wonderful thing to have before going into ANY other specialty area. I had 10 years and am so grateful. I see the gaps in knowledge when someone comes right from school to L & D. I don't wish to argue about it, that has been my observation. However, I also know that no one is knocking down our doors for jobs and we would probably take a new grad.