Orientation-Staffing

[mjscan_07]

I work in a small 5 bed ICU with fairly low acuity staffed with 2 nurses. Our hospitals newest staffing policy is that to avoid any overtime they send Med/Surg nurses back to the unit so they don't have to pay overtime. Unfortunately these nurses have never had any orientation. We have one RN that is actually on the schedule frequently in ICU but has not had any orientation to our unit or previous critical care experience. When asking my manager for orientation I was told to orient while she was working if possible. I was just wondering if this is becoming common practice elsewhere for budget/staffing reasons and what others would do in this type of situation. Thanks

[groovy jeff, RN]

That sounds like a law suit waiting to happen!!! You might want to get some private malpractice/liability insurance because if the uninitiated do something stupid you will probably get named in the suit as well.

[ICUmanager]

I believe this is completely unsafe for the patients and the staff. I would have the ICU nurses go to their manager and if nothing gets done I would go above the manager. I'm sure your manager and administration would not want a nurse caring for their loved one or themselves in the ICU by a nurse who didn't have adequate training in critical care. Over-time is much less costly than a lawsuit or increased staff turnover.

[Christie RN2006]

That is not safe at all! Where I work, we are required to have 2 RNs in the ICU at all times. On a rare occasion they will bring in an RN from our step-down unit to take care of step-down patients that are still in the ICU due to lack of available beds.

[racing-mom4, BSN, RN]

So are they sending the ICU nurses home who are in OT? and then staffing the ICU with MS nurses?? --this I would have a problem with.

There have been a few occasions where due to call ins we have had a MS nurse work in the unit but they are given the healthiest of pts.

[organichombre, ADN, BSN, MSN, LPN, RN]

Call osha asap!

[ErraticThinker]

pretty sure the joint commission would have a few things to say about that...

[cvicugirl, BSN, RN]

It is irresponsible the way your unit is staffed right now--eventually nurse retention and patient care will suffer. While it might seem fine if the MS nurse is given the easy patients, who has your back? Do your MS RNs have ACLS? Is your mgr also the MS mgr? It makes no financial sense to pay OT to ICU RNs when MS RNs aren't getting their hours. When the suits look at the overall hospital staffing costs, nursing OT sticks out like a big red flag. IMO, your mgr needs to either hire more ICU RNs (even a few prns) and cut MS positions (if they aren't making their hours) or (a better idea) suck it up and properly cross train some good MS nurses to ICU. You can always hide orientation costs in the unit or hospital's education budget.