Patient safety while floating

allnurses Guide · Feb 10, 2013

Hi guys, I had a question to the experienced nurses, what would you do in a situation when you are a nurse on medsurge floor, and you were required to float to ICU and take care of patient with PVC and you do not know ICU protocols for dysrhythmias and do not feel competent to carry for this patient. You have already called the supervisor and asked her to come to the floor and relieve you of the responsibility. You are the only RN in ICU at this time and there is an LVN with you as well. I am doing a paper for my leadership class and we are supposed to ask an experienced nurse what he or she would do in a situation like that. Thank you!

Before getting report i would say, I am not competent to be assigned responsibility for a patient in the ICU.

I would notify the medical director of the unit and all the primary and consulting doctors of all patients.

I would use the language of my states Board of Registered Nursing:

http://www.rn.ca.gov/pdfs/regulations/npr-b-21.pdf

It includes the responmsibility of the supervisor, manager, or administrator to only assign clinically competent nurses.

If still forced to float I would put my concerns in writing with the date, time, and name of the supervisor and others I notified that I was not accepting the assignment, only going to help.

I'd make two copies and give one to the person who gave me the assignment and keep one for myself.

brithoover · Feb 10, 2013

The only RN in the ICU? Yikes. I am a float nurse that has been floated to the ICU. After I get report anything I do not feel comfortable with I take up with the charge nurse in the unit. It is then her responsibility to do any skills or interpret anything I am not competent in doing. This is best case scenario. I have at times felt very uncomfortable there but the staff is usually pretty good at backing me up

SaoirseRN · Feb 10, 2013

I float often into the ICU/telemetry area. We often have to use med/surg nurses in the unit for staring reasons, and in my hospital I would provide the direct patient care but the critical care nurses are responsible for interpreting and watching the cardiac monitor and any skills I am not licensed for. Also, I would be assigned the telemetry patients instead of the ICU patients, or whichever is most the appropriate assignment. The ICU nurses would take the more critical cases.

Lexus02 · Feb 10, 2013

Thank you guys, your answers help a lot. I was supposed to interview any nurse, this assignment is due tuesday and my preceptorship starts wednesday only, so I have to other nurse to ask. Again, thank you very much!

Lexus02 · Feb 10, 2013

I had another question, is it possible that one LVN without RN can ever be in charge of medsurge unit?

allnurses Guide · Feb 11, 2013

In my state, and i believe all states an LVN/LPN in an acute care hospital has to work under the clinical supervision of an RN. Perhaps in some states that could be the supervisor. In mine the supervising RN has to be both present and available.

Lexus02 · Feb 11, 2013

Thank you!

KelRN215, BSN, RN · Feb 12, 2013

My truthful answer to this scenario is that I would refuse to float to the ICU in the first place. Fortunately when I worked in the hospital this was never an expectation as we were a large (400 bed) academic medical center with 4 ICUs... the ICUs only floated to each other.