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Discussion

Pedi and NICU the same???

I work on a small general peds unit. Im being forced to float to level ii nicu because according to mgt peds and nicu "are the same thing". I was oriented/trained for 12 hours and deemed competent for level 2 nicu.

I feel totally incompetent and out of my element and have expressed that many times.

Is that safe practice? Are peds and nicu the same? Is it normal practice to float pedi nurses to nicu? Thoughts, opinions, suggestions..

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    • Expert

    I suppose it would depend on what sort of patient assignment you're given. If all you're doing is feeding and diapering babies who need to grow or who are being treated for hyperbili, it's probably safe. But if you're assigned babies on nasal CPAP or who have frequent apneas and bradys then no, it's not really safe.

    I remember a time when I worked in a PICU that was considered to be part of "maternal-child health" and was floated to the antepartum unit for a 12 hour night shift. Excuse me?? What do I know about hourglass membranes or prenatal hemorrhage? I told the supervisor I'd go because there was only one nurse on that unit but if she was on a break and anything happened I was calling a code. Her response was, "Whatever you have to do." Thank GOD nothing happened. I'd have lost my mind.

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    • Author

    Well they say it's feeder growers....sounds easy enough...I guess....just freaked out about different environment, policies, people, charting...etc...i dont get paid to be à float pool nurse...but i have to float to FIVE areas.

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    • Expert

    My employer says that I'm employed by the hospital not by my unit, and therefore I should just do what I'm told and be happy I have a job. (Actually, I think they'd be ecstatic if they could send us anywhere in the system... of dozens of hospitals) Here, float nurses aren't paid any more than any other nurse - because a nurse is a nurse, right? I totally understand your reluctance. The culture on the other units, their charting, their standard practices and all of that are anxiety-provoking. At least you got an orientation. The last time I floated, I went to our surgical NICU and my orientation was a 5 minute tour of the unit - "There's the med room, the breast milk freezer, supply cart..." and about 2 minutes of charting instruction. Then it was "Here are your two babies. The nurse over there is Sue. If you need help you can ask her." I nearly got my head taken off when I drew blood from a baby for the kid's ordered labs. Nobody told me only their NNP could poke a baby for labs. On my unit, the nurse at the bedside is responsible for all of that. So yeah, I sure do know what you're feeling.

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    • Author

    Thanks. I really want to be a team player, BUT safety and my license are the most important. I am not a float pool nurse for a reason! I hate stepping into new units and the "unknown". As it is I float to five units!! And I repeat, I AM NOT A FLOAT NURSE!!

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    I work PICU and float to inpatient/ general peds, NICU (level 3) and step-down nursery. We also can get pulled to 'sit' with patients everywhere on campus- including gero-psych and adult ICU. Good times...

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    I am still orienting in my picu but will be pulled to float to peds, peds hem onc, nicu, nursery, peds ed. Day shift nurses also go to peds same day surgery/recovery. It's a lot but not unusual, I think. Just make sure to protect your license and take only assignments you can handle.

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    Peds and NICU are not the same but if you're talking about a level 2 NICU, around here we call that a "special care nursery" and I think a pedi nurse would be able to handle that. Those floors are typically part of maternity/pedi floors in the community hospitals and the babies are stable enough that they don't need to be sent out to the higher level NICUs. What age gestation are these babies? I know someone who manages such a unit and they don't keep any babies younger than 34 weeks gestation. As a pedi nurse, I could handle a 35 weeker who's a feeder/grower.

    The pedi hospital that I worked at did not float floor nurses to the NICU. When floats were necessary, ICU nurses floated within ICUs (NICU, Cardiac, Medical and Surgical) and floor nurses floated within floors.

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    Pediatrics and NICU are different. However, in order for a hospitals to survive...floating between these areas is necessary because they are the only "like" units. It is important to make sure you let the charge RN know right away if you are assigned to do something that you do not feel comfortable with. It will be uncomfortable because it is outside your comfort zone and no one likes it. If you do not get an adequate response from the charge nurse, call the charge nurse from your home unit. They should advocate for you as they are the ones that will truly know if what you are being asked to do is outside your competency level.

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    We float from NICU to PICU, comp care, regular peds , OP peds clinic and nursery. Throw in there to L/D to be a baby nurse. Believe me we freak at big kids lol And I'm not a float nurse either. I'm just thankful they don't send us to adults anymore! If you get something you aren't comfortable with, speak up. And don't be "that float" that complains all the time, go with a good attitude and look at it as a learning experience....these are the kids that will come back to your unit at one time or another. Good luck!

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    • Author

    Thanks all! Got the courage to suck it up and go!!

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    I work in a fairly large childrens hospital where each of our floors is somewhat specailized. And I have to float, my home unit is the bigger school age kids and I get floated to the infant toddler, the PICU and NICU. Now they say that the NICU all they give us is feeder/growers, but usually there is more going on than that. Last time I was in the PICU my kid ended up being intubated 3 hours into my shift.

    What gets me is whenever I float or we have staff education and someone from a different unit comes to give a talk or whatever, they always say how they couldnt make it on my floor, they just wouldnt know what to do with a big kid....um okay but you take me and put me in with a 1.5kg baby when I am used to 30-80kg kids!?!?!?

    Or how the NICU nurses can only float to the infant /toddler floor and can only have patients less than 5 months in age, but again if you are from my floor we apparently can do anything!!

    We have a float pool that gets paid a significant amount more to be able to go to those units and take the more critical kids, but we still get floated. I am okay going to another acute unit, but floating to the NICU and the PICU are very different worlds.

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    Floating sucks, most nurses are not float nurses. Level 2 NICU isn't that much different from Newborn nursery.

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