Pediatric Nurses Floating in Adult Hospital

[manless]

Hello all!

My colleagues and I could really use some advice. We work on an inpatient pediatric floor in an otherwise-adult hospital. All other inpatient floors are adult-- even our ICU is adult-based, and then there are a few pediatric intensivists and pediatric nurses.

Due to our low census we have been floating to other floors where the census and need is higher. Many of our nurses feel uncomfortable because they're pediatric trained and have never taken care of an adult patient outside of a float. There are arguments that adult patients are outside of our scope of practice and we should not be expected to float, or at the very least, we should be the last resort.

My question is: For those of you in similar hospital situations (peds nurses in adult hosptials), what is your floating situation like? What rules are followed when you float to another floor-- are there specific assignments you aren't allowed to take?

Thank you for your help!!

[HiddencatBSN, BSN]

As a unit I’d go to your manager and express that you are not comfortable floating because you do not have training to care for adults. If they still need to float you a more appropriate assignment would be as a help nurse rather than carrying your own patient assignment. That’s how I’ve often seen peds nurse floats to adults handled.

[NICU Guy, BSN, RN]

We would never be pulled to one of the adult hospitals. Internally, when NICU nurses are pulled to another floor in the children's hospital, we are limited to patients 18 months or younger, unless the patient was a former NICU patient that went home and returned to the hospital.

[JadedCPN, BSN, RN]

I work in a pediatric-only hospital and faced a unique situation with Covid. Several facilities in the area, including two pediatric-only hospitals, started accepting adult patients due to lack of bed capacity in adult hospitals related to Covid.

There were many pediatric nurses who expressed similar concerns regarding taking care of adult patients all of the sudden with no experience. It was made clear by our legal and risk department that having a Registered Nurse license means we are qualified to take care of any patient regardless of age.

We got on-the-spot training for these adult patients. We float to our level of acuity (so pediatric nurses on acute care floors only take care of adult acute care, and pediatric critical care nurses only take care of adult critical care). It honestly wasn't as bad as expected, but the biggest issue was just the fact that we had no choice and didn't feel our concerns were truly heard.

All I can say is follow your gut - I was prepared every shift to refuse an assignment, escalate it up the chain of command, call Safe Harbor, do whatever I needed to do IF I truly felt it was an inappropriate assignment. Thankfully it was just outside of my comfort zone but not inappropriate. Good luck.