PP nurse being sent to med-surg floors to take pt assignment?

[livealoha]

I am a fairly new RN (2.5 years in) and was hired out of nursing school on a postpartum floor that has no nursery so I have new mamas and newborns as my patients. I love my job! However, when our census dips, as it has recently, we have been sent to other units to task.

Recently, we have been told we now have to take patient assignments on med-surg units. I have had to do this once since this has begun and was anxious the entire shift.

I am not comfortable doing this as I feel inadequately trained to handle a med-surg patient and their vast array of medications and diagnoses. Yes, I know I was exposed and taught many med-surg topics in nursing school, but my focus has only been moms and babies for the past 2.5 years...not med-surg issues.

When I asked my director if I had the option of refusing the assignment and being put on call or just calling in she told me I would have to accept the assignment and my only option would be to call safe harbor. (This conversation took place after the fact, in anticipation for the next occurrence.)

Am I wrong in not wanting to accept these assignments or am I making a much bigger deal out of things? I do not want to risk my license or, more importantly, put any patients in danger. I feel a great responsibility to provide the very best care possible to my patients and don't ever want to put their well-being in jeopardy.

[Double Dunker]

I started off in med-surg and have since been trained in postpartum once I went to our float pool. You absolutely are NOT over reacting. The patients are completely different! I know how lost I felt going the opposite direction, and I had 3 weeks of orientation to PP.

I know that in our hospital, if a PP nurse gets floated to med-surg, she goes as a tech, not as a nurse.

[AJJKRN]

I personally don't think you're being unreasonable in the least! I am a med-surg float but would be very unsafe and incompetent to take care of postpartum patients unless they had already discharged home and came back with appendicitis or something totally unrelated to babies and birthing!

[cayenne06, MSN, CNM]

Good for you for questioning this. No one should want ME to be the one caring for their grandfather with pneumonia. I've only ever worked in OBGYN and I don't have the skill set to work on a non-women's health unit.

When I was an LDRP nurse, we floated to other units but never took our own patients. We would be an extra set of hands to do CNA/tech type stuff , or we would be 1:1 with patients on a safety watch or whatever.

I've got no problem pushing some labetalol for severe range pressures on my pre-eclamptic patient, but I get all hinky about even giving an ibuprofen off of LDRP lol. What if I kill someone?!! Please just let me pass out some ice chips.

[not2bblue]

I would quit. It is just like when ER wants to send EVERY pregnant woman to LD just because she is pregnant. No matter why she is coming into ER. Send that pt with chest pains up here without doing a cardio workup and clearing her and she will die here. We had a woman sent to our triage and she was having an asthma attack. What part of that is OB? Either clear her medically first (should be the preference) before sending her to us or keep her in ER and take care of her, we will monitor the baby. I don't want to work med/surg, that is why I chose OB. Seriously unsafe practice to float nurses to units that far out of their specialty.

[Glycerine82, LPN]

I don't think you're over reacting, at all. You've never had an orientation of any kind to a med surge floor and you're in an entirely different specialty. I would decline to accept the assignment. Its not abandonment if you don't accept and it's better than losing your licence or hurting a patient because you make a mistake.

[hmvassar, ASN, RN]

This is actually quite common for hospitals in my area. The best case scenario is to request training or at least a shadow day. I hope all works out!

[Jolie, BSN]

Check to see what your BON has to say about taking independent patient assignments in a clinical area to which you have had no orientation. Many BONs require some (although probably not much) orientation for independently functioning RNs.

An alternative is to be pulled to med-surg to act as a "task nurse," for example doing all the fingersticks, vitals, bed baths and linen changes, etc. While this is not ideal, either, it does protect you from having to muddle thru an independent patient assignment.

Funny how it never goes the other way. If you were short in L&D, I guarantee no other specialty would be forced to come fill your shift.

I was a NICU nurse with no other clinical experience, when I got pulled to oncology. I was wearing baby-themed scrubs and had almost every family comment on my attire. I told them flat out I was pulled and had no experience in adult health, let alone oncology. The charge nurse had some explaining to do to her long-term patients and families. I never got "invited" back.

Our OB units had an on-call system to cover our own staffing needs, and we finally raised enough hell that we were no longer required to float outside of OB. And frankly, any hospitalized patient is sick enough these days to warrant a specialized nurse or his/her care.

[LibraSunCNM, BSN, MSN, CNM]

And frankly, any hospitalized patient is sick enough these days to warrant a specialized nurse or his/her care.

This. Med/surg is becoming more and more acute every day. They simply can't float you to units where you haven't been fully oriented.

[Gary Mendoza]

As a nurse you can absolutely refuse an assignment, anytime and anywhere. I've refused ICU assignments (I'm an ER nurse) and I've refused patients too. I had two ICU patients and two other patients and when the charge tried to give me report on another patient I told her I wasn't accepting the patient because of my current patient load, she got pissed and threatened to write me up for insubordination. I told her to go right ahead and write me up, but I wasn't putting someone's life in danger by overloading myself... I never got the write-up and I ended up staying there 3.5 years all together and that happened early in my time there.

Remember, it's your license at risk and you have every right to refuse an assignment and a patient, BUT they also have every right to fire you unless you happen to live in a state with good labor laws, which I don't.

We are nurses, we are not slaves that just do what we're told. We must critically think, and if a nurse is telling you they can't handle it most likely they can't; and administration needs to learn to listen to that, instead of worrying about budgets and bonuses.

[cccnas]

I think if they expect you to take patients in a med surg floor then they should adequately train you for it. It is unreasonable to expect you to adequately function in an area that you have not practiced in. Now if it is gyn patients I can see that but not the general medsurg population

[JackieShorter]

This was a big concern for us as well. We complained enough where they stopped doing it. but with that med surg nurses arent allowed to float to help our unit either. when they were there they only took care of mothers as well. I would as a whole voice your concerns repeatedly. They will either stop doing it or offer the proper training.