It was my time to float the other night and I was to float to pediatrics. No way Jose!
I have never felt comfortable with children and my specialty has always been with the adult population.
I stood my ground and refused pediatrics.....they said my assignments wouldn't be that bad - 3 infants and 2 older kids - NO! THE ANSWER IS NO!
I would rather be budgeted home that work with kids.
If I was a patient on an adult unit I would not want a neonatal or peds nurse caring for me after a major procedure......I think its safe to say that a child would feel uncomfortable in the hands of an adult nurse.
Sorry if that offends peds nurses, but i can't and i wont work peds.
That's crazy. Safety for the patient and your license means that you stay in your own area of expertise, I am an adult med surg nurse and would NEVER feel comfortable caring for infants and kids... I don't know the meds, the safety issues, etc.
I float to med surg. Not ICU, not ER, and would never consider peds.
You did right. I don't know why your hospital thinks it's safe. Did they put you through peds training? (and therefore you're qualified?).
Had you floated, wonder how the parents would have reacted if they found out you were not a peds nurse! Even with an interest in peds, I would have been scared to float without the proper training. Shoot, I still listen to my niece's HR & resps just to practice counting!
As a pediatric nurse I thank you. I absolutely think you did the right thing. In previous hospitals I've worked in, if a non pedi nurse floated to us they got adolescents only and patients that had straightforward problems like dehydration/vomiting. They were not allowed to care for anyone under 12. I think 5 patients on a pedi floor is a lot anyway, especially to have three infants not knowing if the parents were there or if you'd have a nursing assistant to help you feed them. The average ratios in places I worked were 3:1, max of 4. I also think it's dangerous because children are not little adults. They're issues are generally different and unless you really know how children compensate it's hard to detect small changes...which is vital when working in pediatrics, because they compensate and compensate until they don't and when they go down it's hard and fast. In the adult world a RR of 60 and irregular could end up buying them a tube, in the peds world it can be totally normal. I disagree with anyone who says you should've floated. Yes, the world of nursing is ever changing and adjusting, and yes it's good to learn new skills and specialties, but there's a difference between floating to another specialty adult floor and taking care of three sick babies and two adolescents. What's next, you'll be expected to float to L&D and take an easy assignment there? "But you'll only have to catch two babies!"
As a new (less than 8 months) nurse, with no other nursing experience than NICU, I was asked to float to pediatrics...and refused. When I tried to explain that a 15 year old appendectomy pt is in no way the same skill set as a NICU infant, I was told "Well, didn't you go to nursing school?". I stood firm that I am not willing to risk either my license or the life of the peds pts by going onto a unit about which I know nothing.
To try to get past this, I was given a chance to orient in peds. One shift. Then was asked to take a full load of 5 the next day. I of course refused. If the pedi nurses need 6 weeks of orientation when they start, I need no less than that...and certainly 1 night where I check vitals twice on 3 pts and hang 2 pb meds is not equivalent.
I was threatened with a "doom doom doom" MEETING WITH DIRECTOR *ahhhhhhhyeeee*, but still refused and went home.
Haven't seen the director yet, but she'll hear the same thing I said to the manager. Not worth my license, and not worth the safety of the kids.
Just curious, but are peds nurses floated to other units and expected to take a full load? I agree you did the right thing and wouldn't take that assignment either but wonder if facilities (or staff) that allow someone to refuse to float to a specialized unit also allow those in specialized units to refuse a float to a non-specialized floor.
My facilities will float anyone anywhere but the assignment is adjusted to acknowledge the lack of specific skills. If I were sent to a peds floor, I would have older patients or not have a patient load and instead "float" doing general tasks. Same is true if I were pulled to OB. In the ICU I'd get the most stable patients and in the ER I would primarily do transport and routine tasks (IVs, foleys, etc) rather than actual patient care. When nurses from these areas are pulled to my unit (tele) the same is true, they don't take the same patient load and don't work with the same expectations. 95% of the time this works. Every once in a while we'll get a slacker who takes an hour to enter orders or do a single chart check so they can avoid doing as much as possible but it's definitely not the norm.
Only advice my Mom(long time nurse) gave me when I graduated is: "you can always get another job, NOT another license". In 16 years of nursing I disregarded that once and it was nothing short of a disaster. Hang in there.
Believe me when I tell you this....we used to get floats from all over the house to our NICU (we floated EVERYWHERE) and we would be like....wow, you are not going to be any help at all....and we would do all the VS, meds and let them feed kids. The best was when I got floated to CCU....those nurses were like...are you kidding me??? Nope, hello, I am your help for the day. They sat me at the desk to watch the monitors and told me if they buzzed call someone. I felt awful that I couldn't even help them!
We only float within our services now, maternal child to maternal child, med-surg to med-surg, adult critical care to adult critical care. The only place that does not get floats or float is L/D.
Also, we have age limits set for peds...if we are NICU/baby we only get up to one year old. Peds can have older, adult critical care can go to PICU but they only take adolescents.
Good for you, that was good nursing. What get's lost by those who say you should
"Just go"- is the patient advocacy. Your responsibility to safely care for your patients should always outweigh staffing problems.
Floating is only 1 option, why not transfer patients to another hospital or call in registry, or hold patients in ER. If any nurse feels not competent on the unit-just refuse to go.
BrnEyedGirl, BSN, MSN, RN, APRN
1,236 Posts
I too am suprised they ask you to float to peds. I work ER so yes I do work with kids, but I would never be expected to float to peds or L&D!