Refused to float without orientation ...Terminated

[SFnrs]

I recently accepted a travel assignment for an ICU position that turned out to be Trauma heavy (I have little experience in this area). I met with the director of ICU and we discussed my moving my contract to TCU. I was more than happy to do so. After completing my orientation of 2 shifts...I showed up ready to get to work. Approximately 3 hours into my shift I was told that I would be floating to a Med/Surg floor. I explained that I hadn't worked medsurg and hadn't been oriented. This was an 8 hour shift, so I told the charge nurse I didn't feel comfortable taking that assignment but would gladly go orient so I could be available for any future needs they may have. I also offered to float between the 2 floors and do admissions. I was told that I had to discuss it with the Nurse Manager who they got on the phone. I again explained that going from ICU to TCU then to Med/Surg without orientation in one week was too tall of an order for even the most seasoned of nurses. I was very respectful and even used the words "I mean no disrespect but no prudent nurse would take an assignment without having been oriented to a floor." I also asked him what he would do if someone asked him to work a floor he hadn't had experience with in 9 years without orientation. His reply.... "turn your pts over to the nurse following you and you wont be coming back here or to ICU."I mean When this all started I called my recruiter and did so a couple of times throughout the evening as this situation unfolded. The next day I received my termination notice and the nurse manager blatantly lied...he said that I refused to float and that HE offered me the chance to do admissions and I said NO!!!!I cannot describe how shocked I am. The night supervisor who was in attendance when this all took place knows the truth as I asked her directly if I could do admissions. My problem .... I find myself over a thousand miles from home with no job! I need some advice!

[79Tango]

I understand both sides of the argument and of course the organizational skills are different. I was speaking from the management side of getting called 3hrs into an 8hr shift because someone was refusing to go help out on a lower acuity floor. Someone that was new & who we already accomodated by letting them move to TCU when we needed ICU. I think what got me was this statement to the manager:

"I again explained that going from ICU to TCU then to Med/Surg without orientation in one week was too tall of an order for even the most seasoned of nurses."

I thought you went through 2days orientation and showed up ready to work? If you would told me something along the lines of "I will do it, but I am telling you I havent worked it in 9 years" than fine. But offering me the consolation of willing to "orientate" wouldve been a No Go. Best to not waste anymore time and call the agency for a replacement.

[NedRN]

Yes, 2 days orientation is more than sufficient for the experienced traveler in their area of expertise. But focus on the "without orientation" part of your bolded quote. That is the relevant part, and I fully agree (as did the hospital). Foolish move on the part of a manager who was likely not trying to fill an urgent need on the floor, but trying to extract the full value out of a traveler on a unit with low census. A good manager would have recognized a heaven sent opportunity to give a better orientation to the TCU without the mentor being overwhelmed by the census.

[NedRN]

@79Tango: are you by chance a manager? You also seem unfamiliar with travelers and are speaking in the third person.

Calling the agency for a replacement is not practical in most locations. For example there are no per diem agencies where I'm working for rapid contingent staff and it often takes a month to get a traveler anywhere. A good traveler is the next best thing to regular staff for continuity and good patient care. Rapid shuffling of random per diem nurses with less orientation is the last option. Again, I wouldn't want my mother going to such poor management. In addition, the word gets out with travelers, and good travelers will avoid such hospitals. Then the bill rate goes up. Beginning to understand what poor versus good management means? Ultimately, it should be about patient care, but good management means lower costs as well through better practices and improved retention.

In this particular instance, management wisely recognized their error. I'm not sure why you are having trouble with this.

[79Tango]

Whose having trouble? My point about the bolded quote was more about the OP telling the manager "they gave too tall of an order for even the most seasoned of nurses."

That is a pretty bold statement coming from someone that has not been proven a "good traveler." Nobody was talking about "rapid shuffling of random PerDiem nurses" either. Stuff happens & we simply do not have the luxury of coaching, developing, mentoring travelers. Im not saying that we dont help out, get people up to speed and accomodate travelers. They just need to be showing promise and willing to work.

[NedRN]

But it is an accurate statement no matter the messenger. If you want to can the traveler and get a replacement, rapid shuffling of registry nurses is what you are going to get - or no one.

Who the heck is "we"? This is a traveler forum. You still haven't identified what you do but it sure doesn't sound like you know nursing. If you think a simple weeklong orientation of an ICU nurse to the floor (same as typically provided for an experienced floor nurse traveler) is a luxury, I hope you are not in charge.

[EmergencyNrse]

I'm sorry about your predicament but I'm advocating for the facility. Not that

I agree with the nursing supervisor that lied but that you were ill-prepared for the assignment.

Many nurses I run across want to travel but they just don't have enough experience. I have sad this before: You absolutely have to be comfortable in your skills in order to travel. When you sign a contract you have to posses the skills and experience to hit the ground running. These facilities don't have the time to baby you. They are hiring you for the whole package. I wouldn't have invited you back either.

Kaiser does this all the time. Hire you in for a critical-care area and float you down to the areas they are really short. The really $#!tty jobs too they cant fill with travelers even if they advertised for them- Neuro, Tele, Med-Surg. You might rock in ICU but you don't have enough experience to be a traveler.

[NedRN]

I work in the OR. Traveling now for 17 years. But I guess I don't have the experience to travel by your definition. Can you float to the OR with no orientation? I have an ER traveler friend (guessing you are ER by your name) who has been traveling over 10 years. Never been floated to med-surg. ICU yes, after orientation.

Kaiser asks about floating in their interview, and skills lists and work history will reflect appropriate skills.