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Discussion

Should a telemetry nurse be expected to float to a critical care unit?

Should a telemetry nurse be expected to float to a critical care unit?

Why or why not?

Should a telemetry nurse be expected to float to a critical care unit? 56 members have participated

  1. 1. Should a telemetry nurse be expected to float to a critical care unit?

    • Yes. No problem.
      6%
      6
    • Absolutely not.
      39%
      35
    • Maybe: cite the conditions please
      52%
      46
    • Other: please share your thoughts
      1%
      1

Please sign in or register to vote in this poll.

Featured Replies

Only if the tele nurse has been cross-trained and is not assigned to the sicker pts.

  • Author
Only if the tele nurse has been cross-trained and is not assigned to the sicker pts.

By "cross-trained" do you mean oriented to the unit? Or trained specifically to critical care in addition to telemetry?

I have seen tele nurses floated to ICU on very rare occasions. Usually it is someone with ICU experience in the past, and they usually take patients that are tele overflow to the unit, or stable patients scheduled to come up to the floor within the next 24 hours. There is also usually a lot of support given.

Only if the tele nurse does not have an assignment. If the nurse is there to assist the nurse, but not be responsible for ICU patients.

Our Tele Nurses ARE the ICU nurses, so I guess I'm not a good one to weigh in on this question!

yes, if the nurse has icu experience and has been oreinted to that unit.

[color=#483d8b]yes, even if the nurse doesn't have icu experience, but is taking patients awaiting a room on the floor.

[color=#483d8b]yes, even if the nurse doesn't have icu experience, but is doesn't have an assignment and is doing things like dressing changes, blood sugars, etc: things they have an established competency with.

[color=#483d8b]i'll even go out on a limb and say that they should float in "emergency" situaitons where they are the most qualified person to be taking that assigment. as the nurse, i'd be mighty ticked, but trying to see it from a different perspective (that of the supervisor) i can see where sometimes you have to make decisions that look stupid, but it is the best you can do. and as that nurse, i'd that that assigment "under protest" and probably start looking for a new job.

[color=#483d8b](when i was in school, i worked as a secretary in a small hospital. one night, our icu was full [which was extrememly odd], and they didn't have enough nurses. one of our house supervisors, who was a former tele nurse [no icu experience], was told she had to float to the icu and take an assignment that night. she did -- she was pretty unflappable -- i don't remember anything bad happening. i do remember her saying "wow, i've never taken care of a patient on a vent before." )

[color=#483d8b]i'd say "no" in all other situations. you just can't "cross-train" a tele nurse to icu. they have to work there for quite a while before they can master the stuff you need to know in icu well enough to just do it occasionally. in other words, there is a big difference between "cross-training" and "orientation." cross-training is for someone with a similar skill set to go pick up a variation of skills in another department. such as ccu to msicu, or icu to er. cross-training doesn't imply a very in-depth orientation -- more of a "this is how we do this here, and this is why."

When I did tele I floated to ICU all the time. We got a 2-3 pt assignment and it was always the stable non vented pts.

  • Experts

My telemetry unit was combo Tele/Resp so we got all the stable vent dependent patients. I was floated to CCU/ICU when their acuity high or staff callouts and assigned least critical pts.

Remember one night reassigned to ICU in 79when just me and NA for 8 pts---course that was days when we only had 4 bedside cardiac monitors and no Swan's/Pumps/A-lines; I was deemed most knowledgeable person to fill-in--as LPN, however in RN program. No orientation, except by the NA where equipment located. Stupid to accept assignment YES, unaware I should have declined.

Orientation should be part of formalized float policy and staff given opportunity to be cross trained if they desire ---to groom future critical care nurses.

Whenever you are floated to an area/ specialty that you are not fully qualified for be very cautious about accepting a patient assignment. Remember it is your assessment of qualifications that count when accepting an assignment not the employer in the guise of a nurse supervisor. It your ability to practise nursing in the future that is in jeapordy. The BON will not accept as an ecuse that my employer gave me the assignment.n It will simply state that you should of refused and then suspend or revoke your liscense.

Better to be disciplined for refusing an assignment then lose the abiltiy to earn an RN salary.

  • Author
When I did tele I floated to ICU all the time. We got a 2-3 pt assignment and it was always the stable non vented pts.

Maybe it's the semantics that confuse me, but if the patient is stable, why would they remain in a critical care unit?

In California both the RN accepting the assignment and the manager assigning that RN are held accountable.

I wouldn't refuse to float but would refuse to be assigned to patients in peds, post partum, or other area for which I don't have the education and experience.

From the BRN:

...It is the RN's responsibility to determine whether she/he is clinically competent to perform the nursing care required on the new unit or with the new patient population. If the RN is not clinically competent to perform the care, she/he should not accept the patient care assignment. The RN may accept a limited assignment of nursing care duties, which utilizes his/her currently existing clinical competence...

...Nursing administrators, supervisors, and managers have a crucial responsibility to assure appropriate and competent nursing care to patients/clients. The BRN requires nursing administrators, supervisors, and managers to only assign patient care to RNs who are clinically competent. Nursing administrators, supervisors and managers may have their licenses subject to discipline if they do not ensure assignment of clinically competent RN staff....

http://www.rn.ca.gov/practice/pdf/npr-b-21.pdf

Maybe it's the semantics that confuse me, but if the patient is stable, why would they remain in a critical care unit?

Because tele bed in not available yet.

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