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

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

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

56 members have participated

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

Why or why not?

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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Specializes in Utilization Management.

Thanks for the clarification. :)

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Specializes in Corrections, Cardiac, Hospice.

I am going to weigh in on the Maybe side. When I was at the hospital I would occasionally go to CVIC to help out in a pinch. I would only take the open hearts that were off vents, stable and ready to transfer to PCCU. OR I would take a thoracotomy. I would NOT feel comfortable taking a fresh open heart or one that wasn't stable.

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Yes...as long as they are given appropriate patients. If appropriate patients aren't available (i.e. on vents, diprivan, icu gtts, etc.)...they should still float, but only as "helping hands". I've had to do that when the entire ICU was vented, and I was bored, but I was comfortable and the nurses found me to be a help. :)

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

1. If bed on floor not ready

2. If you are still waiting for the okay from the 22 consultants on the case to move pt out of icu

3. If pt family is having a fit about pt moving out of icu

4. If attending is nervous about moving a pt out of icu

5. If pt is on Ativan protocol for alcohol withdrawal, and is almost done. At my hospital, the floor won't take them while still on the protocol

6. Any number of other stupid things.

Oldiebutgoodie

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Specializes in er/icu/neuro/trauma/pacu.

Ideally a float would be lateral or previously experienced, then maybe the ER nurse-but ER can't give up a nurse, they are usually short anyway. A tele nurse should have basic knowledge of critical patients, since many tele patients were in icu just 5 seconds before they became a tele pt. Any ICU that was so short they needed a float nurse-really needs that nurse, and tele is probably the best choice for safe care. I am certain the assignment would be the most stable, or least likely to crump patients

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Specializes in ICU, Agency, Travel, Pediatric Home Care, LTAC, Su.

I will have to say that a tele nurse should be expected to float to ICU. Like some of the above posters have mentioned, if we, the ICU, ask for help it is because we desperately need it. What I have seen done in the past is that the tele nurse will have a quick tour of the unit, ie:where the supply room is, linen, code buttons, etc, and how to chart. Then, they should only be given stable patients that have floor orders. I have seen some ICU's give tele patients, "stable" patients that are still ICU patients, and I do not agree with that. Cause if sh** were to hit the fan, especially with the tele nurse having a ICU patient with no transfer orders, you know it would come up in court that the question would be asked, what qualifies you as a tele nurse to take care of the ICU patient? And the answer would be, nothing. Not good. I firmly believe that if the tele nurse is given a patient or two that have transfer orders they should be assigned a buddy. ie: An ICU nurse that they can go to ask questions to and what not. If the scenario is that, there are no transfer patients in ICU I would say, please send me the tele nurse anyways. They could float and help with turns, baths, starting IVs, answering call bells, blood sugars, etc. I will end this by saying I have no problem if a tele nurse they send to me doesn't feel comfortable taking an assignment. I would still have them there to help us out by floating, then not have them there at all.

Sorry if this is long winded, and doesn't flow the best, been up for a long time and I am very tired, but can't sleep.

Glad someone got this thread going!

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I don't think nurses should float outside their specialty areas for any reason ever. There is no reason that a unit should not be responsible for its own staffing and should be allowed to take nurses from other units. This is what on-call systems and nursing agencies are for, is it not? If a nurse wants to float/cross train, that is fine, but mandatory floating needs to be eliminated.

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Specializes in Critical Care.

From a board perspective, floating is normally considered an employment issue and not a board issue. As a result, most boards of nursing simply state that you must be competent to do the job asked of you by your employers and you bear responsibility for not accepting assignments that you are unprepared to do.

In reality, where I used to work when we did rarely float tele nurses into the unit, they either got all tele patients overflowed into the unit and waiting for a room on tele, or lower acuity patients. For example, at that time, DKAs on an insulin gtt were considered critical care pts because of the frequent blood glucose checks: the work was too time consuming to do with 5 other pts. So, a tele nurse COULD take care of this 'critical' patient because they were assigned to critical care not because of the complexity but because their care was too time-consuming to do with a high number of pts.

The bottom line is this: if you are being floated to CCU, they can't expect you to take pts that are beyond your experience. We would never have given a tele float, say, a balloon pump, or multiple titrating gtts.

~faith,

Timothy.

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Specializes in Utilization Management.

I have seen some ICU's give tele patients, "stable" patients that are still ICU patients, and I do not agree with that. Cause if sh** were to hit the fan, especially with the tele nurse having a ICU patient with no transfer orders, you know it would come up in court that the question would be asked, what qualifies you as a tele nurse to take care of the ICU patient? And the answer would be, nothing.

My thoughts exactly.

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1. If bed on floor not ready

2. If you are still waiting for the okay from the 22 consultants on the case to move pt out of icu

3. If pt family is having a fit about pt moving out of icu

4. If attending is nervous about moving a pt out of icu

5. If pt is on Ativan protocol for alcohol withdrawal, and is almost done. At my hospital, the floor won't take them while still on the protocol

6. Any number of other stupid things.

Oldiebutgoodie

All that plus this place didn't allow any nitro or cardizem gtts on tele.

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This may sound like a silly question but, what makes an ICU nurse different than a tele nurse? I am still a pretty new nurse (one year since graduation)so, I really don't know what I would/should say if the small hospital that I work at asked me to float to the ICU. I've had orientation to the three depts in this hospital...the two regular floors with vented pts and no tele and the ICU. We just opened a tele floor this past week and I was one of the first nurses to staff it. I have taken tele training, and been ACLS certified and the pts I had all ran normal sinus rythyms but, I will admit I was still pretty nervous to have an actual assignment on this floor. I am now wondering if there is other training and/or certification that I should have to agree to float. Now that I have started on tele, I'm sure it's just a matter of time before this comes up.

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