Staff Management And Nursing Assignment

[LisaCam]

I work in ICU and Our manager is trying to cross train tele or DOU nurses to work in ICU as needed. I think it’s unsafe and create lot of drama since those nurses who are cross trained would not want to go back to their home unit. It’s also not safe for some body who just got trained to go back and forth between ICU and tele or DOU. I think becoming a safe ICU nurse takes time and experience. The management just wants to control nurses without having to create new positions. I just need more arguments. What do you think?

[Nurse Beth, MSN]

The most important thing is to match the nurse's competencies with the patient's needs.

For example, in our ICU tele level patients are often held up from transferring out because there's no available tele beds. So having tele nurses float to ICU and manage these patients is better overall than an ICU nurse going heavily out of ratio.

[JKL33]

A big problem is demonstrated in @Nurse Beth's and @JBMmom's posts. Nurse Beth describes a very reasonable approach. JBM describes what I bet many of us have directly witnessed where there is a great (or at least viable) starter idea and then, against all reason, it is decided to drive the idea straight off the rails.

Further, the choice to defy logic and human capability adds a great deal of mental and emotional distress that is difficulty to qualify. It's one thing to ask people to try something while fully acknowledging that the group will need to (and will be allowed to) make tweaks and improvements along the way. It's completely another thing to choose something ethically wrong and completely irrational and then blame and get mad at everyone else for not being able to do it and/or not liking your idea.

[Nurse Beth, MSN]

3 hours ago, JKL33 said:

It's one thing to ask people to try something while fully acknowledging that the group will need to (and will be allowed to) make tweaks and improvements along the way. It's completely another thing to choose something ethically wrong and completely irrational and then blame and get mad at everyone else for not being able to do it and/or not liking your idea.

Righty...and come up with poorly thought out plans without asking for  bedside clinicians' input. Nurses know what will work and what won't work.

[Music in My Heart]

Well...

Some ICU players are pretty soft and require "intensive" care rather than "advanced" care; and that's an important distinction. An expert nurse off of a tele unit can reasonably be trained to provide care for some of those lower acuity patients. Provided, that is, that there is a mechanism in place for an expert consultation readily available at all times.

As with most things, it's really in the details and implementation.

[JBMmom, MSN, NP]

1 hour ago, Music in My Heart said:

Some ICU players are pretty soft and require "intensive" care rather than "advanced" care; and that's an important distinction.

For sure that's true, but they're a soft assignment for PROPERLY trained ICU nurses. And the problem with assigning those patients to a float nurse is that they're most likely to be moved out of a unit, and then they're open for an admission, which could be anything. And again, our unit works pretty well together and I think we support floats/new nurses pretty well, but to choose to float in untrained nurses when we were already short was a disservice to everyone. And I foresee this happening only in the least ideal of circumstances, like those that we were experiencing. For example, five nurses for 12 patients with eight on strict precautions means that the likelihood of finding someone to consult is small. If a doctor determines that a patient needs ICU level of care, they deserve an ICU trained nurse, and a nurse deserves the proper training for any environment in which he or she is expected to practice.