Unsure About Position: Critical Care Float Pool RN (+ ED)

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Unsure About Position: Critical Care Float Pool RN (+ ED)

I just recently took a new job as a Critical Care Float Pool RN and in this position I would  be able to float to the Critical Care units as well as the ED. I have experience in both areas. I was excited about the opportunity to work in both departments. It would give me the skill set and the variety that I need to maintain job satisfaction in nursing. 

I was informed by a few of the employees who work at my job that the critical care unit is always understaffed even before Covid hit. I know that as a float nurse I will be sent to the unit where I am needed most.

I have been doing ER for several years now and I can't possibly see my career going forward without having the opportunity to work in the ER on consistent basis. I also enjoy working with kids and dealing with pediatric emergencies. The ER at this facility has a pediatric ER but they have dedicated pediatric ER nurses who will always staff that area, so it will be very rare that I get a chance to work in pediatric emergency area. 

My other concern was that when I began the job they only wanted to give me the BARE minimum orientation and when I expressed my concerns about wanting more orientation, my manager seemed somewhat resistant to that idea. 

As soon as I finished my Critical Care orientation and began orienting in the ED they wanted to completely pull me off orientation and have me fill shifts in the Critical care unit. Their excuse was they really needed help and wanted me to finish my ED orientation at a later time. They were successful at that. 

I am just worried that I won't ever get the chance to work in the ER as it seems like ICU will always need help no matter what. The ER is almost always staffed and even over staffed some days. 

I took this position believing that I'd be working in both areas but I see that's not going to be the case at all. I was told in my interview that I'd be floating to both departments. I kind of feel a little bummed. I don't want to leave because I know they need my help but I don't feel satisfied with this job at all. 

What should I do? I need some advice. 

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Don't get me wrong I also love the Critical Care as well. 

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Let your supervisor know that you accepted the position for the aforementioned reasons and that you are looking for that kind of arrangement. I honestly don't think that's asking too much.

If they can give some sort of reasonable timeline for the current situation of only being needed in the CCUs then it makes sense to hang in there as long as you can at least briefly be re-oriented to ED when the time comes that you will be going down there more regularly. You aren't going to forget the basics, but if you're gone for 6 months there will probably be dozens of more protocols and "work flows" and EMR tweaks and expectations and other changes.

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On 1/13/2021 at 12:14 AM, CowgirlHippy said:

I just recently took a new job as a Critical Care Float Pool RN and in this position I would  be able to float to the Critical Care units as well as the ED. I have experience in both areas. I was excited about the opportunity to work in both departments. It would give me the skill set and the variety that I need to maintain job satisfaction in nursing. 

I was informed by a few of the employees who work at my job that the critical care unit is always understaffed even before Covid hit. I know that as a float nurse I will be sent to the unit where I am needed most.

I have been doing ER for several years now and I can't possibly see my career going forward without having the opportunity to work in the ER on consistent basis. I also enjoy working with kids and dealing with pediatric emergencies. The ER at this facility has a pediatric ER but they have dedicated pediatric ER nurses who will always staff that area, so it will be very rare that I get a chance to work in pediatric emergency area. 

My other concern was that when I began the job they only wanted to give me the BARE minimum orientation and when I expressed my concerns about wanting more orientation, my manager seemed somewhat resistant to that idea. 

As soon as I finished my Critical Care orientation and began orienting in the ED they wanted to completely pull me off orientation and have me fill shifts in the Critical care unit. Their excuse was they really needed help and wanted me to finish my ED orientation at a later time. They were successful at that. 

I am just worried that I won't ever get the chance to work in the ER as it seems like ICU will always need help no matter what. The ER is almost always staffed and even over staffed some days. 

I took this position believing that I'd be working in both areas but I see that's not going to be the case at all. I was told in my interview that I'd be floating to both departments. I kind of feel a little bummed. I don't want to leave because I know they need my help but I don't feel satisfied with this job at all. 

What should I do? I need some advice. 

Out of curiosity, what state are you in? This seems to be happening a lot in my area (Southern California).

Anyway, maybe "float nurse" is not the best position for you if you have strong preferences ...but right now, it seems like everyone is floating everywhere. Things are just that chaotic.

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31 minutes ago, Sour Lemon said:

Out of curiosity, what state are you in? This seems to be happening a lot in my area (Southern California).

Anyway, maybe "float nurse" is not the best position for you if you have strong preferences ...but right now, it seems like everyone is floating everywhere. Things are just that chaotic.

I’m in Massachusetts. And yes I agree with you that maybe being a float nurse isn’t right for me. I just love working in both areas but I just feel deceived in what I was told in my interview to what I’m experiencing now. I just can’t help that I feel dissatisfied. I guess I just need different opinions to help me with my decision going forward. 

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Specializes in Pediatrics, Pediatric Float, PICU, NICU.
8 hours ago, CowgirlHippy said:

I’m in Massachusetts. And yes I agree with you that maybe being a float nurse isn’t right for me. I just love working in both areas but I just feel deceived in what I was told in my interview to what I’m experiencing now. I just can’t help that I feel dissatisfied. I guess I just need different opinions to help me with my decision going forward. 

I would keep in mind that right now you are entering a float position during peak respiratory season AND during a pandemic, so I am not surprised that you're spending more time in ICU at the moment. As a float nurse, I always found myself in critical care units during respiratory Winter season far more often, but found myself evenly distributed to the other areas during non-respiratory season. 

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Specializes in New Critical care NP, Critical care, Med-surg, LTC.

I understand that the job may have been described differently, but if the actual title is Critical Care Float RN, I would think that the primary goal is to cover the critical care units, and the emergency department aspect of the job would be a secondary responsibility/benefit. I'm sorry that it's not working out as you had hoped, you mentioned that the critical care was short staffed even before COVID, so it sounds like that would be the primary coverage area for your position. And as someone with experience in both areas already, I'm not too surprised that you weren't offered a long orientation. For our float pool staff, if they are already experienced, two days on each unit is about all that is offered. 

Sounds like you are really looking for an ED position. Only you can decide whether it's worth it for you to stay in this position for a while or you should start looking elsewhere. Good luck with whatever you decide.

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Specializes in school nurse.

If it's a hospital system with long-term potential for your career, you may want to rough it out until COVID is under control then make a move (if you still need to).

Is your schedule such that you could get an ED per diem job somewhere in the meantime?

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Specializes in CRNA, Finally retired.

Always get a contract in writing.  For now, it might be reasonable to have in the contract ER for a certain number of days in each month because you WERE hired as a Critical Care Float.  Everything is upside down right now but I don't think it's unreasonable to insist in a minimal number of shifts in the ER.

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Specializes in ICU/community health/school nursing.
On 1/13/2021 at 12:14 AM, CowgirlHippy said:

I just recently took a new job as a Critical Care Float Pool RN and in this position I would  be able to float to the Critical Care units as well as the ED. I have experience in both areas. I was excited about the opportunity to work in both departments. It would give me the skill set and the variety that I need to maintain job satisfaction in nursing. 

I was informed by a few of the employees who work at my job that the critical care unit is always understaffed even before Covid hit. I know that as a float nurse I will be sent to the unit where I am needed most.

My other concern was that when I began the job they only wanted to give me the BARE minimum orientation and when I expressed my concerns about wanting more orientation, my manager seemed somewhat resistant to that idea. 

YEP. That's ICU, although it may be worse now with COVID than it was when I was in the ICU preceptoring "training class." There is simply too much to know and outside of training on cardiac rhythm and interpretation and memorizing some oft-used drugs....you may be on your own.

You didn't ask this but: Critical care (ICU/Telemetry/what have you) and ER seem to have a lot in common but they don't really. One is about juggling and managing the complex needs of a set of patients whom we know are sick, and the other is about juggling many more patients to find out who is sick and who can get out of here and go see someone else.

Mr. Ruby Jane was an ER nurse the first decade of his career and while his skills are still excellent, he does not know how to prioritize care. While I was an ICU nurse for the first year and I can prioritize care but when I have an emergency I literally have to reach waaay back and it all comes down to circulation/breathing/airway anyway.

SO - perhaps you are feeling that push - that you like the ED setting and rhythm more than you like "critical care?" Just a thought. A previous poster advised that you give the gig a little time and once we're out of the COVID swamps things may be better.

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On 1/13/2021 at 9:25 AM, Jedrnurse said:

If it's a hospital system with long-term potential for your career, you may want to rough it out until COVID is under control then make a move (if you still need to).

Is your schedule such that you could get an ED per diem job somewhere in the meantime?

I really don't want to work the extra hours because I am really afraid of getting burned out again. If I ever get to the point I will just leave nursing altogether. I agree with you that maybe I should just try to stick with the gig until covid cools down and see what happens. I will try my hardest....

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On 1/13/2021 at 10:48 AM, ruby_jane said:

YEP. That's ICU, although it may be worse now with COVID than it was when I was in the ICU preceptoring "training class." There is simply too much to know and outside of training on cardiac rhythm and interpretation and memorizing some oft-used drugs....you may be on your own.

You didn't ask this but: Critical care (ICU/Telemetry/what have you) and ER seem to have a lot in common but they don't really. One is about juggling and managing the complex needs of a set of patients whom we know are sick, and the other is about juggling many more patients to find out who is sick and who can get out of here and go see someone else.

Mr. Ruby Jane was an ER nurse the first decade of his career and while his skills are still excellent, he does not know how to prioritize care. While I was an ICU nurse for the first year and I can prioritize care but when I have an emergency I literally have to reach waaay back and it all comes down to circulation/breathing/airway anyway.

SO - perhaps you are feeling that push - that you like the ED setting and rhythm more than you like "critical care?" Just a thought. A previous poster advised that you give the gig a little time and once we're out of the COVID swamps things may be better.

I am not going to lie, I do favor the ER a little more than critical care however I don't want to give up critical care at all. Critical care keeps me fine tuned with my critical thinking skills, pathophysiology of various diseases, ventilators, drips etc.... So I love both areas but I need to work in both consistently in order stay satisfied with my career in nursing. I can't just work in one area and not the other. But I agree with you as well, that I should give it more time and see how it goes. I am trying to remain hopeful. 

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