What Are Our Rights...

[MochaRN424, ASN]

Hello, I have been a nurse for 17 years and a MBU RN for 11. Our unit is constantly being floated to the NICU, L&D and OBGYN. While we are left to handle it when we have 4 couplets no tech. The worst for me is both L&D and NICU. I do not see how supposedly being certified by completing the NeoNatal Resuscitation Program is supposed to properly prepare a nurse to act in an emergency for such a delicate population. Recently there was a situation that was all over the news. Now the expectation is for us MBU nurses who normally care for well babies to now take classes in how to care for fragile babies? They are indeed fragile but because they are understaffed and under the spotlight this is what it has come to. I don't need anyone telling me get another job because I've been trying as I have become anxious over the last 3 years. I want to know has anyone else been in a situation where management is forcing nurses to float to areas where they truly don't feel comfortable or qualified? The most recent for the NICU they made it mandatory that everyone has to be a charge and have a full assignment. Quite a few nurses have quit I'm trying to figure out what Im doing wrong. Speaking to peers there isn't much out here as they too have been looking. I can't afford to up and quit without something else but God forbid if my license is lost then what?

[heron, ASN, RN]

There are no good answers unless you have a union and a written contract.

Professionally, according to my BON, we are required to refuse assignments for which we are not trained. (I did this when a facility attempted to float me to ICU where I had neither training nor experience.)There are, as far as I know, no actual laws against the practices you describe. Your employer has the right to define your job description, so without a written contract, you're stuck.

May I suggest asking your BON or an attorney familiar with nursing malpractice law for the safest way to proceed. Meanwhile, check out  nursing agencies.

There is no magic bullet. Your choices are: get the training required to be competent in those areas, refuse the assignment and take the consequences, or remove yourself from the situation altogether.

[Spiker, ASN, RN, EMT-P]

 I'm retired after 40 years now, but as an evening shift OR RN, & a Paramedic, I often helped out in the PACU, ER, & ICU during "quiet" times.....so much so that I completed unit competencies for all 3 units.  However, I rarely had to actually work a full shift with a patient assignment in either of those units, mostly helping with VS, meds, starting IV's, helping with procedures, etc.  One afternoon I was greeted by our OR supervisor in the locker room as I changed into my scrubs: she told me I was taking a 12 hr shift in ICU instead!!  Not thrilled, but off I went.  Only to find out I had a 3 patient assignment!  A young kid, OD on a vent (pavulon!); a 55 yr old man, extending his MI (dopamine & NTG drips to seesaw back & forth), & a guy being discharged in the AM (mostly q2h assessments, & he slept all night).  I'm thankful the CNA's were awesome, but I still ran my butt off all night. Don't get me started on charting.  Anyway, while I didn't feel too "over my head", I felt pretty frustrated to have the patients I was given!  I told my supervisor to never do that to me again..... I'll help where needed, but such an assignment for a 12 hr shift wasn't really appropriate, imo.  Anybody else have thoughts about this? Am I wrong? 

[MochaRN424, ASN]

Dear Spiker wrong not at all. They say they are grateful for help but how is this appreciation shown? By dumping their worst cases knowing it is many times more involved. I could understand one challenging case but all 3? That was poor. 

[Spiker, ASN, RN, EMT-P]

MochaRN424 said:

Dear Spiker wrong not at all. They say they are grateful for help but how is this appreciation shown? By dumping their worst cases knowing it is many times more involved. I could understand one challenging case but all 3? That was poor. 

Thanks for the support; I'm afraid it probably happens more than ever now though.  So many units are short-staffed.  Even the OR has changed significantly.  When I started in the early 80's, we had 2 RN's & 1 ST for each room.  This helped with quicker turnovers, as well as help for more difficult cases.  We also gave each other meal breaks (I'm a scrubbing RN, loved it!).  Then as people left, so did the positions, for "budget" needs.  Be strong, everyone.  Do your best to learn as much as you can for each unit you may find yourself sent to!