[sasperger]

Just curious if ICU nurses are being pulled to general floors? We are trying to set up a standard to prevent this from happening, just trying to get some feedback. Thank you.

[All41]

Usually when a nurse is pulled to another floor, she is given the worst assignment there. They usually have no idea what is happening and accept the assignment before knowing what they are getting into. Being cross-trained is going to become necessary as our economy worsens and the supply of nurses dwindles. I would suggest that nurses seek to cross-training before being madet to. Several of our PACU nurses work in the ED and OR. If you are in the planning stages then PLEASE plan ahead and don't thrust this on staff. Get them involved in the process. Ask them where they might want to cross-train. Offer an afternoon shadowing a nurse from that unit in order to get a feel for the specialty. Start an inservice program for nurses who want to cross-train and offer an hourly compensation to work off the regular unit. Don't be penny wise and pound foolish. You get out of something equal or better that which you invest when it is with people. [img]/ubbthreads/images/graemlins/smile.gif[/img]

[traumaNERD]

Why is it a problem for ICU nurse to be pulled to general medical floors? I would see a problem if a med/surg nurse were pulled to work in the ICU. Granted, it is not an ideal situation to pull a nurse from one unit and float them to another. I guess I am just having trouble understanding the point of this particular thread.

[TracyR]

I am an ICU nurse, and yes, we sometimes get pulled to other floors, and yes we sometimes get the worst assignments, and yes we are sometimes left in the weeds by the staff on those units... but think about it;

Are we not some of the more higher skilled nurses? Not better, mind you, just equipped with a broader skill mix? And with this broad skill mix, and expertise, are we not better able to handle the worst assignments?

Sure, I would rather stay on the unit and care for the more critically ill patients, but we are all in this thing together, and personally, I really don't mind lending a hand where it is needed... if indeed it is truly needed.

Now, if I am sent to another unit just because some staffing idiot just can't see the forrest for the trees, that's a different story all together. In any case, the other nurses will appreciate my assistance, and I am always grateful at the end of the day that it is not me in that hospital bed.

[bluesky]

Hi all.

The problem is this: When they pull ICU nurses to the floor, they are assuming since the ICU nurses are so skilled, that they are teh jack of all trade nurses and can handle anything. The is true in the sense of one sick patient - ICU nurses are very much skilled in the situation of one or two sick patients.
Being pulled is ok when you have had the experience of 6 patients who are minimally sick. BNut when a nurse started in teh ICU out of school they are not experienced in the floors. To have 6 patients who are only minimally sick, and need 50 pills each, it is something taht they are not experienced in. That is where the problem arises. ICU nurses should stay where they are trained, and floor nurses whould stay where they are trained. At least they should try to only send ICU nurses with floor experience.

[TracyR]

Well put, bluesky.

[medi]

Hi Sasperger,
Are you having any success preventing your ICU nurses being pulled to unfamiliar floors?

I think "pulling" is a terrible policy & wish something could prevent it alltogether. First of all it's very demoralizing to the staff affected by such policies because they accepted a job in one particular practice area & then come to discover that they are subject to being forced to work in all sorts of unfamiliar settings without notice.

That can give a person a sinking feeling and a dread of going to work!

While it is true that ICU Nurses are the greatest when it comes to handling the care of their ICU patients that doesn't mean they should be expected to walk into an unfamiliar unit and smoothly take on caring for a mixture of patients with all sorts of different medical conditions, unfamiliar doctors, different charting, unknown routines and supply areas.

Think about it.. nurses who routinely work those floors get an orientation to the unit- they aren't just thrust in one day & told good luck!

To a nurse used to working with one specialty set of patients (in this instance ICU patients) it can be quite disconcerting to suddenly be confronted with patients who need various types of preps for this or that that the nurse may not be at all familiar with.

How would an ICU nurse (or OR Nurse, or NICU Nurse) know offhand what prep to give to someone getting a GI series for example? Think about the differences in charting even! Lots of difference between charting in the ER or ICU, or OR than on a floor. I'd say pulling nurses around is a lose-lose situation for the patients and the nurses.

The hospital should put more effort into building up a larger base of per diem or pool nurses to call in to fill staff shortages and not pull nurses around in my opinion.

It's putting your license at risk and your morale in the dumpster! Pulling policies suck.

There.. not elegant but that's my opinion about forcing nurses to work unfamiliar units. Best of luck stopping administration from doing it! Let us know how it's going please?

Sara

[Latinanurse]

I for one am way more concerned with floor nurses pulled to the ICU. It is dangerous and fits the mentality of "a nurse is a nurse" Would a medical supervisor demand a cardiac surgeon perform brain surgery just for one shift? any thoughts?

[medi]

I'm with you Latinanurse.. it outta be illegal

[CCRNMaui]

Hey all,

This is my first post on this website, so bear with me.

I've been an ICU nurse for about 8 years now. And that's all I know. Give me a Swan, Balloon Pump, SVO2 monitor, and Levo, Dopamine, and Dobutamine...and I'm set. ICU was my first job out of nursing school and I love it. I knew it was what I wanted to do from the start. I was even a PCT in the ICU for two years before starting in that same ICU.

Now, I don't have a clue what the theraputic Aminophyline or Lithium levels are unless I look at a book. Not an every day thing in the ICU. I don't usually give 20 oral meds to one patient in a shift, let alone giving that many meds to 6-7 patients.

My charting consists of extemely detailed, sometimes minute to minute changes, especially for new open hearts or transplants.

So I tell you, when I float to another unit that doesn't have q1hour vitals as a standard, or the lovely chime of a vent or balloon pump in the background.....I'm lost.

I'm all for helping out our fellow nurses, but understand that when you get an ICU nurse in a floor setting like me...Expect a novice!!! ICU nurses have a different mind set all together. Floor nurses are probably the most organized nurses I've ever seen. How they handle 6-8 patients, I have no clue. True they are more stable, but that's just the point. Even the stable ones in ICU get ICU care...please tell me if I'm wrong.

SO, In a nutshell, I'm not completely against floating if it is in dire need, but I may be more of a hinderance than help because I'm not afraid to ask questions or for help if I really need it.

And besides all that, most of us went into our specialties because that's what we wanted to do. If hospitals are expecting nurses to know what to do when floated to other units, don't you think there should be a little float bonus attached to the hourly pay? (I used to be an ICU manager also and tried to push admin into giving a float bonus...almost brought the nurses to agency pay) Just a thought. Keeps our nurses in the hospital, gives them an incentive to learn something about other units, and cross trains nurses to be more proficient in other settings of the hospital.

Sorry, my thoughts are all over the place. But that's all I have to say about that....