[Ricu]

I think we're all saying the same thing; each unit DOES have its discipline specialty and those nurses have mastered it. Expecting a nurse to float into another specialty area and function like a "regular" is unreasonable. As others have put it, working under such conditions is dangerous. In ancient nursing history or at least ten years ago, floating nursing staff onto other units experiencing staff shortages was a practical way to address a temporary situation. Often perdiem staff fit those short shifts better because they usually were acquainted with the unit. In reality, getting them when they were available was luck of the draw. Specialties weren't so well established then and those core nursing skills got you through the shift. This solution just doesn't work anymore and the practice should be stopped. I'm not sure what the solution to the problem is but I think that staffing to the maximal nurse/patient ratio as a norm leaves you one sick call away from a crisis. Let's be reasonable - and safe- and allow a bit of breathing space in the nurse/patient ratio. I don't think the floor would end up with nurses sitting around reading the paper. Everyone would still be busy, maybe a little less frantic and certainly the unit would be in a better position to work with unexpected staffing shortages. Any thoughts?

R

[MagRedC5]

Originally Posted by Ricu

I think we're all saying the same thing; each unit DOES have its discipline specialty and those nurses have mastered it. Expecting a nurse to float into another specialty area and function like a "regular" is unreasonable. As others have put it, working under such conditions is dangerous. In ancient nursing history or at least ten years ago, floating nursing staff onto other units experiencing staff shortages was a practical way to address a temporary situation. Often perdiem staff fit those short shifts better because they usually were acquainted with the unit. In reality, getting them when they were available was luck of the draw. Specialties weren't so well established then and those core nursing skills got you through the shift. This solution just doesn't work anymore and the practice should be stopped. I'm not sure what the solution to the problem is but I think that staffing to the maximal nurse/patient ratio as a norm leaves you one sick call away from a crisis. Let's be reasonable - and safe- and allow a bit of breathing space in the nurse/patient ratio. I don't think the floor would end up with nurses sitting around reading the paper. Everyone would still be busy, maybe a little less frantic and certainly the unit would be in a better position to work with unexpected staffing shortages. Any thoughts?

R

Your thought sounds good to me. :thumbsup:

[NavyJim58]

I'm not surprised there are a lot of replies to this thread. This is one of those age old gripes. While I feel for the ICU nurse who is pulled to the floor, as a nursing director I have to look out for the good of the hospital and not just the ICU/PCU. Unless you work in a closed unit you should expect to be pulled to other units when census rises unexpectly or too many people call out, etc. Obviously, if you are being pulled to another floor often like weekly then admin needs to address this problem. I had a part time nurse who recently refused to float to the medical floors. I fired her the next morning. At the hospital I work for we determine where nurses are qualified to work and they can be floated where needed if they are qualified. I did my share of floating to other units over the years and I griped about it also but I went and did my best. I also agree that the medical charge nurse upon receiving a floater from ICU should realize they will probably not be operating at full eficiency. thanks for listening.

[MagRedC5]

Originally Posted by NavyJim58

I'm not surprised there are a lot of replies to this thread. This is one of those age old gripes. While I feel for the ICU nurse who is pulled to the floor, as a nursing director I have to look out for the good of the hospital and not just the ICU/PCU. Unless you work in a closed unit you should expect to be pulled to other units when census rises unexpectly or too many people call out, etc. Obviously, if you are being pulled to another floor often like weekly then admin needs to address this problem. I had a part time nurse who recently refused to float to the medical floors. I fired her the next morning. At the hospital I work for we determine where nurses are qualified to work and they can be floated where needed if they are qualified. I did my share of floating to other units over the years and I griped about it also but I went and did my best. I also agree that the medical charge nurse upon receiving a floater from ICU should realize they will probably not be operating at full eficiency. thanks for listening.

What are your sentiments on a Med/Surg RN floating to an ICU?

Wow, you fired the nurse that refused to float? Where? Was this at a Military Medical Facility? I know if a civilian nurse in Texas feels their patients would be at risk D/T uncomfortable [to the extreme] w/floating to Med/Surg that they could call Safe Harbor. It is a very complicated process, so I won't go into the details here, but other TX RN's should be familiar with SH.

I realize as an ANC officer, Critical Care RN [8A] I'm required to float at MAMC. In fact, I have floated from ICU-E to ICU-W, which was no biggie. Often, we wil float to the Cardiac Stepdown Unit [2S] down the hall. Again, no biggie. In fact, when our ICU is at full capacity, and we are short staffed & have 2S over-flow patients sometimes a 2S nurse will float over to help us out. However, I seriously doubt a Med/Surg nurse will ever float down to our ICU? Then again, while I'm in Iraq the sky is the limit regards to nursing roles, LOL.

Wow, you fired that nurse, huh? Your a tough Admin... I should ask Aaron to keep you in mind for a Mod position here. :39:

[cougarnurse]

May sound a bit stupid, but I always figured a ICU nurse would be able to work Med-Surg. 'a bit' easier than a Med-Surg nurse floating to ICU.

'Cat'

[MagRedC5]

Originally Posted by cougarnurse

May sound a bit stupid, but I always figured a ICU nurse would be able to work Med-Surg. 'a bit' easier than a Med-Surg nurse floating to ICU.

'Cat'

Nope, don't sound stupid to me at all.

[Neversettle71]

:houra:
Man... I love this discussion. What a diverse and expressive group we nurses are! I can readily see almost every side to the discussion. Keep posting!

[MagRedC5]

Originally Posted by justatraveler

Frankly, monitors lie.

With all due respect, monitors can be inaccurate, but they don't lie. Always, the first observation should be how the patient looks & acts, rather than what the monitor reads. However, if VS are needed Q 15 mins., including Swanz numbers, etc., then let us not ignore the advantages of modern science.

[Skipper_RN]

Originally Posted by nightstar3dp

I work in a small rural hospital where we don't often see the critical care patients with the illness you have mentioned, most of them with those type of symptoms are contained in the ER and air-lifted to a bigger hospital so wider ranged capabilities and a higher acuity levels can be met, however I would be interested to know how to take care of those patients like you would, I can almost promise you not even the ICU RNs on staff at my hospital have hung some of the drugs you have listed, which means in the event, they would look it up to!.

The meds he mentioned are very common meds in the ICU. I have never met an ICU nurse who hasn't hung those meds. Most vented patients require diprivan or some other form of sedation, which can have the unfortunate side effect of dropping their blood pressure, thus the levophed. That isn't taking into account other issues contributing to the drop in BP such as sepsis among other things. Anyway, back to the point of the thread. I am a Neuro ICU nurse who has never worked a regular floor. I would feel completely out of my element. Thankfully, I have a union contract which states that ICU nurses can only be floated to other ICU's or Step-Downs. We also float our travel nurses before regular staff, that works in my favor since there are nights that I am the only regular staff RN on the unit.

[MagRedC5]

Originally Posted by Skipper_RN

The meds he mentioned are very common meds in the ICU. I have never met an ICU nurse who hasn't hung those meds. Most vented patients require diprivan or some other form of sedation, which can have the unfortunate side effect of dropping their blood pressure, thus the levophed. That isn't taking into account other issues contributing to the drop in BP such as sepsis among other things. Anyway, back to the point of the thread. I am a Neuro ICU nurse who has never worked a regular floor. I would feel completely out of my element. Thankfully, I have a union contract which states that ICU nurses can only be floated to other ICU's or Step-Downs. We also float our travel nurses before regular staff, that works in my favor since there are nights that I am the only regular staff RN on the unit.

Hey Skipper, I like your Union :thumbsup: