I am a L&D nurse and have been for years. At my hospital when our census is down we get floated to other floors. We do not get a patient assignment because we have to be available to run back to our unit at a moments notice. When we float we do vitals, and generally help the nurses with whatever needs help. When they float to us they are with us the whole shift. We usually will have them do vitals and meds and answer call lights. We will still do the assessment because they are usually nervous about doingit, but if they want we are more than happy to teach them. We are so grateful to the nurses that come back to help us.
I have all the respect in the world for ICU nurses. I do not understand what thye do but they are good at it. I recently worked hand in hand with an ICU nurse to save a pregnant mother and she left me in absolute awe!!
many hospitals will still continue to float nurses, but if nurses respect each other and work together it should not be a horrible experience. It might even be a learning experience.
In my impression, this nurse expresses an appreciation for any help she can get regadless of the source. It speaks well of her and her colleagues to be grateful for whatever help they receive. What does it say for the rest of the hospital staff? Would you say they are ill prepared? I'm not sure what the best answer is here.
R
I had to read through all of these responses carefully. First of all, I'm a nurse on an extremely busy Orthopedic / Surgical floor. Having been a nurse for 17 years I'm not unfamiliar with really hard work but I can tell you that this position demands the very best of my skills, my knowledge, my ability to ask for help or clarification and so on. I am extremely fortunate, in that, our unit has a very strong core team of day nurses (TEAM being the most important part). We help each other!
My first response to the original post was "HMMMMMMPHHHH, You mean to tell me that the best, of the best, of the best are complaining when they are forced to come work with us. Give me a break".
However, upon thinking about it more, it would be hard for a nurse who's used to taking care of 1-2 patients (sometimes three?), to go to a floor where you have 4-8 patients. (For the record, I've never had 8 patients on my floor) What's doubly hard about that move is sometimes those 4-8 patients require nearly as much attention per patient as some I.C.U. patients (ok so it might not be the same sort of attention). The patients in I.C.U. are often so sick that they simply can't pose some of the difficulties that a floor patients care can. I.C.U. nurses also have less exposure to family members because of shortened visitor times. The I.C.U. at my hospital also seems to have alot more physician support.
It would be nice if none of us ever had to float but I say truthfully that I do not think this will EVER be a reality. Afterall, our job is to provide care to patients in need, not just patients in need on our unit.
The other issue in this is, as floor nurses we too, sometimes have to float to other floors. We don't like it much either. We don't know the routines, where the supplies are, who to go to, what some of the particular quirky Dr.'s quirks are and somehow we just trudge through.
The best thing we can do as a profession is treat one another with loving kindness and help one another. Be an example of this and maybe, just maybe someone will follow your lead.
Originally Posted by singingtothewheat
Dear singing,
I agree with a lot of what you said but because I perceive a judgement against ICU nurses, feel as though your opinion is selective and exclusive. You admit to not having critical care experience but still feel qualified to make judgement against what you believe the workload is. You count patients where we count procedures, treatments, equipment, interventions, medications and the amount of time spent in them. You also grossly underestimate the degree of family interaction and the intensity with which this interaction takes place. Every ICU that I've worked in has unlimited visitation. Finally, you incorrectly assume that the presence of physicians in the unit means less responsibility for the nurse. Before you make another assumption, I HAVE worked med/surg/tele and OR, have had as many as ten patients in a shift, am no stranger to floating, so I do speak from experience. Workload is workload. It may look different depending on where you work but VERY few nurses sit around regardless of which unit OR which shift they work on.
Walk a mile in the shoes before judging the gait.
R
I don't think I ever said anything about nurses "sitting around." You did make a point though, work load is work load and we ALL get to share the triumphs as well as the low points. As I stated in my reply, I think it would be great if someone could figure out how to do away with floating entirely. I don't think that is going to happen though. Sorry if you were personally offended.
No, the "sitting around" words were mine but it was the sense I got after reading several of your statements about ICU nursing responsibiltites; ICU patients are too sick so simply are not capable of creating the same challenges that surgical and/or orthopedic patients can, ICU assignments of two "or maybe three?" (let me add an exclamation point after the question mark,!) patients are the norm, your ICU seems to have more physician "support" and finally "the best of the best of the best" complains about working with us really went over the top. What does that mean? I wonder if you may not view ICU work as "simply potential" and not real, like yours. At one point you make statements about harmony among nurses and " let's support each other wherever we work," agree with my inference of work = work, but make critical and divisive comments about a certain branch of nursing, critical care. How do you really feel about your fellow nurses NOT working on your floor in your very strong CORE team? Specialization of nursing aside, your comments seem to come from a mindset which is less about floating but about inflexibility.
My offense as you put it is not really personal but professional.
R
Singing,
Let me apologize because I feel as though I'm coming down on you as an individual when really, the viewpoint(s) that you express are as I see them, common.
R
Re: ICU nurses pulled to general floors
"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."
Floating - Another age old problem that has no easy answer. My first 'feeling' when I read these posts is concern for the total lack of teamwork and respect for other nurses throughout the organizations that everyone works in. I think that is sad. Secondly, I agree floating is hard and not an easy or permanent solution. However, floating can work and be an effective to solution to staffing crunches during times when census is fluxuating through out the house.
We have tried to adopt a policy that ED and ICU nurses float to each of those units to help those respective units (closed coverage) unless someone volunteers to float somewhere else if census is low and they do not want to go home. Also we have people on the Med/Surg and Progressive Care floors sign-up to float to the ED for overflow patients to help the ED staff and take that burden off of them since that creates not only unsafe patient care practices but the ED nurses are not familiar with the inpatient paperwork and procedures. We are in a resort town and census is opposite for the ED and inpatient units.
It has worked out quite well. We have had more volunteers, because instead of getting 'bad' patient care assignments or dumped on the nurse that floats is basically an extra set of hands and does VS, finger-stick glucoses and that sort of thing; unless she or he has been competencied to work in that unit. The best part of the floating is the respect among staff...everyone is appreciative and treats that person well. Help is help....and we are all nurses. It beats the heck out of stuggling all shift!
~BeachyCEN
It is interesting to me, a CCU staff nurse, that you think the "good of the hospital' means floating Critical Care Nurses. You are, of course, referring to monetary "good". Cost effectiveness and the bottom line. Otherwise, you would surely have a float pool in place and not be stressing out your Critical Care nurses, which undeniably affects patient safety ANYWAY you look at it. You cannot possibly believe that stressing out Critical Care nurses by floating them is in the best interest of Patient Safety? Has it not been proven time and time again that nurse stress/burnout/staff patient ratios is DIRECTLY related to patient safety? If I worked for you I would unionize my fellow nurses and give them a voice. Hopefully you will never get sick and wind up in your own CCU. Shame on you for using and burning out critical care nurses this way!!! I realize I am only guessing, but I'll bet you felt very authoratative firing the poor part-time nurse, and I hope you had to pay her unemployment. Did that solve your bad moral in the Critical Care Units? My guess is you made it worse sir. Bad moral is STRESSFUL and increased nurse stress and burnout directly affects patient safety!! You are part of the problem in health care, sir. You are definately not Part of The Solution. Go to Iraq and take your scare tactics with you. By the way, does "not operating at full efficiency" refer to the CCU you short-staffed in order to make numbers on the Med-surge unit? Do you realize the SICKEST patients in the hospital are in the Critical Care Units? Do your Critical Care Nurses also handle codes and rapid responses? Shame on you for not appreciating them. What comes around goes around, and what will you do when it is your turn? Hospitals also "downsize" in management areas, also. Some hospitals want to be "Magnet" hospitals in which case they would empower nurses. Your turn is coming sir.
I think the problem is not just one of Cross training. It seems UNIVERSAL that it is the Med-Surge units affected with high turnovers and short staffing problems. It needs to be addressed and fixed. Patient/Staff ratios is the problem. Coupled with these are mainly new nurses who need positive support. NOT Negative, Punitive support which is often what happens. Fix that problem first, and you may not see a need for cross training. Nurse will Pick up overtime and come to work when they are treated fairly. Nurses are the Ultimate Patient Advocates, and I believe in them.
Posting Permissions
Reply With Quote