To pull or not to pull (That is the question)

[Bouche]

Hi folks
This is my first posting so bear with me. I am an Cardiac ICU nurse. Technically just getting my feet wet (3 years). I have decided to work the crazy shift 11a-11p. So I come in when crap is hitting the fan, love it in the ICU hate it on the floor. When our census is low I can get pulled 2 out of my 3 shifts. That's not the problem I can deal with it. But, the problem lies here, I could recieve 2 patients on the ICU at 11 am then come 3 pm I have to give those patients up because it is "my turn" to get pulled. I give report go to the floor and pick up 5 patients. Attempt to do my assessments, give meds and trouble shoot by 7 pm then I am needed back in the ICU. I fumble through my report and head back to the unit to get report on 2 additional patients (not the ones I had before). Unfortunately this also happens to the 7a-7p nurses. Where is the continuity of care???
My question is, are there any laws against pulling for 4 hrs?
By the end of the day I forget my own name not to mention the patients. Thank god for name band identification before meds! I drive home with knots in my stomach.
IS THIS CRAZY OR JUST REALITY!!!!!!

[Ricu]

Hi folks
This is my first posting so bear with me. I am an Cardiac ICU nurse. Technically just getting my feet wet (3 years). I have decided to work the crazy shift 11a-11p. So I come in when crap is hitting the fan, love it in the ICU hate it on the floor. When our census is low I can get pulled 2 out of my 3 shifts. That's not the problem I can deal with it. But, the problem lies here, I could recieve 2 patients on the ICU at 11 am then come 3 pm I have to give those patients up because it is "my turn" to get pulled. I give report go to the floor and pick up 5 patients. Attempt to do my assessments, give meds and trouble shoot by 7 pm then I am needed back in the ICU. I fumble through my report and head back to the unit to get report on 2 additional patients (not the ones I had before). Unfortunately this also happens to the 7a-7p nurses. Where is the continuity of care???
My question is, are there any laws against pulling for 4 hrs?
By the end of the day I forget my own name not to mention the patients. Thank god for name band identification before meds! I drive home with knots in my stomach.
IS THIS CRAZY OR JUST REALITY!!!!!!

Hi,

Your predicament is a difficult one. I don't know of any laws restricting the floating of staff but I do know of institutional restrictions. I too am an ICU nurse and our institutional policy is that ICU nurses have the option to float. If they choose to, they float for the balance of or the entire shift but they do not to take assignments. We help in all other ways but the understanding is that we are to be free to return to the unit if needed. Other options during low census are to take PTO, or many of us do committee or education work during those times. The situation that you describe where you take two patients when you arrive, float for four hours and take many more patients and then return for your final four hours and receive yet two different patients not only breaches the idea of continuity of care but greatly increases the liklihood of error both of which you already indicated. Two excellent reasons that such practice shouldn't be allowed. How can you NOT be frazzled and have all of your patients meds, treatments and diagnoses run together in your head? I'm sure you discipline yourself to keep it all straight but for your manager to expect that you do it on a steady basis is unreasonable. Whenever I've floated and had to return which has happened before, it's for admissions only. It sounds like there are staggered shifts where you work which might make consistency difficult but there are other options. Maybe you or other floated nurses who get called back should function as helpers unless you get admissions. For nurses to give up their assigned patients to you when you get back seems senseless. It sounds like you and others in your unit are victims of poor management as well as lack of consideration. To answer your question, I think it's crazy. Maybe it's reality where you work in which case, I would look for a different job and get rid of the knots. Nursing is hard enough without playing fifty-two pick up with the patients. You and they deserve better. Good luck,

R