Practice only within competence
The nurse is floated for one shift to the neonatal intensive care unit, where the nurse has never worked and has had no orientation. The best response is to tell the supervisor about the competence gap and ask for tasks within one's own competence. Under the Code of Ethics and the nurse's duty to maintain competence, the nurse accepts only work that the nurse can perform safely, explains any gap honestly, and asks for help or a safe alternative. This protects the critically ill newborns and the nurse, and it still helps a short-staffed unit.
Why floating is not simply refused
Floating is a normal part of hospital staffing, used to cover shortages. A nurse who refuses outright, without offering any safe alternative, may leave the receiving unit dangerously short. The ethical path is neither blind acceptance nor flat refusal. Instead, the nurse describes what the nurse can safely do, for example taking vital signs, assisting with feeding or positioning under supervision, gathering supplies, or helping with documentation, while experienced NICU nurses manage the critical care.
| Response | Ethical and safe? | Reason |
|---|
| Tell the supervisor and ask for tasks within competence | Yes | Honest, safe, still helps the unit |
| Decline and stay on the home ward | No | Leaves the unit short with no alternative |
| Accept but take only stable-looking babies | No | Hides the gap; NICU babies change quickly |
| Accept all and rely on written procedures | No | Procedures do not supply competence |
Why the other responses are wrong
Taking only the babies who appear most stable sounds cautious, but newborns in intensive care can deteriorate quickly, and recognizing early signs requires skills the nurse lacks; choosing clients without informing the supervisor also hides the risk. Accepting the full assignment and relying on the unit's written procedures confuses having instructions with being competent; procedures cannot replace training in neonatal assessment, equipment, and drug dosing.
Accountability
The nurse is accountable for the care the nurse provides. If harm results from practicing beyond competence, "I was assigned" is not a defense. The nurse should also not abandon clients already in the nurse's care; once a safe assignment is accepted, the nurse completes it or hands it over properly. Documenting the discussion with the supervisor according to policy is wise.
Exam takeaway
Key point When floated to an unfamiliar specialty unit: inform the supervisor of the competence gap and accept only tasks you can perform safely.