# Situation: A registered nurse has worked for 3 years on the medical ward of a private hospital that cares for many clients with diabetes, thyroid disorders, and liver disease. The nurse is planning a career in diabetes and endocrine nursing. The nurse is floated for one shift to the neonatal intensive care unit, where the nurse has never worked and has had no orientation. What should the nurse do?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=630563  
> language: ko  
> subject: Nursing Practice IV — Care of Clients with Problems in Nutrition and Gastrointestinal, Metabolism and Endocrine, Perception and Coordination

## 문제

Situation: A registered nurse has worked for 3 years on the medical ward of a private hospital that cares for many clients with diabetes, thyroid disorders, and liver disease. The nurse is planning a career in diabetes and endocrine nursing.

The nurse is floated for one shift to the neonatal intensive care unit, where the nurse has never worked and has had no orientation. What should the nurse do?

## 보기

1. Decline the float and stay on the medical ward, since floating is voluntary
2. Accept the assignment but take only the babies who appear most stable
3. Accept the full assignment and rely on the unit's written procedures
4. Tell the supervisor about the gap and ask for tasks within own competence **✔ 정답**

**정답: 4**

## 해설

The Code of Ethics and the nurse's duty to maintain competence mean the nurse accepts work only within that competence, explains the gap to the supervisor, and asks for help or a safe alternative. The nurse must neither practice beyond competence nor abandon clients already in the nurse's care.

## 심화 해설

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.

## 임상 시나리오

Floating Without CompetenceSafe response to an unfamiliar unit
When floated to a unit such as the NICU without experience or orientation, the nurse tells the supervisor about the competence gap.

The nurse asks for tasks within own competence, such as vital signs or supportive care under supervision, so the unit still gets help.

The nurse is accountable for care given and must not practice beyond competence or abandon accepted clients.

CautionDo not refuse outright without offering a safe alternative, and do not quietly pick the stable-looking babies to hide the gap.

## 핵심 개념

- **Floating** — Temporary reassignment of a nurse to another unit to cover staffing needs.
- **Competence** — The knowledge, skills, and judgment needed to perform a role safely.
- **Accountability** — Being answerable for one's own actions and decisions in practice.
- **Abandonment** — Leaving clients in one's care without proper handover or arrangement for their continued care.

## 같은 주제 문제

- [Situation: A registered nurse has worked for 4 years on the orthopedic and eye surgery war…](https://mymerci.kr/pages/nclex_q.php?qn_id=630361)
- [Situation: A registered nurse has worked for 4 years on the orthopedic and eye surgery war…](https://mymerci.kr/pages/nclex_q.php?qn_id=630362)
- [Situation: A registered nurse has worked for 4 years on the orthopedic and eye surgery war…](https://mymerci.kr/pages/nclex_q.php?qn_id=630363)
- [Situation: A registered nurse has worked for 4 years on the orthopedic and eye surgery war…](https://mymerci.kr/pages/nclex_q.php?qn_id=630364)
- [Situation: A registered nurse has worked for 4 years on the orthopedic and eye surgery war…](https://mymerci.kr/pages/nclex_q.php?qn_id=630365)
- [Situation: The nurse educator of a government hospital manages staff development for its e…](https://mymerci.kr/pages/nclex_q.php?qn_id=630461)
- [Situation: The nurse educator of a government hospital manages staff development for its e…](https://mymerci.kr/pages/nclex_q.php?qn_id=630462)
- [Situation: The nurse educator of a government hospital manages staff development for its e…](https://mymerci.kr/pages/nclex_q.php?qn_id=630463)

---

More free questions: [기출문제](https://mymerci.kr/)

_학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요._