In the hospital where I work, administration is cross-training nurses to work in several units. In my medical/surgical unit, a few nurses have been cross-trained in PACU. We were told we'd be scheduled to work there 1 day a week, but so far our actual experience there has been minimal.

I'm worried that requiring nurses to work in areas where they haven't acquired proficiency creates more opportunity for errors. The old saying, "jack of all trades, master of none" comes to mind. Your thoughts?-L.S., LA.

Cross-training nursing staff is nothing new, but the trend has been accelerated by the nursing shortage and fluctuating patient census. To ensure safe, high-quality patient care, both you and your employer have obligations, as delineated by the American Nurses Association:

* You're obligated to provide safe, competent, and ethical care to your patients, regardless of practice setting. You must continually assess your own knowledge and expertise, and seek additional training or other resources as needed to maintain your competency wherever you practice.

* Your employer is responsible for having a "systematic plan" in place for cross-training staff it requires to float to an unfamiliar unit. This includes "sufficient orientation and preparation, including nurse preceptors and nurse experts to ensure RN competency."

* You have the right and obligation to express your concerns without personal repercussions if your employer places you in a potentially unsafe practice situation.

You may be required to float as a condition of employment. But if you believe your employer has failed to prepare you adequately, demand changes. Remember, you're responsible for maintaining your competence. If a patient is harmed, you'll be held accountable for your nursing judgments and actions, even if your employer falls down on the job.

Source: American Nurses Association, Principles for Nurse Staffing, 2005. Available at http://www.nursingworld.org/MainMenuCategories/HealthcareandPolicyIssues/Reports.