The problem with floating ER Nurses - page 4

by crabalot

10,366 Views | 35 Comments

As ER Nurses, are you required to float to wherever in your hospital? I have never been asked to float because of the dynamic nature of the ER until I started working where I am now. (Sorry, not telling where!) Anyway, I have... Read More


  1. 1
    "Sometimes we are used as sitters for psych 1:1 patients"

    I work in Psych, and that is ridiculous. We use Mental Health Workers (basically CNA's) as 1:1s. Using an RN is paying way too much.

    "My position is the ER can change from calm to tornado in one hour and we need to be ready for just that."

    Is there a way to only float in 4 hour blocks? granted, that could still suck, but this way they can "keep" the RN all day, 4 hours would at least be a limit.

    "We have a useless union."

    Yup. We have MNA. Now get this, this is the union of most of Minnesota. So if all the MNA hospitals negotiatied at the SAME TIME and didn't agree UNLESS all the other hospitals agree - think of the power. It would be like teamsters (or like they used to be).

    ah well...

    On another note, seeing as how I work in inpatient psych, I am so not up on medical stuff, it would be a terrible idea to float me.

    Dian
    ProgressiveThinking likes this.
  2. 0
    OP: since it appears that your ED has been floating out for a while, you could do a retrospective study comparing similar time periods before and after the floating rule change, looking at adverse events, incident reports, outcomes, and the like. Your working hypothesis would be that floating nurses from the ED increases poor outcomes, and thus increases costs to the hospital.

    Also, are you filling out incident reports every time your department gets slammed and the other floors refuse to release your patients? Just 'cos they're inpatient doesn't mean they're the only ones who get to cry "patient safety" when ratios become ridiculous.
  3. 0
    I can't help you out, but I have not worked on a general hospital floor in more than 20 years and that was when I worked in ICU. I would have no idea what the routine is on the floor. It would be like floating an OR nurse to the floor. Just because your title has RN behind it does not mean you can be a jack of all trades. I have given birth to 2 children and am an RN but that does not qualify me to safely work in L&D! You might as well float me to maintenance as unproductive as I would be!
  4. 1
    Quote from TheSquire
    OP: since it appears that your ED has been floating out for a while, you could do a retrospective study comparing similar time periods before and after the floating rule change, looking at adverse events, incident reports, outcomes, and the like. Your working hypothesis would be that floating nurses from the ED increases poor outcomes, and thus increases costs to the hospital.

    Also, are you filling out incident reports every time your department gets slammed and the other floors refuse to release your patients? Just 'cos they're inpatient doesn't mean they're the only ones who get to cry "patient safety" when ratios become ridiculous.
    ...and by "refuse to release your patients", I meant "refuse to release your nurses". My bad.
    Esme12 likes this.
  5. 0
    Because of stuff like this they started creating Critical Care Float nurses at one hospital I was at. They would float to ED, ICU, CVCU and PACU
  6. 0
    I work at a variety of facilities in my large metro area and have experienced the following:

    Most have some float guidelines in the union contract. For example one contract says RNs can be floated, for tasking only, as need to like units (ortho to med surg, ER to ICU) and must be called back when ratios in the donating unit mandate the return (ratios also in the union contract). So I've been sent to other units to help out, start IVs, give some meds, help with procedures etc. No biggie, get sent back to my ED when needed. Never chart anything cause the floor uses a different system, floor nurses do it for me and even thank me for helping out. It's cool. Builds rapport and we tend to be less witchy with each other when giving report later on too cause we have worked together.

    I have worked for a hospital system with their own float pool (several facilities in same town) and kinda acted like agency. They would call and send me to one of the facilities on the days I said I was available and I would go wherever they needed me (getting paid critical care pay and a float pool differential no matter where I went, SWEET!)

    Some of the facilities have "push backs". Where in some day staff are called and asked to come in later due to census (its volunteer, we have plenty who want to sleep in or not work a 12 hr shift). They all also have varied shifts, 3p - 3am, 1p - 1a etc to account for the difference in typical pt census.

    As for your situation, even though your union appears weak, it is still a good idea to fill out an ADO (assignment despite objection),submit it to your union and keep a copy of it. Eventually you will need it when your state BON comes after you because some poor pt died because you were so poorly staffed. And I agree with a previous poster, this is a staffing and patient safety issue. I would encourage you to review your union contract concerning staffing issue, and float policy if there is any and remind management that this will come back to bite them when someone sues because they didn't get appropriate and timely care resulting from not following the staffing guidelines set out in a legal document they signed.

    So sorry you and your comrades are going through this. These hospitals chains can be such money grubbing _____ (fill in the blank). I've had my best experiences working for nonprofit hospital systems.

    D.


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