The problem with floating ER Nurses

MassED, BSN, RN · Oct 22, 2011

If it's a matter of keeping your job, I'd float.

You can do anything if you work in an ER. You might need pointers on the specific rules and intricacies of a specific department, but why not? I worked on a floor prior to the ER, and it's much easier. Different stress, as in not life-threatening or urgent 24/7, so you shouldn't have an issue if your job depends on it.

And where I work, we don't float, but you bet your hiney that I would if it was either that or go home and take PTO.

hiddencatRN, BSN, RN · Oct 22, 2011

At my hospital, floats are taken from over staffed/low census units. So we never float in the ED- we're one of the units that usually GETS nurses pulled from other departments.

NicuGal, MSN, RN · Oct 22, 2011

I don't work in our ED, but I have many friends that do. They don't float when it is really slow, but they will go over to the ICU's and lend a hand (they are not assigned patients, they just help out) and they get paged if needed back in the ED. Our ICU's are adjacent to our ED, so doesn't take long for them to get back there.

TrafalgarRN · Oct 22, 2011

Hey...if they called me to be a sitter i would go running :)...and it would be the most easy but boring 8 hrs of my life.

But to your question...i have never worked in a place where they float ER nurses and from a legal point its a risk issue when you float to other floors where you are not trained. I would not have any idea what happened in the ICU, NICU, PACU, OR, Pedi e.t.c. I would fit in Telemetry and Med-Surg but i would still be apprehensive since i don't know what are their processes. The question is what units are being offered when you float? Is there any training offered? What happens if you say no?

For the Research Paper...I would checking your state BON on Floating and then Google Scholar will help you piece the article...good luck:)

PS: Some Link on the Issue from the Texas Board.

http://www.bon.texas.gov/practice/faq-floating.html

RNewbie · Oct 22, 2011

Couldn't find anything specific to the ER either but I found these (you may have already seen them):

http://ccn.aacnjournals.org/content/28/6/51.full

http://www.hsmsweb.com/htss/Just+the+FAQs/What-are-some-successful-floating-policies/ArticleStandard/Article/detail/144068

You can probably find more info specific to the ER and more scholarly if you subscribe to scholarly journal websites but they charge.

Mulan · Oct 22, 2011

So the problem is not floating but leaving the ER short staffed because of the floating?

LaughingRN · Oct 22, 2011

Where I work ER nurses aren't floated (they are the only nurses in the hospital that aren't) and no other nurse floats to the ER

My understanding of this is that ER is so different from floor nursing, that it would be very difficult.

Ex. The ER using one software program for computer charting, the entire hospital uses another (which is the same), The ER does not use MARS, all other floors do etc etc, the ER has no routine, the floors all have similar ones

This isn't remotely a them against us thing.

It is simply too different to float nurses without extensive training first

VICEDRN, BSN, RN · Oct 23, 2011

The best argument I can think of is that ER is considered pre-hospital care while in-patient is acute care. In other words, we aren't qualified at all for that type of care.

Altra, BSN, RN · Oct 23, 2011

www.scholar.google.com

Why is this being done where you work? Is the ER overstaffed on certain shifts? What is the alternative to floating - sending people home? And what practice is in place to "recall" staff in the event the bus suddenly pulls up to the ER?

msn10 · Oct 23, 2011

But to your question...i have never worked in a place where they float ER nurses and from a legal point its a risk issue when you float to other floors where you are not trained. I would not have any idea what happened in the ICU, NICU, PACU, OR, Pedi e.t.c. I would fit in Telemetry and Med-Surg but i would still be apprehensive since i don't know what are their processes.

Rural nurses do it all the time, and they have a much larger ratio (not number) of traumas. That is why they call the rural nurse a "generalist." Unfortunately for the purpose of your argument, most of the research says that nurses should be trained in multiple areas and keep those certifications/training seminars up to date yearly. (Winter, 2010; Bales, Winters, & Lee, 2009; Scharff, 2010).

I think it would be hard to go from oncology or short stay to ER or visa-versa, but an ICU or cardiac nurse should be able to cross train and float and ER go to those units. If hospitals did it right, they would have float pools where nurses have a home unit, but then have 2 cross trained units they are capable of going to. Lots less PTO's.

highlandlass1592, BSN, RN · Oct 23, 2011

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 been tasked with presenting our arguement as an evidenced based research paper but I'm having a hard time finding studies where ER Nurses are not floated because of the nature of the ER. There are plenty of articles supporting the general idea of floating, but none that I've found generic to the ER. Can anyone send me any AJN, RN, ANA or any other journal article that proves why it isn't a prudent idea to short the ER for any reaon? I'm not opposed to floating as a matter of principle. I feel we are the front line Nurses and we should never be in a position where a life is at stake because we had to sit 1:1 with a suicidal patient (yes, we frequently are called to do just that). If I do a good enough job, I'll try to publish in AJN or wherever so all may see the light! lol.

Why not contact the ENA to see if they have a position paper or research on the topic? As they set the standards for ER nurses, I'd start there