[NurseFromTexas]

I personally feel floating those out of their familiar spectrum is dangerous to the patient. If you feel comfortable going to other areas outside of your unit that's great but it shouldn't be expected. We float on our floor which contains OB, GYN, L&D, WBN and SCN. These are areas in which I have knowledge to work and care for patients. Other than these areas I would refuse to go and hope I still have a job in the future. The problems I have had with floating is you get to other floors and I feel as though they dump the patients they know they do not want.

[veegeern]

Originally Posted by NurseFromTexas

I personally feel floating those out of their familiar spectrum is dangerous to the patient. If you feel comfortable going to other areas outside of your unit that's great but it shouldn't be expected. We float on our floor which contains OB, GYN, L&D, WBN and SCN. These are areas in which I have knowledge to work and care for patients. Other than these areas I would refuse to go and hope I still have a job in the future. The problems I have had with floating is you get to other floors and I feel as though they dump the patients they know they do not want.

I agree with you about patient safety. However, our facility has a policy that anyone can be floated to any unit. When I get to another unit, I let the charge nurse know what I am comfortable with...so far we've been able to work something out where I'm working within my scope of experience. I always keep in the back of my mind that the day may come when I'll have to "buck the system" and refuse an assignment. I don't look forward to it happening, but I'd rather have those consequences than the ones that go with compromised patient safety.

[NurseFromTexas]

Anytime we have had someone arrive on the other floor and refuse the assignment there is always a supervisor telling them they could be charged with patient abandonment.... so my curiosity is when are you actually abandoning the patient. If you refuse the assignment you never actually recieved report or maybe it is in the middle of report that you feel this patient is someone you can't care for due to your decreased knowledge of their situation. I would not refuse to go to a floor as a aide cause I do agree we should all know how to do vitals and baths on every patient but as far as treatments and meds if you don't use them often you loose your knowledge of them and can cause someone alot of harm.

[veegeern]

I agree. It's quite a delima, but again, so far I have been able to work something out...

[MissJoRN]

When I worked in Peds we were a "half closed" unit. We could float out (assuming we had the luxury of 2 RNs to start out with) but other nurses could not float in and care for pedi pts. Occasionally if we were really stretched a nurse might float in as "extra help" but the peds RN was resposnible for all meds, fluids, assessments, and charting on pedi pts. If we had a young adult, the floated nurse could do that. Generally the result would be me still providing total care for way more than safe # of pts, stressed to the gills, and a floated nurse sitting at the desk commenting on how nice peds is, so easy, nothing to do... Then telling her co-workers how easy the peds nurses have it!!
Ideally peds nurses would be floated to Maternity for nursery, PP, or GYN pts but any floor was fair game- Med Surg, rehab, or transitional care most often, occasionally psych, and occasionally ICU/CCU where we got our turn at being "extra help"
The one policy I hated (I think unique to peds) was that PRNs didn't float! Peds PRNs considered themselves exclusively peds nurses and refused to float out. I understand that to a point but very unfair when I would be floated out as a fulltimer, often happened to be 4 hours into a 12hr shift when I already knew all the peds pts! (to quote an above poster "booooo!")
Now it's nice in the OR, completely closed we just get extra days off, and I love extra days off!

[Daytonite]

Originally Posted by NurseFromTexas

I personally feel floating those out of their familiar spectrum is dangerous to the patient. . .We float on our floor which contains OB, GYN, L&D, WBN and SCN. These are areas in which I have knowledge to work and care for patients. Other than these areas I would refuse to go and hope I still have a job in the future. The problems I have had with floating is you get to other floors and I feel as though they dump the patients they know they do not want.

My response to this as a supervisor was to point out that basic nursing is still basic nursing. A blood pressure on the OB unit is pretty much the same as taking a blood pressure on the medical unit. The same goes for answering lights, giving bed pans, taking people to the bathroom, giving medications and taking care of their IV's. The very specific stuff like checking someone's fundus in PP or wedge pressures on a patient in ICU are something that should be done by the regular staff of those units. They should have the wherewithall to know that, and if not, then the float needs to page the supervisor and tell him/her that the staff is expecting you to do something you have no knowledge of how to do. Do you tell the supervisor you feel you have been given patients the regular staff don't want? Did you tell the supervisor you felt dumped on? I would defend you and get after the regular staff. I let staff who do that know that I wasn't going to put up with it, that they were getting a float to help them out, they were anxious about it and they were to make the float feel comfortable, otherwise I guess they didn't need the extra pair of hands that badly. They didn't have to know about the rules I had to follow with regard to the acuity. On the other side of that coin is the burden a float is to the unit they are going to and they make it clear they do not want to pitch in and help to the best of their ability. That has nothing to do with abandonment and everything to do with insolence, attitude, insubordination, and basic old childish pouting. When you come back from a two week vacation you are faced with a whole assignment of new patients you've never seen before. You never know what you are going to encounter when you walk into a patient's room. What do you do? Basic nursing until you learn about their other more specific needs. Floating is not a whole lot different when looked at that way, special needs of a particular unit aside. Most everything done with a patient begins with basic nursing care and we all learned how to do those basic things.

By the way, board of nursing aside, walking off the job is viewed in other professions as job abandonment and grounds for immediate dismissal in most places. Why should it be different with nurses? I find it hard to understand people's refusal to compromise, especially when their job in on the line.

[gtmoore]

I work on a renal tele unit and we can be floated anywhere, including the ICU/CCU or PACU, even on occasion to the ER. When us Tele nurses are sent to the ICU/CCU, we are usually given the low acuity patients.

However, we're becoming a closed unit beginning on 12/11, thank God!

[Maggiemay]

Hmmm, floating.........not a favorite topic. It is really hard to get out of your comfort zone to float. We have special groups within nursing that nurses can float to. For instance: CCU, telemetry and intermediate cardiac float within their group. THen the "general" nursing areas such as Med/Surg, Ortho, and Oncology float within their group. ED and OR are on their own. E am told this was for competency reasons, which seems to work pretty good. I think it is better for the patients.

ON a RARE occasion nurses will float to other areas, but it is not required. If you are out of your "zone" then you are not expected to work independently, OR the patient load is adjusted to your level of competence.

Bottom line is the patients get cared for.

Happy Day!!!!

[Warpster]

I loved floating from floor to floor and from hospital to hospital, but it's certainly not for everybody.

My last job had a rational policy that floated among med surg or among womens' and childrens or among the specialty units. That eliminated the awful shifts where an ICU nurse would be caring for neonates for the first time since nursing school or someone from the pulmonary floor would find herself in pediatric ICU for a shift from hell. Cross training was offered for anyone who agreed to float, and there was a small increase in hourly pay for doing so.

[HappyNurse2005]

We can only be floated to other cardiology units. There are 5. two medical cardiology floors, cardiac surgery icu, cardiac surgery pcu, and ccu. Each shift, it is determined if there are any "needs" in any of those 5 units, which units have excess staff for their census, etc, and if necessary, we can be floated. But only to other cardiac units.