[SCRN1]

I work prn on my floor. If our census is low and it's my turn to float, I have the option to go to the other floor or to stay home. However, those who are staff with benefits have to float when it's their turn.

[dfk]

AT OUR FACILITY, IF ANYONE HAS OVER 15YRS(IN TERMS OF HOURS), THEY DON'T HAVE TO FLOAT, NOR DO THE CHARGE NURSES, EVEN IF UNDER 15 YRS. NOT SURE WHAT I'D RATHER HAVE TO NOT FLOAT.

[barefootlady]

Call me nuts but I usually love to float every once in awhile. It gives me a chance to meet new staff. Learn how things are done on other floors. I am generally only expected to do what they know I am familiar with doing, and I get to learn a new thing or two.
Everyone takes turns floating, except charge nurse, since our charge position is split between 2 nurses, they have to take their turn floating.
No one seems to mind floating on this unit. In fact, morale is very good at this facility. Smiles and cheery hellos are still abundant. People help one another. Generally, it seems to be a good place.

[monroea23]

In my hospital the ICU (where I work) is self staffed, we do not have to float to other units but if we are cut for a day due to low census we may let nursing services know if we are willing to work on another floor if we want to keep our hours. I will not float. In the ICU I am in complete control of every aspect of my patient's care from calling labs to doctors to giving baths. I am not comfortable giving up that control to a charge nurse on the floor who doesn't know my patient from Adam.

[fergus51]

In our hospital travellers float first and since we always have travellers, I never have to float. Our unit (NICU) has to float to PICU, peds or heme-onc. We take floats from all those units, plus mother baby.

I think forcing nurses to float is the stupidest thing in nursing. Basic nursing is not something most of us do anymore. In my unit, a lot of the nurses have never worked in any other specialty or they have been in this specialty for 10 years or more. How competent do you think they can be on an adult medical floor? Yes, they can take a BP, but normal BPs for our patients will be something like 50/30 with a mean of 41. Yes, they can give meds, but our doses and drugs are not the same. They just don't have the basic knowledge of pathophysiology for those diseases anymore, let alone the knowledge to deal with the specialized equipment or family members. How much confidence would you have in an adult nurse looking after your 18 month old without having any peds experience? Or a peds nurse looking after your 82 year old grandma without any recent med-surg experience? I just don't understand why we expect nurses to be able to do this. Can you imagine asking a doctor to do that? "Well, I know you're an OB/GYN, but we're short in cardiology and it's just basic medicine right?"... Would never happen because we recognize that specialists are not generalists. Nowadays most nurses aren't generalists either.

For nurses who enjoy floating and feel they have the experience to do it safely, I say good for them. That just isn't the reality for all nurses and expecting it to be is ridiculous. I've personally seen several patients caused harm by having float nurses.

[Gompers]

I work in the NICU and I'm kind of glad it's not a "closed" unit. For one thing, it could mean mandatory overtime if we're really busy, and I am not so much into the whole overtime thing. For another, there are some nurses who don't want to stay home without pay, even for one shift, so it's nice to have the option to float if nurses are needed elsewhere.

We only float to the newborn nursery, pediatrics, and PICU. They try to give us babies in peds and PICU, but it doesn't always work out like that. When nurses from those units float to us, we give them "easy" assignments. I don't mean they'll be sitting around all night - I mean that they get the relatively healthy babies that are getting ready to be discharged, things like that. Sometimes we'll give the PICU nurses a little bit more to deal with - IVs and CPAP, maybe. On the other hand, when we get floated to PICU, we'll get vented babies and toddlers. I once got a fresh trach! But we don't want the float nurses to be uncomfortable or scared, so we don't give them vented babies when they come up to work a shift by us.

No one really likes floating, so luckily we rarely have to do it - like once every 2 years, seriously. Maybe if we floated more, we'd be more comfortable with it?

[stphnrnm]

I am a nurse manager, in my hospital we have a "pool" of nurses, Registered and enrolled (LPN) nurses, allocated to float during each shift. They report to Nursing Administration Office at the beginning of their shift when it would have already been decided which area would need assistance and they are allocated there for that shift.There are times when specialty areas need assistance,(only general trained nurses are in the pool). This is where the shuffling comes in, if there is a critical care nurse or obstetric nurse elsewhere that can be utilized, then they are exchanged with the "pool" nurse.This works out very well as there is just an exchange of hands. However the ill feelings come in when the pool nurse is used and there is still a shortage, then you have to pull from the quietest area that can afford it, then there is the question of who gets moved today?
All in all, when you sign on with my hospital there is a written clause which tells you that you may be required to work your scheduled shift anywhere in the institution where needed, this is invoked as a last resort as it is considered an infraction if you refuse to float when requested. We try to reduce overtime wherever possible, but we do not allow patient care to be compromised
stphnrnm

[kadokin]

Originally Posted by Daytonite

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.

But, why float an RN to a unit to take v.s. and give baths? Come on, is this REALLY cost-effective? BTW, our hospital experimented w/having non-nursing personnel as house supervisors for a time. The director of respiratory care felt any nurse could float anywhere at any time, because "a nurse is a nurse is a nurse". What a fool. Would he feel the same way about this if a psych nurse was assigned to care for his loved one on ICU? You folks need to stop and think about the VERY specialized knowledge that staff members accrue when they work for a time in a particular speciality. Yes, even unit clerks and CNAs know how to enter orders and report to their superiors in very specific ways that are critical to pt. safety in their speciality. Think about it!

[Littlewonder]

I just have one little comment to make. As a fairly new traveler (on to second assignment!) I do not float!!! It is already difficult enough to learn the routines, locations of supplies, and physician preferences in the department you signed up for, let alone try to figure all that out in a different unit! I would be compromising patient safety if I floated, because of the extra time it would take me to do everything - it would detract from patient time. And if the unit was already short staffed the other nurses just generally don't have the time to help as much. I currently to LDRP/nursery with prior experience in ICU and Med/Surg but I would not be safe in an ICU or Med/Surg because I am already slower in these areas and being unfamiliar with the work environment would just make it worse. Has nothing to do with not knowing HOW to care for the patient! Just with not having the specific knowledge base unique to that unit. I can deal with that in LDRP - at least I get one shift of orientation!!!
I get by with not floating because I always have it put in my contract. So, I don't go to those hospitals who always float travellers first!

[lee1]

Do any of your hospitals staff in 4 hour shifts??? We have many types staffing in our hospital. Some nurses work 12 hours for example 7am-7pm. Some work traditional 8 hours. Some work 11am-11pm for the special needs of their unit, say OHS where cases come out later in the AM.
The 4 hour pull is always difficult but we also float within our competent areas. ICUs---ICUs or medica/surgical clusters. Med telemtry to med telemtry. Oncology to oncology, etc.
Do any of you use a questionaire that can be filled out at the end of the float and handed back to the Director of their own floor, etc. Several questions are asked and is a good tool for evaluating problems and seeking answers if used.
We also have a float committee that meets and is made up of the night supervisors, staff nurses, managers.
However, despite all of this, the 4 hour pull continues to elicit the most discomfort and we still do not have a good solution. BTW, we are a high acuty hospital and do have float pool only nurses that work Mon-Fri but when not enough we have to resort to those staff nurses where units are overstaffed to pull from. A log book is kept on each unit so that nurses float in turn. Agency float first. Travelers generally float in turn.
I think part of our problem is the cluster-----4 bedded areas that are between ICU and step down telemtry. Charting there is the same as the med/surg floor, not the ICU. ICU nurses that are pulled there don't always seem to get the same amount of attention/support as other med/surg nurses. Maybe that is just a med/surg mentality that there is an ICU nurse on the floor she shoud not need any help, BUT, certainly she still needs breaks/meals, help with turning, admissions, off floor testing, etc.
Now that brings up another problem. Our Head nurses take patients, charge nurses take patients. There is no one person unless the Director is there that is without patients.