"Floating" rears its ugly head again - page 4

Once again I found myself in the position of charging and being told one staff member (not specified) would have to float to another unit. This was not floating to a like unit - it was going from... Read More

  1. by   nell
    All right Ryan! Well said.
  2. by   mattsmom81
    You are so very right Ryan. I totally agree.

    Administrations motives are always $$$$, aren't they??

    LOVE the idea of asking the CEO if he would be comfortable floating to CEO another corporation today.... he MIGHT see our point....(but we could probably kiss our job goodbye....LOL!)

    I've complained a lot on this forum about nurses needing to set boundaries/limits, and I have pizzed a lot of people off (particularly ER nurses, when I refuse admissions due to unsafe conditions)

    We MUST set boundaries....administrators will push and push and it's up to us to say 'NO MORE'.
  3. by   olnursie
    Floating the unecessary evil! Our hospital has a critical care float
    pool and they pay those nurses more money to go to anywhere
    they send them! But- the rest of us still have to take our turns
    "floating" by "turn". I had been there for quite a few years-the only way I could get out of it was to do asst.lead(they don't have to float) Why not have a critical care float pool- and a med-surg
    float pool? Some people actually do like the thrill-but at least it could be in some related area.
  4. by   hoolahan
    Sure we can all do tasks, so can monkeys! Why don't we train monkeys to take VS, and float them instead??

    Seriously, if I was on a floor and couldn't push an unfamiliar IV drug, and another nurse did it for me, is that where the responsibility ends?? What about monitoring the side effects of those drugs? Would you know to watch for widening QT interval? Or do you just know enough to recognize sinus vs not-sinus rhythm. And what about the nurse who does give the drug? If I were giving a pronestyl loading dose, I would be uncomfortable leaving the monitoring to a float. Yes, we can teach people, but it's not easy when other pt's are crashing, a DNR just died, and you want to be there for the family, usually when a nurse is floated, there is already a busy unit, and it is hard to pin someone down to get an OTJ orientation. This is where a good nursing education department comes in.

    I never said I wouldn't help out where I was comfortable, or that I wouldn't help a nurse who was floated, I am simply advocating for an orientation. It's been 21 years since I graduted from nursing school, and I haven't stepped on an OB or psych unit since. I am no supernurse, I know my limits.
  5. by   mattsmom81
    Hey, if I had to choose between having an extra set of hands (even if it's only to assist with basic stuff) and have NOBODY...I would choose the extra set of hands. If anything, they can do CNA type work, or secretary type work, answer phones... things familiar to them. I don't mind doing these types of things in OB IF I am being helpful to the OB nurses. I don't look at myself as a 'trained monkey' here.....

    Some days we are so understaffed we have to be grateful for what we can get...and I am. Nurses today have had to learn to be very flexible and be problem solvers with our short staffed conditions.

    No it's not a perfect situation but I don't see those much anymore.
    We do the best with what we've got some days.

    Finding that 'line' where we say 'NO' is a personal decision. And of course we are obligated to educate managers about the dangers of relying on this type of floating on a daily basis...as it is much better to have a fully oriented group offloaters who are comfortable on several units....we all prefer this I'm sure.
  6. by   hoolahan
    Originally posted by mattsmom81
    Hey, if I had to choose between having an extra set of hands (even if it's only to assist with basic stuff) and have NOBODY...I would choose the extra set of hands. If anything, they can do CNA type work, or secretary type work, answer phones... things familiar to them. I don't mind doing these types of things in OB IF I am being helpful to the OB nurses. I don't look at myself as a 'trained monkey' here.....
    I deserve to be thrashed for that stupid comment mattsmom, you make an excellent point. But, if I came onto a floor and volunteered to be the unit secreatry type for the night, my concern is, if something bad happened, wouldn't all parties working be liable if it was b/c of poor staffing, or inadequate monitoring? That's where I am coming from. I could see a lawyer making mince meat of a nurse in a witness stand who said, "I was only doing tasks." My feeling is, if yoou are an RN, and you are on a unit, and you have accepted responsibility, you also have liability.
  7. by   RNinICU
    We have a closed unit and do not have to float out of ICU if we don't want to. We have the option of taking a day off if we have a low census, or of working on another unit. None of our specialty units have to float, but we also do not get help from the other units when our census is high or staffing is short. We cover our own. On occassion, someone from the telemetry unit or stepdownunit has come in to ICU to help out, but they never have an assignment. Instead they do tasks like IVs and signing off orders. Some of the med surg units are very resentful of the fact that we do not have to go work on their floors when they are busy and we are not. Of course, these are the same people who think ICU is eay because we only have two patients.

    I usually will go out to the floors. Most of our staff simply refuses to float. I don't mind floating, and I have never been asked to do anything that I am not comfortable with. I will sometimes work on the floors even if it is not my turn to go if I know the floor is really short staffed.

    We also have a system for keeping track of who's turn it is to either take a day off of float. It seems to be getting more complicated though. We actually have a twelve page policy that outlines every detail of our self containment policy.
  8. by   labornurse
    In our OB/Nsy unit, the only place other nurses float is to the postpartum floor. We, however, are expected to cover every other unit in the hospital. If there is an influx of pts, we cover our own unit. One time we had so many pts we were drowning in labor, postpartum, nsy, and nicu. One of the OB docs asked why there weren't more nurses coming in to help. We explained to him that all the nurses on the unit that could possilbe come in were already there (our unit manager had just worked labor for 30 hours straight and had gone home to bed for a while) and the hospital said there was no one to float to our unit. The OB got really angry and said that if there was no one that could float, then he would go and get the DON to work labor:chuckle
    Needless to say, a nurse from OR was magically transported to work postpartum so that nurse could come back and do labor Since then we have been getting more help with nurses and aids from the other units, but we still float more out than in. I agree it is a dangerous practice. We have all been oriented to med/surg for 2 days, but we are floated to all areas of the hospital and many of us haven't been oriented to other places. When I float, I only do tasks because sometimes I am the only labor nurse in the hospital.
  9. by   mattsmom81
    I know what you mean, Labornurse...when I float out of ICU I don't like to take an assignment either, cuz when a patient goes bad in house or one comes into the ER, it will be mine. So... it's less complicated for everyone for me to task rather than take a full assignment, knowing I can get pulled away any minute...

    If I can help out in another unit without compromising safety, I generally will try to help them, because next time it may be ME needing help in ICU and I want them to reciprocate.

    Hoolahan, you may be right about the legal risks....any legal nurses out there who can advise us???
  10. by   mattsmom81
    I know what you mean, Labornurse...when I float out of ICU I don't like to take an assignment either, cuz when a patient goes bad in house or one comes into the ER, it will be mine. So... it's less complicated for everyone for me to task rather than take a full assignment, knowing I can get pulled away any minute...

    If I can help out in another unit without compromising safety, I generally will try to help them, because next time it may be ME needing help in ICU and I want them to reciprocate. Now granted, this is in MY OWN FACILITY where I have a certain comfort level...and this comfort level may not exist everywhere...so again it becomes an individual decision IMO.

    Hoolahan, you may be right about the legal risks....any legal nurses out there who can advise us???
  11. by   RyanRN
    Trouble with only 'helping out' when floated, is that most of us don't have that choice. And you can't operate beneath your license. For instance an RN cannot work as an LPN. You are fully responsible for everything under description of the RN license.

    We don't have that support from managment. It still boils down to them against us and 'their' licenses are not on the line. Once asked mine if he was going to court with me should I make a mistake and get sued. No answer.

    That says it all.
  12. by   shodobe
    This is why I went into the OR. No one can float in because it is a highly specialized unit so I don't float out. Besides are union contract only specifies the OR floats to L&D and then only to help them on emergencies. I did do some floating when I first got into nursing and worked on a M/S floor. I felt very uncomfortable about this and refused to go anywhere but the other M/S floor.This is one of the few things a union contract got us, the pairing of units into "modules". You cannot float outside of your modules.This is another reason hospitals do not want unions, your ability to have a CHOICE! Mike

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