Floating to diffrent units in your hospital - page 2

I was just wondering what are the policys for floating in your hospital?... Read More

  1. by   prenurse
    I work on a med-surg unit currently, we are always being pulled to other units: OB, ER, PEDS, PCU, ICU, Telemetry. We have a book that is kept showing which nurses were pulled when/where. We go by the book on who's turn it is to be pulled. I am going back to the ER Jan. 1st and down there nurses don't go anywhere; they are never slow and never have extra nurses.
    If you do not go to a unit when you are pulled they can write a variance for insubordination. (sp?) unless you have valid reason why you don't want to go; like a speciality unit that you don't feel comfortable with.
    Last edit by prenurse on Dec 1, '05
  2. by   SmilingBluEyes
    I work in a closed unit, meaning we don't float. But we do get low-censused if there are not enough patients, so it's a double-edge sword.
  3. by   Mississippi_RN
    Quote from SmilingBluEyes
    I work in a closed unit, meaning we don't float. But we do get low-censused if there are not enough patients, so it's a double-edge sword.

    I would rather float... I have told them repeatedly that they can send me off the unit to work but don't send me home... LOL.. Don't mess with my money. I live 30 minutes from work and if I don't get the time and get sent home... I end up in the red.
  4. by   Tweety
    Quote from SmilingBluEyes
    I work in a closed unit, meaning we don't float. But we do get low-censused if there are not enough patients, so it's a double-edge sword.

    Our women's floors don't float either, except post-partum floats to gyn and gyn floats to pp. L&D and nursey doesn't float. ER nurses don't float anywhere either.

    I might add that ICU nurses don't float to med-surg and visa versa.
  5. by   veegeern
    [quote=Daytonite] each unit maintained a float list that was usually kept in their report room. It was merely a log of who floated, what date, and to where. So, if 5 nurses showed up to work on the medical unit and they were told one person had to float to the surgical unit, they consulted the log to determine who the last 4 among them floated before #5 who was the lucky winner. There are times when some staff members will actually volunteer to go to the head of the line to the relief of the rest of the people on the unit that shift.

    Now, PRNs were utilized first. PRNs where I worked were expected to float, no exceptions, unless they had been called in at the last minute and had made a special deal with regard to floating. So, after the PRNs had been moved around, the next group that got "picked on" was the regular staff.


    This is basically the same way that it works in our hospital except that our PRNs are usually floated off the same log. An exception would be one that has specialized experience over the nurse whose turn it is to float. I'm on an Internal Medicine Floor. Most of the patients in the ICU/CCU are ours, so when a nurse needs to be pulled to "the unit" they are usually pulled from our floor. Sometimes that means that a non-medical nurse is pulled to our floor to work. If we have to go to somewhere like Peds/OB/L&D/Post Partum, then we generally take VS, give PRNs, etc... Also, our surgical floor is really good about weeding out patients with routine care and giving them to a surgical nurse that is pulled to their floor.
  6. by   SmilingBluEyes
    Personally, I like the closed unit. If I get low-census'd there is always the opportunity to make it back up in just one shift where all hell is breaking loose. I hated floating in my other hospital---I was never much use to them, and usually just wound up pushing meds and the minute OB got a patient, then I had to go back.

    I am not really interested in working in foreign areas; I have enough to deal with in doing LDRP and GYN as well as newborn nursing. It's enough variety for me.
  7. by   HappyJaxRN
    They float us out based on acuity of our pts and based on the number of transplant pts we have. I haven't floated since July of this year. Swweeet. I hate floating because I feel backwards where ever I go...A lot of times tho, I'll have a better night if I float out. If we get any transplants tho, we are usually floated back because not anyone can be a transplant nurse. A float nurse usually takes our med/surg pts.

    We have a float book that we go by and we take turns floating. Altho, if you're PRN staff, you always float first no matter who's in line to float next. That kinda stinks....but I'm not complaining....(not a PRN'er ).
  8. 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.
  9. by   veegeern
    Quote from 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.
  10. by   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.
  11. by   veegeern
    I agree. It's quite a delima, but again, so far I have been able to work something out...
  12. by   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!
  13. by   Daytonite
    Quote from 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.

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