At my hospital we have divisions. Let me elaborate:
Critical Care is comprised of CCU, ICU, and CVICU (1:2 ratio)
Step-Down is comrprised of IMC and CVIMC (1:4) ratio
--- no PCTs ----
Telemetry is telemetry (1:8) with two PCTs for the floor
Med/Surg (1:8), Surgical Telemetry (1:7), ER, L&D, Post-Partum, Peds
Critical Care and Step-Down and Telemetry are considered one division. This means that our unit nurses frequently float to step-down when there is a need. Every once in a blue moon will a unit nurse have to float to telemetry.
When critical care needs help, every rare once in a while will we get a step down nurse to help us, and even then, that nurse will have to be assigned the less acute patient (obviously)
Step Down nurses are more readily floated to telemetry
Unit nurses are NEVER floated to med/surg or surg/tele or L&D, PP, Peds. If a nurse is cross trained in ER, he/she can be floated there.
Being floated to step-down is a major cause for complain at my institution. We're working on limiting the division to critical care ONLY. But this means that us critical care nurses will be responsible for ensuring an adequate staff, and if not, we'll just have to triple up.
I was recently at a conference in San Diego (CRRT - it was awesome) and learned that many hospitals (including Canada) do indeed ship their unit nurses all over the hospital.
I personally feel this is a dangerous practice and couldn't fathom risking my license under those circumstances.
Your best bet is to find a magnet hospital and apply there.
Best Luck and I hope I didn't ramble too much,
Quote from PCloudy
Hello everyone! I haven't been on here in a very long time but it's good to be back. Seems like the forums are as active as ever. My question is (sorry if it's a bit long): What do your hospitals do regarding the floating issue? Where I work, ICU staffs the rest of the hospital (most often Stepdown and M/S) due to poor retention, poor scheduling, etc.
Rarely is the favor returned. We'd like to be a closed unit but administration always finds a reason to float us - sometimes relentlessly - if our census is down. Yesterday, in the first 4 hours of the shift, we experienced 3 codes, 2 deaths, a transfer out and couldn't even chart before the supervisor was walking through to find out who was going to Stepdown.
Moral is very low. Nurses that have been there 15-20 years are resigning and our manager seems to think that any warm body will do. In the two years since she "took over" (as she calls it), she has failed at appropriate hires 100% of the time. Most of her prize employees have quit and the one or two that remain cannot carry their weight.
Well, I could go on forever but in the interest of preserving sanity, if you have a solution to the ever-present threat of floating to unfamiliar areas, please send me a reply. It's a very hot topic in my unit right now.