Floating nurses

  1. I have an issue I really need to get input on. I manage several large telemetry and PCU type areas. Staffing is usually tight...however, once in a while the clouds part and the census in the ICU drops. This means our ICU nurses have to float. Evidently there is an unwritten rule that preceeds me that states that ICU nurses can "bump" the PCU and Tele nurses...causing the PCU/Tele nurse to have to float to med surg areas, while the ICU nurse works on Tele/PCU. While my staff take this like true professionals ...wear a game face and go, for which I'm extremely proud of them for...they end up feeling quite demoralized about the circumstances. I don't blame them. I've attempted but am not getting very far in communicating with the ICU manager about this. Plan to keep trying.
    I fell terrible about this organizational behavior, I'd love to change it, and I'd also love to hear what you think...how this is handled in your hospital, etc...
    Thanks bunches! b
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  2. 38 Comments

  3. by   askater
    What do you mean by "demoralized"?
  4. by   babsRN
    I meant demoralizing in this context as having a negative impact on the morale of the employee...basically feeling less than valued and/or worthless as an employee.
  5. by   janisrn
    Our ICU nurses rarely float due to a normally high census but.....our facility has a float policy. I have had ICU nurses float to one of my med/surg units without any problems. I have also had ICU nurses float to tele and then float a tele nurse to the med/surg floor. It usually depends on which nursing supervisor is working and is usually her decision. Maybe you can get a team together and develop a float policy. Get some staff from each unit involved. Good luck!
  6. by   askater11
    I get pulled to other units, I'm a step-down cardiac nurse. We get pulled to the med/surg. stepdown, CCU and all other cardiac units. (I've gotten pulled to other med/surgical units too...even though we're not supposed to)

    I never once felt demoralized getting pulled. And I still don't understand why they'd "feel less valued".

    Our unit has fluctuating amounts of patients. Thus we often get pulled to other units. I don't feel it's a good idea getting pulled to units that don't follow your scope of nursing. E.G. a cardiac nurse getting pulled to med./surg./O.B./ But otherwise I don't mind getting pulled, as long as the nursing unit takes in account my past history in nursing. (e.g. I work on a unit that pulls sheaths out;we give other nurses pool nurses and patient that are from other units basic cardiac patients;no one with sheaths)
  7. by   micro
    If you can nurse in icu, you can nurse somewhere else.....I see decreased morale.......
    Why should two nurses+ get shuffled, when only one would do.....
    hierachy in nursing.........right or wrong??????? I am here so you have to go?????
  8. by   ArenRN
    As you said... there is an unwritten rule.
    Why not write the policy? If the ICU is low census then those are the nurses to be floated.
    There is no reason to float Telemetry nurses since they are not the ones with low census.
    I work ICU and absolutely hate to float, but would not wish the same on someone else or bump them. It does not make sense floating two nurses to cover one place.
    If the reason for floating the ICU nurses is because of low census, give them the choice of floating or taking the day off as vacation or without pay.
  9. by   Fgr8Out
    We had a period of time when ICU/CIC nurses who floated to our Med/Surg Unit were absolutely incensed about the whole idea. Certainly more than qualified, the nurses primary complaint was that they were unused to caring for the amount of patients we routinely assigned - as in the Intensive care settings they generally have only 1-2 patients. And, no matter how we might try to assign them differently, many of these nurses made the shift difficult because of their attitude. I know they felt out of their element, but the lack of professionalism I saw at these times was dumbfounding.

    We don't float from this group any longer... although they do float within the other Critical Care Modules at our facility. I guess everyone is happier this way.

    Peace
  10. by   susanmary
    Last edit by susanmary on Sep 25, '03
  11. by   arbley
    I am a relatively new manager of a cardiac surgery step-down unit. We have "regular" staff, pool staff, part-time staff, local agency staff, and travel nurses. Usually our staffing and census are such that floating is not an issue, but when it is, it comes with some headaches and some problems that I am not sure how to address. Their traditional way of doing the float thing is to just look at the "float book" and see who has to go this time. The problem is that I have ended up with my reliable, skilled nurses leaving to work a shift on another unit, and nothing but pool, travel, or agency nurses on my unit. I do not think this is a wise practice and it is not acceptable to me as it concerns patient safety, quality of care, and retention of my regular staff.

    I am thinking of instituting a no-float policy for the regular staff, and having the pool, agency, part-time, and travel nurses float first. I am just not sure I can get away with it. The in-house politics may make it difficult.

    I have made a start on changes, but any great ideas as to how to institute new policy on this, and how to present to staff would be appreciated.
  12. by   live4today
    Originally posted by babsRN
    I have an issue I really need to get input on. I manage several large telemetry and PCU type areas. Staffing is usually tight...however, once in a while the clouds part and the census in the ICU drops. This means our ICU nurses have to float. Evidently there is an unwritten rule that preceeds me that states that ICU nurses can "bump" the PCU and Tele nurses...causing the PCU/Tele nurse to have to float to med surg areas, while the ICU nurse works on Tele/PCU. While my staff take this like true professionals ...wear a game face and go, for which I'm extremely proud of them for...they end up feeling quite demoralized about the circumstances. I don't blame them. I've attempted but am not getting very far in communicating with the ICU manager about this. Plan to keep trying.
    I fell terrible about this organizational behavior, I'd love to change it, and I'd also love to hear what you think...how this is handled in your hospital, etc...
    Thanks bunches! b

    Having worked all three areas myself, I would have preferred to be the one to float to the med/surg units over the ICU nurses I worked with who may have had very little med/surg experience. SOME ICU nurses do not feel comfortable floating to med/surg units, so I always volunteered to float since my nursing background is of such a variety that I felt comfortable floating throughout the 'house' to many different units. I guess I can understand the reluctance of the ICU nurses not wanting to float to med/surg because many of them feel it would be like sending a Pediatric Nurse to an Adult Med/Surg Unit...but NOT all ICU nurses feel this way, just some that I have met who have worked strictly ICU patients. I say ask for volunteers first, then if you don't get a volunteer who is willing to float, pull names out of a hat and float the names you pull. Whatever keeps your staff's morale high, go for that!
  13. by   bbnurse
    I recently had staffing issues about floating, use of the team leaders as staff and complaints about "fairness". I asked for 6 volunteers who were the most vocal about the issues to be part of the team to decide how to meet the patients' needs and still keep staff happy. The team decided how we would deal with time off, floating, who to call off first and all the little details for the entire unit. After each meeting, they would discuss the guidelines with the teams and come back with new questions as well as answers. Together we waded through the complexities of what everyone was willing to live with for the patients' safety. It got loud. It was stressful. It was also successful. It is after all, the staff who has the issues and the resolutions. By placing the only unbreakable rule first, we found solutions that we could all understand. That rule is "the patient comes first, the unit second and the nurse third". It works. We even posted the rules so it could not be said, "no one told me that"....
  14. by   fedupnurse
    Floating is just one of the many reasons we have a shortage in this profession. Would any of you go to a gynecologist for a heart cath? Sounds silly but that is exactly what is expected of nurses being required to float to units/floors when they are bunfamiliar with that specialty area. This a nurse is a nurse attitude has simply got to stop! If there is any floating at all,critical care should float within critical care. Med surg stays in med surg. Imagine how the staff feel when they request a shift off and can't get it because we are being utilized as the float pool! I realize that as managers you have to staff your units, but please, let's practice some retention issues and perhaps this floating nonsense will not be an issue anymore! It would make everyone's life much easier!!!!!!

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