Floating

[Rexie]

Recently, a local hospital had a one day strike. One of their issues was their hospital's policy regarding floating nurses to other units.

I'm curios what other hospitals do about floating. What kind of floor do you work on, what kind of floors are you able to float to, what floors are you not required to float to, and what level of comfort do you have with it.

I've seen hospitals where medical nurses were not required to float to the ortho floor. I've seen other hospitals in which medical nurses are floated to surgical, emergency, etc. For example, a seasoned medical nurse told me that management attempted to float her to the ED. She refused to go, stating that if she applied to work in the ED and got the job, she would have been given a few weeks orientation and she didn't feel qualified to go as a float. I'm not sure if she went under protest or not but she got me thinking. I know another nurse who had always wanted to work in the ED and went happily. Is one right and one wrong?

Personally, I have floated from the medical floor to the trach/vent floor in an LTAC but we floated often enough to develop a certain level of comfort and we had a lot of support from the regular staff on that floor. However, floating from a medical floor to the ED would make me nervous.

[ChristineN, BSN, RN]

I worked in a float pool for 3 years so I became very familiar with the policies at my hospital for being floated. If you are a med-surg nurse you can get floated to any area (ice ICU, ER) if you are taking care of med-surg pts in that unit. If you are being expected to take care of pts that are beyond your level of care then that is an issue. Only nurses that are tele trained should be expected to take pts on telemetry.

[SaoirseRN]

I am also in a med/surg float pool (six years now) and work medical, surgical (general, urology, and ortho), day surgery, outpatients (antibiotics, transfusions, iron, etc, things needing nursing but not admission), palliative, and telemetry when needed (though the policy is the critical care nurses still look after the monitor). I have also floated as workload in ER and on occasion helped out as extra hands in maternity when they just need another RN on the floor.

Aside from maternity, I have been oriented to all these departments, and I think it is reasonable to request orientation if you are likely to get floated often. Of course, urgent situations happen and sometimes it isn't possible, but I think if I were floating regularly I would at least like a formal introduction to the department and their specific quirks.

[Vespertinas]

A seasoned medical nurse told me that management attempted to float her to the ED. She refused to go, stating that if she applied to work in the ED and got the job, she would have been given a few weeks orientation and she didn't feel qualified to go as a float.

Any job you apply to would give you a few weeks orientation. When nurses are floated, it's considered a critical situation and that argument shouldn't apply if at least you're given same level-of-care patients.

[missnurse01, MSN, RN]

Where I am at you get 4 hours orientation before being floated to that unit. We are unionized, so you have it spelled out where you will go. when I work cvicu, we can float to neuro icu, tele, and med surg. It is a nightmare. the only people that can float to us is neuro icu. No one floats to ER.

I have worked ER at other places and have had them send down people from all over the hosp to help. It was common for them to send us l&d nurses when their unit was empty. They did not do primary care, just assisted with procedures, starting iv's giving meds etc.

I think it would be hard to float outside of your work group. That is why this facility does it that way.

[brithoover]

I floated to every floor except PACU and OR. 2 days orientation on each floor

[LNRN11]

I work CVICU and we are expected to float just about everywhere; SICU, MICU, ED, Med-Surg, you name it. On occasion, we will get nurses floated to us, but we only give them patients they are used to handling (i.e. MICU nurse will get the vented respiratory failure/CHF patient, not the STEMI straight out of the cath lab) Unfortunately, I have heard of nurses receiving patients that are not appropriate when floated to other units. A nurse from my unit with no SICU experience ended up receiving a fresh craniotomy when he got floated. Needless to say, it made him pretty nervous. :\

[eatmysoxRN, ASN, RN]

I am floated almost as much as I'm on my own floor. We are expected to go where ever we are needed. Any of the ICUs. Ortho. Med surg. Oncology. Respiratory. Peds. L&D. Gyn. ED. Post cath. Just where ever except OR and CCL.

I would have liked to have been oriented to the other areas but I only received orientation to my floor. Anywhere I am pulled I'm expected to hit the ground running. Take 3 icu patients like the nurses who work there regularly (they don't give me vents but I have had critical patients and admissions to the unit). We don't receive any type of incentive even though float nurses (who aren't utilized when a floor is low census and they can just pull other staff) get paid much more hourly.

[Morainey, BSN, RN]

I just started a thread about this in the General forum a couple of days ago. My floor is ortho med-surg and we are expected to float to tele, med-surg, and very very very infrequently the mother/baby unit (they basically use you as an extra set of hands, answer call bells, take care of med-surg patients if there are any there) and the ICU (they give you a floor level patient or two).

I have been dumped on while floating, but usually people are very nice and helpful and thank me for floating there at the end of the shift.