FLOATING POLICIES - page 2

by BROWN_KK 7,186 Views | 15 Comments

Just curious what other nurses experiences were with floating. As an ICU nurse I am being told at my new place of employment that I must float essentially everywhere with as little as 30 min. orientation because it is a "lower... Read More


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    My hospital recently changed the "floating" policy as well (do I sense a pattern here? ). Anyway, under the new policy 1)PRN nurses are not automatically the first to go; whose ever turn it is to go, goes and 2)Nurses in the "critical care division (ICU's and the 3 tele floors) CAN be floated to med/surg. The ICU nurses are "freaking" about this policy change. I can't say I'm happy about the idea of being floated to m/s either but supposedly they are going to put a cap on how many patients we can take (5 max). I certainly am not going to accept an assignment that I don't feel qualified to handle, ie giving chemo. Many nurses at my hospital have been there a long time and up till now, had a lot of loyalty--many RN's started as nurses' aides. However, the way management is treating the staff, all they are going to do is drive a lot of nurses out the front door to agencies or other areas of nursing ie home health. So it will be interesting to see how things evolve.

    Laurie, RN
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    Originally posted by zimmermears:
    In reply to the floating issue. I just took a new job in a local hospital. I found out that the staff nurses are expected to float to any area in the hospital including all of the specialty units. I feel this is a VERY unsafe policy. Does anyone know where JACHO stands on this issue? In one case a Psych nurse was asked to float to Med/Surg. She stated that she was uncomfortable with this, and was told if she did'nt float it would be grounds for termination. Needless to say, she walked out and never came back. Hospitals wonder why they have a retention problem? I would like to suggest a new float policy that would include only floating to 2-3 units. If anyone has a policy like this that has worked, please contact me! zimmermears@aol.com Thanks to anyone who can respond!


    Some of the bigger centers I have worked in have gone to cluster areas of floating where you should be able to function and the patient population and load resemble your home unit. (i.e. monitored units, med-surg areas etc.....) This business of floating outside your region is ridiculous, dangerous and stressful. Indeed, stressful enough to drive nurses from their hospitals and from the field altogether.
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    A previous poster asked about what JCAHO's position on this issue is. So I decided to try and find out. A search on the word "floating" did not yield anything on the JCAHO website. However, I was reading some items under the "standards" section and noticed that they do have a mechanism for complaints. Of course "The Joint Commission encourages anyone who has concerns or complaints about the quality of care to bring those concerns or complaints first to the attention of the health care organizationís leaders". Obviously the people at JCAHO really have no clue what is truly happening in our hospitals! Imagine if they got FLOODED with complaints about every hospital and "patient safety" issues! Yikes! I'm sure my facility would not take it too well if someone were to file a few complaints with JCAHO over the fact that they are planning to change our ratios (giving each nurse MORE patients) and allowing us to float anywhere in the hospital! How beneficial are these actions to patient safety?

    One more thought: Does anybody think filing a complaint with JCAHO will really be effective, even if I were to include evidence (in the form of prior studies)that show less patients/nurse = better outcomes? I'm more than happy to do it, I just don't want my efforts to go for nothing.

    Laurie

    [This message has been edited by LLDPaRN (edited October 18, 2000).]
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    Originally posted by BROWN_KK:
    Just curious what other nurses experiences were with floating. As an ICU nurse I am being told at my new place of employment that I must float essentially everywhere with as little as 30 min. orientation because it is a "lower level of care". Where is the respect for the organizational and assessment skills of the med-surg nurses who take care of these insane assignments of 10 or more patients? I simply do not possess these skills after 10+ years in an ICU. Why are they considered a "lower level of care"? And why do nurses endanger their licenses by taking assigments they are not really competent to handle? Where is JCAHO in all of this? I just do not get it!!!!!!!!!
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    I must agree with you. I have been searching for anything that has to do with floating to med-surg floors. I have also been an ICU nurse for some time.(12yrs). We are presently in dispute with our hospital over low census days and having to use our own PTO time or having to have this same PTO time pro-rated if we don't. When we go into discussion with them, we have been told that they will use this very suggestion to us. That we can always float to a med=surg floor if we want to make up the time. Therefore, we need some ammunition to come back at them. Like, we are used to intense assessment of our patient so therefore would have a difficult time streamlining the assessment to fit a larger patient assignment given to us on the floor. OR getting use to the entirely different charting that comes with floor nursing.Finally, I agree with the statement that if the floor nurses don't have to come up to ICU then why should we have to float to the floor? We think that the hospital is not respecting that we have special training and are required to have certain skills to work in ICU. So treat us with some respect and don't require us to float to floors. A nurse is a nurse is a nurse.....NOT!!!!!
    Originally posted by BROWN_KK:
    Just curious what other nurses experiences were with floating. As an ICU nurse I am being told at my new place of employment that I must float essentially everywhere with as little as 30 min. orientation because it is a "lower level of care". Where is the respect for the organizational and assessment skills of the med-surg nurses who take care of these insane assignments of 10 or more patients? I simply do not possess these skills after 10+ years in an ICU. Why are they considered a "lower level of care"? And why do nurses endanger their licenses by taking assigments they are not really competent to handle? Where is JCAHO in all of this? I just do not get it!!!!!!!!!
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    HEADS UP!!! You should never ever accept an assignment that you do not feel comfortable with. You make sure the charge person on the other floor knows what you will and will not do (ie if you give my meds then I will do more VS or whatever) and if you do receive such an assignment you should call the supervisor immediately and state the problem, and then you should write an anecdotal note to the director, your UM, their UM and the supervisor. If you have to be responsible for yourself, no one else will be. We have been floated to adult ICU's and we tell them that we will only act in an assistants description! Once you accept an assignment you are then held accountable, but if you refuse an assignment you consider unsafe, then you are saving yourself alot of trouble!

    Unfortunately, floating is becoming a fact of life for many of us and we need to take the bull by the horns!


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