Are you expected to work on a unit you haven't oriented to?

1) Sure, it's called floating

2) charge RN, other unit RNS

3) Where I am, float pool RNs only go to the ICUs after training. Floor and SD RNs never float to the ICUs. ICU nurses float to other ICUs and SDUs. We don't age-cross, so peds RNs don't float to adult, adult RNs don't float to neonatal, etc

YIKES! This is a pretty serious issue for all nurses. I don't know of any state Nurse Practice Act that allows nurses to simply "hope for the best" if they are given an assignment that is beyond their capability. It is our responsibility to identify these situations and take appropriate actions so that patient safety is not jeopardized.

As an ICU nurse, I have dealt with many 'reluctant floaters' where anxious and sometimes even tearful when they came through the door. Heck, I'd feel the same way if I was turned loose in OB -- screaming meemies, here I come!!!

That being said, there are always basic patient care activities that take place in any environment. We can all take VS, give baths, administer routine meds, change dressings, ambulate & feed patients. . . . The key to successfully floating in a specialty area is to establish a collaborative agreement (mini team) with the 'native' nurse. Let him know your limitations and your capabilities. He's not going to expect you to titrate the drips or change out art lines.... but you can do the other stuff.

Floating is orientation that consists of "the breakroom is there, the supplies are over there, and here is your patient assignment".

This works because only nurses with a year of experience or more float, there is a limit to where you can float. Floor nurses float to other floors, ICU nurses might float in other ICUs. Some units are closed units, meaning no floats ever.

I used to be float pool, and the charge nurse is your main resource.

The biggest thing for the float pool nurse is an appropriate assignment. In Cardiac ICU, a float would not take a balloon pump, they would be given a stable pair who are likely to be transferred out that day. The very unit specific skills like balloon pumps, fresh post-op transplants, unstable trauma patient, etc are rarely given to the float staff.

Absolutely I've floated somewhere I didn't have orientation! I worked cardiac step down and floated once to hospice, a couple of times to L&D where I got postpartum moms, and once to ortho post-op.

Going to L&D was the most different but the nurses were awesome support and PP moms are generally pretty easy. Give their ibuprofen on schedule, Tylenol #3 PRN, and feel a few funduses (fundi??). Hospice had med surg overflow as well so wasn't horribly different. Ortho post op basically had a lot more equipment than we do with different policies. The nurses on both floors were helpful when I had questions but I was able to manage okay.

Some nurses go out of their way to make sure the float nurse is doing okay. Lots of nurses were nervous about our floor because ours was the highest acuity out of the unit and had cardiac gtts, chest tubes, post cardio thoracic surgeries, etc that they either didn't get or hardly ever got. We all kept an eye on their monitors and tried to be friendly.

Now after ranting I don't remember all of your questions. Sorry. If I missed something I'll edit!

Yep. When I was a m/s floor nurse I floated to other floors, as an adult ED nurse I've floated to floors, peds ED, and PACU.

Generally the charge nurse is the go-to person for most questions and other staff can point you in the direction of supplies and equipment. If you have a question or a concern, speak up. If you're floating, they're understaffed and probably very glad to have you. Even if there are things about the unit you're totally unfamiliar with (like I probably wouldn't be comfortable on OB or certain ICUs) you can always task- even the most complex patients need basic nursing care, too.

I have, but I only did CNA duties when I did.

Thanks for the feedback everyone!

I'm most interested in float pool experiences for "cross ICU" staffing - i.e. you've trained MICU but are sent to SICU having never been on that unit, or you've oriented PICU but never NICU but are sent there. If staffing circumstances are preventing appropriate orientations to ICU settings as a float pool nurse is one type of ICU orientation enough to "cover" you so that you can realistically take assignments in other ICUs?

Our float pools go by service. Adult ICU goes to all adult ICU and can be pulled to floors if needed. Floor floats stay on floors, they don't have ICU training. Only time they go to ICU is if the step down has low acuity. Maternal-child stays within Maternal-Child. L/D is closed. NICU can float to PICU and vice versa but both these units can go to peds or nursery, no moms.

Thank goodness we don't go by "A nurse is a nurse" anymore like when I started there.

I can still see the horrified look on the CCU charge nurse's face when I showed up to float, with a bursting at the seams-everyone unstable-coding census. I got plopped at the monitors and told to call the nurse if their patients strip went off.

Finally some positive comments about nurses floating!

As opposed to a comment several months ago, "I would not want a float nurse taking care of my family!"

1. yes, but the floor has to be equivilant in acuity to the floor we work on.

2. the staff is there to support, usually.

3. n/a