Closed Nursing Unit

Always makes me laugh when people talk about how they hate being floated. Anyway, if you were to close your unit there are a few things you'd have to do. One you'd have to have a nurse or two on call every shift incase you get a sudden run of admits. Then your unit would also have to absorb the cost to train float pool members on your closed unit incase your staffing numbers go to crap with admits and or sick calls. Otherwise you run the risk of working short more often than you would like. I know in not all cases, but I've come across a few hospitals in the area that because they're closed units they require one year nursing experience to get hired on there, so if you have a few people leave you wouldn't be able quickly stock back up with new grads, you'd have to wait for a bunch of people who would want work on your closed ortho unit. Now that is assuming the one year thing, if the DON and hospital admin were fine without the experience it might not be that big of an issue.

Thanks for the info! Luckily, we're a joint replacement unit so we don't get general ortho admits from the ED or OR. We're able to look in advance at the schedule and adjust our staffing to fit the week. Occasionally we get a few patients we weren't expecting but not enough to drastically change our staffing needs.

Hi,

I work on an orthopedic unit as well. A few years ago, we became a "closed unit". Except not really. It worked out to us working short when we had call ins, but still being floated. The hospital got around this by having the stipulation that we could float to "overflow" units, or any unit if there was a "staffing crisis". We never had a definition for what qualified as a staffing crisis and it generally happened when our manager wasn't around to fight with staffing about it. At our facility the closed unit thing really hasn't been beneficial in my opinion. When things were initially working, we would cover call ins and things like that, by just texting everyone on the unit and working as a team. Usually someone would come in for overtime.

Always makes me laugh when people talk about how they hate being floated.

Out of curiosity, why does this make you laugh? I am one to whom the thought of being next up to float can ruin the night before: forget any sleep. It's part anxiety as to 1) what type/acuity patients I will have, 2) will I know the docs, 3) will I recognize acute issues that I only learned about in nursing school 15 years ago; and part concrete knowledge that my assignment as a floater will consist of the worst of the floor's patients, spread from one end of the unit to another.

Is that funny? I'm not trying to be flippant. Most nurses that I know absolutely loathe floating. Apparently, you don't.

A Closed unit means taking ownership for ensuring 24 hour safe staffing and working extra if someone is out sick.

The nursing staff who are inflexible and refuse to help when staffing is thin, will soon find that they will not have preference in scheduling or vacation requests. You need a strong manager who can stand up to people who don't pull their weight.

The question you need to ask is "Are my coworkers mature enough to function as a closed unit?"

I work on an ortho unit and we end up filling up with off-service pts and/or having to float on the weekends mostly. For some reason, this time of year, staffing is a little wonky. Floating is not my favorite thing but it is part of the job. you learn a lot. it prepares me for the off-service pts we get.