First RN Job in Float Pool?

[dbricson]

If I apply for my first job in the Medical Float Pool at a large, major hospital in my state, will I sink or be able to swim after the 3-month orientation? I've heard it's a great experience to float.

But as a new grad, what are your thoughts?

[Wuzzie]

I’m sure people have done it successfully but it’s an awfully big bite for a new grad to chew.

[TriciaJ, RN]

It helps a bit if every unit in the hospital is set up identically. If each unit has done their own thing in terms of remodels and how things are stored, you're going to be driven nuts just looking for stuff.

After that it's down to how big an orientation do you get and what kind of ratios you're looking at. It could be doable with a lot of support, or you're just sharp and intrepid.

I personally would prefer to cut my teeth on one unit before branching out.

[Kallie3006, ADN]

I worked float pool and loved it. I also had 2 years on one unit before I was able to go to the float pool and I personally think that makes a huge difference. When you are first starting you are not just learning a new system, you are learning a new way of thinking, prioritizing, communication and learning how to even be a nurse. I have read some new grads starting off in this position and they thrived and on the same hand, I have read new grads take on this challenge and sink. I would recommend learning how to be a nurse before learning how to tackle the changing demands for various units or patient populations.

[Here.I.Stand, BSN, RN]

I wouldn’t say it’s impossible, but I wouldn’t recommend it for a new grad. Under ideal circumstances it takes a good year or two to become comfortable in our practice, simply because school can’t possibly teach everything there is to know about real-life nursing.

Add into that, you’re having to learn multiple specialties (my first job had floors for neuro/ENT/adult “peds” pulmonary so adults with CF or PPH; BMT/heme/onc; solid organ transplants; ortho/bariatric/surgical gyn-onc; med tele, and med surf. That’s a ? ton to learn!!!!)..............learn multiple unit cultures, getting to know multiple teams of nurses and providers, multiple unit policies......

Do you know how much orientation you will get on each floor? That makes a difference. I don’t know what is common for new grads, but a friend who started in float pool in my hospital got maybe a week or two on each inpatient unit. She did have more in the ICUs when she was deemed ready to train there.... but wow, a week or two on each floor is really intense.

Especially these days where nursing schools by an large are lacking in the practical aspects of nursing. I hear the old hospital-based diploma schools were second to none... but in the years since joining AN I have heard more times than I can count “I didn’t learn xy&z skill in school because we would learn that on the job.” Or, that a 2-3 month orientation is inadequate, and the nurse doesn’t feel comfortable being independent.

Your school may have been great — I don’t know — but if it wasn’t, you will have the added burden of learning skills in addition to all of the other things.

Early on I will advise you to identify nurses who you can look to after orientation. It could be floor nurses who seem to embrace teaching and mentoring, or ask your own manager if there are other float nurses who would be open to that role.

Another idea is to ask for reputable sources from which to study on your off days. For example, I briefly remember learning about neutropenia and graft-vs-host... but I didn’t learn nearly enough about BMT in school. You will likely need to supplement your knowledge — particularly if you have short orientations on each unit.

[Nunya, BSN]

I would be very concerned about a hospital that would hire a new grad for it's float pool-- concerned as a nurse and concerned as a patient.

[RNperdiem, RN]

I would be uneasy with new grads working float pool.

When we hire new grads to our unit, experienced nurses are looking out for them. Charge nurses make sure the assignments are appropriate, other nurses in the same area are extra-available for help and advice.

If the new grad belongs to one place, there is a sense of ownership and responsibility for them. A float nurse is a guest. Sure we will help them out, just like any other nurse, but there is no mentorship or anything extra.

[Kitiger, RN]

It's a whole different world out there from when I graduated with my hospital-based diploma. I worked float right off the bat, and I thrived. I didn't have to learn where things were kept on the different units, and I didn't have to figure out the culture on each unit, because I had already worked those units as a student!

I started out Med-Surg float, then added Peds, then the various intensive units (ICU, Cardiac Step-Down, Peds ICU, NICU, Intensive Care Surgery).

I learned early to avoid the regular Peds floor. I wasn't there long enough, and I got sick every time I worked there.

I just shake my head, reading about how some new nurses don't know how to start IVs, have never put in a foley cath, and have no idea what to do with a trach! ?

[brownbook]

I was a new grad float. My whole 34 year career I have loved floating.

As a new grad I had the new nurse misperception, put pressure on myself, that was supposed to know everything, every illness, disease, medication, treatment, etc. I felt embarrassed and stupid when I had to ask questions.

Yet when I floated I didn't feel that self imposed pressure. It didn't bother me to think, say, I'm a float, I don't know about that drug, treatment, etc., and ask for help.

So that's my why Iove to float rational.

[SteelGrey]

I think it's possible, however 3 months seems short for sink or swim. I have seen it done well with about a year of orientation. Starting with basic med-surg for a few months to get a foundation , then mini orientations in the various other units until basic competency is achieved. Also, depends what your hospital gives floats or even each unit-- are you getting more routine pt's that you are capable of or is anything fair game?

Nights versus days?

Ask to shadow!

[JadedCPN, BSN, RN]

I definitely wouldn't recommend it as a new grad with only 3 months orientation. I have seen one successful new grad float pool residency program in Cincinnati, but those new grads got an entire year of orientation process where they oriented on a unit for so long, then had prescheduled shifts on said unit to "practice" what they completed in orientation, then moved on to the next unit.

Not saying it can't be done. I just wouldn't recommend it. I do thoroughly enjoy being float pool though and could never ever go back to working a floor again.