Greetings all. I am in search for a solution to a problem in my workplace.I work in a 50 bed ER with about 90K+ visits yearly. Our ratio like anyone else is 4:1 (unless you are assigned to the trauma rooms, etc.) Our managment has allowed for extra staffing to "float" and assist to help those with regular room assignments. This help can range from helping with a critical patient, procedures, medication adminstration, discharge/admit, allowing for lunch breaks, you name it. However, we have hit a vicious cycle.It starts with only but a few people who are possibly burned out and tired. They sit while the float nurses work. So they get burned out, and stop helping like they should. Then when it's their turn to take room assignment, they have upset others by not helping, and then in return do not receive help. Then we may have an influx of GN's or nurses new to our department arrive and they may or may not receive help. And so the cycle continues until cliche's form and favoritism begins.Our managment recongizes the problem and has asked in our help to come up with a solution. Our current solution is to assign "team leaders" with specific qualifications and background. Each team leader is assigned to 3 nurses who are in turn over their set of 4 rooms. This has helped a great deal, but the problem continues as there is still lack of accountability. We tried a feedback tool, where each nurse comments and rates their team leader for the shift and turns it in. We received quite a few but what to do with the feedback tools has become a problem. The staff has seen nothing done about their feedback and has lost faith in the system as nothing seems to have changed.Does anyone have any experience in this, and if so, were you able to find a solution to the problem? How do you encourage people to step up to the plate, do their job, and be responsible? There is fear that if we cannot correct it, then upper managment may step in and either make rules for our department or do away with the float positions all together.