Float staff having a hard time

Nurses General Nursing

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There is a very specialized unit in which some of the nurse friends I work with also float to, let's call it "Unit X." This unit has the reputation of being unwelcoming towards float nurses, especially the newer float nurses. Many of these nurses dread going to that unit. Here is a common scenario I often hear happening on this unit: New Nurse makes a mistake during an orientation shift. Unit X Nurse sees this mistake, and instead of going to New Nurse to tell him/her about it and provide a good teaching moment, he/she will correct the mistake themselves and go talk behind New Nurse's back to the other Unit X nurses. It is not even a med error where a patient has been directly affected. It's more things like a med not being constituted the right way (but has not been administered to the patient yet) or an IV line not being primed properly.

Other, perhaps more trivial things have also occurred on the unit: the Unit X nurses chat amongst each other without including the floats. They all decide to order food and don't include the floats (not the most polite thing to do, but definitely not the end of the world, IMO). Or, when a new float nurse is running around the unit, very busy with their patient load, the other nurses will just sit there and whisper about them instead of offering to help. Nurses from other units have suggested to them that they should get in touch with the manager of the float pool and let he/she know what is going on. However, a lot of them do not want to tell the manager; one nurse in particular said she didn't want to because she doesn't like confrontation. I then told her that there are other nurses who seem to be unhappy on that unit, so if they joined forces and all went to tell the manager, she wouldn't have to do it alone. The float nurses seem very eager to learn, but don't feel they are being supported in their learning on this unit.

I'm just curious to know the right way for this situation to be handled. Would it be better for the newer float nurses to politely confront the nurses on Unit X when the negative behavior occurs? If so, how should they go about doing it? Would going straight to the float pool manager also be a good idea? I currently don't float to that particular unit, but I guess it would also be helpful for me to know how to handle it in case I end up working there in the future.

Specializes in Case manager, float pool, and more.

I work float pool. I was trained/oriented to all the equipment in our hospital, given classes, provided a decent orientation on all floors I have to float to. Personally, I have always been welcomed and shown appreciation on every floor so far. I have gotten the "crap" assignment a few times but that is more the exception where I am. I have a kick-buttocks manager who sticks up for us. I agree with what psu_213 wrote, this is a management issue.

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Specializes in Med/Surg/Infection Control/Geriatrics.
"The float nurses seem very eager to learn". Float nursing is not the time to learn. Float nurses are expected to hit the floor running. (been there, done that)

This is a management problem. They should NOT be using nurses in the float pool that make errors in medication preparation and priming IV tubing. Perhaps the float team does not receive adequate orientation to different areas.

Sounds like unit X is tired of being sent float nurses that can't pull their weight.

Okay. Play nice now. Yes, it is frustrating when the Float Nurses come and they aren't properly trained.

But speaking as a former Float for Med Surg, rather than criticize this nurse, the fault lies with facilities sending new staff to the floor without proper Precepting.

Perhaps if she goes to her Direct Supervisor and requests more Orientation and have a Preceptor that actually is with her on the floor to which she goes for a few weeks, would help her get her "sea legs." That is how I was taught and it worked very well, because the nurse that precepted me had a great reputation.

Floating is a challenge with the best of skilled nurses, let alone a new one. New staff need support and a floor that is unwelcoming deserves what they get.

But that aside, a suggestion regarding meals, etc.: Sometimes I bring treats to new floors when I come and take a moment or two when we are gathering for report to say hello and ask with a smile that if there is something that I happen to "miss" while I am there, would they please let me know so I may attend to it? That can help with trust. Also offering to help other staff when you can and not wait to be asked, also helps.

Go in smiling.

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"The float nurses seem very eager to learn". Float nursing is not the time to learn. Float nurses are expected to hit the floor running. (been there, done that)

This is a management problem. They should NOT be using nurses in the float pool that make errors in medication preparation and priming IV tubing. Perhaps the float team does not receive adequate orientation to different areas.

Sounds like unit X is tired of being sent float nurses that can't pull their weight.

Can't like this enough. One reason I really appreciate my employer's "no-float" policy for new grads and new hires. Float nurses need to be independent, competent, confident staff. The whole idea is that you can plug in and get going. I am usually treated very well when I float. I also don't expect the staff to be best friends with me when I'm there. One practice I do not approve of is when everyone gives their worst patient to the float. Our charge doesn't permit that. But if I couldn't prime IV tubing, they'd be right to side-eye me.

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Specializes in Travel, Home Health, Med-Surg.

These float nurses should not be doing all the same tasks that the regular staff are doing. This is a highly specialized Peds Onc unit. JUST having peds experience is not sufficient for Peds Onc. I cant imaging what they are doing as far as IV priming goes unless you actually mean IV set up, piggy back with multiple piggybacks etc., and if they are reconstituting than yes you need to be extremely careful with dosing etc. I worked in adult Onc for many years and floated to peds onc but (even as an experienced oncology nurse) was never given patients getting chemo or who had other high acuity needs. This sounds like a bad idea depending on the patients they are given and the nurses who work on that floor know it!. If they are giving them low acuity patients than the float should be able to handle that without difficulty, esp with peds experience. The only thing I would do is pass on all the good info here from all the other posters to your friends since you are not directly involved.

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Specializes in NICU.

As usual it is the we are sending you help= a warm body method of mgmt.Floating regular unit staff instead of having a competent float team is one of the worst aspects of hospital nursing.No one is happy and the patients suffer. I have no solution suggestions for you ,it sounds too messed up,there needs to be a meeting between both groups and guidelines as to assignments and a comment to the unwelcoming behavior,as well as the floaters pulling their own weight.

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I was a float nurse for a large pediatric hospital several years ago. And I was floated everywhere. I only got two shifts orienting on peds hem/onc. That being said, at the time, I had 12 years peds experience, including PICU.,

That hemonc unit had the pickiest policies of all regarding float nurses. And for good reason. You need certifications to be qualified to do a lot of the work there...certs regular peds staff don't have.

Pickier than the CVICU. As a float, I was absolutely not allowed to administer chemo. Pretty much, I mainly was given mostly sickle cell kids, hematology patients, and kids who weren't getting chemo that day. I'm struggling with why the IV tubing would be a problem, but then again, the tubing and pumps were standardized thru my hospital. And not giving antipyuretics to an immunocompromised kid prior to sussing the fever is kind of peds common sense 101, a peds float should know that regardless of the unit. And as for mixing meds, my assignments didn't really involve that...what I didn't know how to do, which wasn't often, I looked up the policy and doubled checked with charge if the policy wasn't clear to me.

If this is a peds float pool, it sounds like either a poor hiring issue or a poor management communication issue. The peds onc manager should be communicating the nurse competency issue to the float management and they need to make a corrective game plan. If the orientation cannot be changed be be more intensive, perhaps they need to set a policy that limits the type of patient a float pool nurse can take on that unit. If this is a general adult pool being used to cover this unit, that's a pretty poor setup.

As a peds float nurse, the way my institution ran it, floating to hem onc was never problematic to me. I received assignments within my skill set and the staff didn't have to baby me. You can slap even the best peds nurse into peds hemonc and not expect them to be fully competant doing things that core nurses need certifications to do.

Very weird. Regardless, being nasty to floats is never productive. And complaining to lateral peers is useless...this seems like a system problem and needs management level intervention. Everybody loses here...core staff loses because untrained nurses are a time suck, and the float nurses lose because they have to go where they are told and they have very little say in backing out of assignments, even when they aren't comfortable.

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"The float nurses seem very eager to learn". Float nursing is not the time to learn. Float nurses are expected to hit the floor running. (been there, done that)

This is a management problem. They should NOT be using nurses in the float pool that make errors in medication preparation and priming IV tubing. Perhaps the float team does not receive adequate orientation to different areas.

Sounds like unit X is tired of being sent float nurses that can't pull their weight.

Understandable. However, the regular nurses of Unit X need to stop gossiping, if indeed they are, and start behaving like people of understanding, people who respect their fellow nurses, people who put the patients' welfare first.

OP - do the super busy floats ever ask the sitting and gossiping X'ers for help? How does anyone not sitting with the X'ers know what they're whispering about?

Your pal, OP, who doesn't like confrontation, is getting what she deserves. She's a chicken-hearted little mouse who wants others to fight her battles for her. This is infuriating. Not that she isn't smart to not make waves, it just is maddening that she refuses to stand up for herself at all.

I'd advise keeping out of it until you have to get involved. perhaps you never will.

And to not invite floats to send out for food is really rude. It hurts so badly to be excluded like that. Personally, I would let them know that I wish they had included me and how much it hurts to be treated like an outsider. It guess no one ever taught them how to reach out and welcome folks. It's so lonesome to be left out. Very juvenile and cruel, however unintentional it might be.

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Can't like this enough. One reason I really appreciate my employer's "no-float" policy for new grads and new hires. Float nurses need to be independent, competent, confident staff. The whole idea is that you can plug in and get going. I am usually treated very well when I float. I also don't expect the staff to be best friends with me when I'm there. One practice I do not approve of is when everyone gives their worst patient to the float. Our charge doesn't permit that. But if I couldn't prime IV tubing, they'd be right to side-eye me.

No they wouldn't. They'd be right to speak to you about it, nicely, directly. The goal should not be to find errors, rather to keep patients safe and to work as a team. This means setting aside griping, backstabbing, and criticizing. It means helping, teaching, nicely, but strongly enough, helping nurses who have erred to learn the right way.

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I work in ER. I do not expect float nurses to do my job like I do my job. Honestly, that would be a poor reflection on my competence.

Sometimes the best use of a float can be to not give them an assignment, but to have them do tasks that unit competent nurses would spend time doing, then up the assignment for the actual nurses in the unit.

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Management sent us a warm body recently.

I introduced myself, she told me she generally works med surg, but they just didn't need her today.

"Can I get Mr Smith in 13 a soda?"

"Sure. Thanks." (Mr Smith twisted his ankle, awaiting XR)

20 minutes later.

"Should I check Mr Smith's sugar?"

"Why?"

"He's a diabetic"

"Well, since you just gave him a soda, I am pretty sure I know what his sugar is doing. It's OK, you don't have to check."

Gee, shocking they didn't need you upstairs today.

If you would like to to see a busy ER doc's head actually explode, tell her that you gave a diabetic a soda, checked the sugar which puts the 364 BG on the medical record, and you want to know what she wants to do about it.

This is not at all indicative of floats in our department. Some work as ER nurses, some need support, and some are extra hands. Sometimes they bring some expertise which we don't have. Regardless, they are treated courteously, and we generally appreciate the help. When I read here what happens in other places, I feel grateful for my work

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Sounds like typical B/itch nurses to me

Actually, like typical b/itch Mean girls in general.

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OP - do the super busy floats ever ask the sitting and gossiping X'ers for help?

To be honest, I'm not completely sure if they ask or not. It goes both ways - when you see another nurse very busy on the floor, the polite thing to do would be to ask if he/she needs help and to help them. However, no one is a mind reader. So, if there is a super busy nurse who needs help, he/she should be forthcoming and just ask for it. If a nurse asks, and they refuse to help, then welp, that's a problem.

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