Floating to diffrent units in your hospital

JennRN&Mom23 · Dec 1, 2005

Not sure of our policy exactly but they do often call in Medical nurses to look after admits in ER. I always say no to those shifts because you never know what you are walking into.

Otherwise, I've seen them float from other floors to medical (from ob or surgical) when we are busy. It never happens the other way around because medical floor is always the craziest and always the floor needing extra help.

lwd338 · Dec 1, 2005

I am a float LPN and I love my job!!!!!!!!!!!!! I dont have to get involved in the units "politics" + I dont get mandated either, I have been an LPN for 30 years and I have finally found employment heaven hahahah ( I have been at the same hospital for all this time so I know it like the back of my hand, and they know me as well) I started floating a few years ago when I needed to go full time due to a son in college otherwise I was on a Telemetry foor which I still call home when I float there.

Mississippi_RN · Dec 1, 2005

If we are slow on our floor, they are liable to send us anywhere! About a month ago, I came in to be pulled as charge on Holding Unit (with four psychiatric patients with schizophrenic patients). Usually, I will be pulled from PostPartum (where I alternate charge with the other RN) to Newborn Nursery to Labor and Delivery sometimes. I do not mind so much about that though since I work in Maternal Health Services and we can be floated at any time to one of those areas. About 2 weeks ago, I was sent to one of the hard core Medical Surgical floors, but I hung tough. We do get a lot of Med-Surg overflow on our PostPartum floor but none of the really bad, bad stuff. It was kind of refreshing though. They wanted me to go to ICU and work one night, but I flat out refused to stay late....I do not anything about all those monitors and I felt like the night was not the best time to try to be orientated.

bluestar · Dec 1, 2005

When census on unit is low we float.

P_RN, ADN, RN · Dec 1, 2005

For many, many years we had a closed unit. If we were short-we covered it. I didn't float for almost 15 years. Managament changed and just about every week we went somewhere. I drew the line at monitored beds....too out of practice. If they wanted to pay me $25+ to hand out prns or sit with a patient that was fine. Otherwise I took a DWP.

Daytonite, BSN, RN · Dec 1, 2005

Having been an acute hospital supervisor in two places I can tell you exactly how this worked. The supervisors during the off shifts and the nursing managers of the day shift would determine if musical nurses (that's what we lovingly called floating) had to be done. Then, each unit maintained a float list that was usually kept in their report room. It was merely a log of who floated, what date, and to where. So, if 5 nurses showed up to work on the medical unit and they were told one person had to float to the surgical unit, they consulted the log to determine who the last 4 among them floated before #5 who was the lucky winner. There are times when some staff members will actually volunteer to go to the head of the line to the relief of the rest of the people on the unit that shift.

Now, PRNs were utilized first. PRNs where I worked were expected to float, no exceptions, unless they had been called in at the last minute and had made a special deal with regard to floating. So, after the PRNs had been moved around, the next group that got "picked on" was the regular staff.

If we supervisors got a call back that a float hadn't shown up on the floor someone was to float to, or that the nurses were arguing over whose turn it was to float, then we merely went back through our master staffing sheets in the nursing office where this information was recorded and made the final determination of who was going. It was very seldom that we had to make an off the cuff decision as to who was going to float.

Floating nurses to ICU or CCU was the hardest and most delicate to do. Very simply, most people are scared to death to go into the ICU. Stepdown nurses get resentful because they are often sent to the ICU or CCU and then someone from med/surg is sent to stepdown to replace the person who got floated to ICU. We occassionially had a circumstance where we might have needed an RN in the ICU and we knew that an old ICU nurse was now working on one of the medical floors. We would often make a personal visit and attempt to talk the old ICU nurse into floating back to the ICU for one night. However, we did this very rarely. If floating is not done fairly, there will be a lot of resentment and hurt feelings.

Let me just point out that floating was as distasteful to us supervisors as to the rest of the staff. We had to mediate disputes over it. However, we had a very expensive acuity program that our Director of Nursing said we had to utilize and follow or else we had to stand front and center in her office and explain why we deviated from the acuity. The program was run just before the start of each shift and spit out numbers telling us how many nurses we could have on each unit (this was based on census and updated acuity information input by nursing). If a unit was allowed 4.6 nurses according to the accuity program, we could either go with the 4 nurses that were scheduled for the unit and could add a fifth nurse if another unit was considered overstaffed. If a unit was allowed 2.1 nurses according to the acuity and there were 3 scheduled, we had to pull a nurse from them if there was a need somewhere else or ask for a volunteer to go home (how often do you think that happened?).

lwd338 · Dec 1, 2005

Our union says that we HAVE to be offered AET before we are made to float AET is approved excused time meaning you can take the day off without pay rather than float and it doesnt count against your accrued time at the hosp. Most nurses take this and the nurse fromthe previous shift will get mandated if no one can be found.

KatieBell · Dec 1, 2005

Every hospital I have worked at had a policy for floaitng that involved "FLOATING WITHIN COMPETENCY" meaning that it would be completely inappropriate to send a Med Surg nurse to ICU, or even tele, if she was not tele certified.

So I worked in ICU, I floated to the other ICU's and stepdowns and tele.

The floor nurses would float between different med-surg floors.

Now, I'm doing ED, pretty much everywhere I have worked does have a closed unit policy. We don't take on floaters and we don't float out...I like that better, but I guess the floating in my early year of nursing was not so bad.

dfk, RN, CRNA · Dec 1, 2005

in my hospital, i work sicu, and anyone in the icu/ccu/micu/sicu/cticu will float among each unit when necessary.. if anyone floats to cticu or micu, no one will get a fresh heart or iabp (unless trained).. there have been instances when critical care nurses are floated to med surg (boooooooooooo!!!), as we are "here to staff the hospital, not the unit." - i say to my nurse mgr, "go *$@k off!!!

RNsweetie · Dec 1, 2005

I was a float nurse (my first position) and it was great, i learned so much I was floated to med, surg and emerg/ observation. I had exposure to everything and and really feel that it gave me a broad base for any type of nursing. I could have been pulled at any time during my shift, to where it was busy. that never did happen to me but the possibility was there.

At my current position, i am a permanent on post partum and when our cencus is low, we are ususally pulled to LDRP to take over PP patents and then they are free for labouring moms.

We are particularly slow this week ( a real rarity) I called in fro an LOA and hurray for me, got it!!! I think i shall clean the house!! (sad I know)

lee1 · Dec 1, 2005

To Daytonite,

What kind of acuity system does your hospital use?? Is your system paperless???

Our hospital is now in the middle of switching to electronic system and we hope eventually the patient acuity will be transparent and easy to pull out the numbers as you describe. For example, every order will have nursing acuity already figured in.

Lee