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Floating to diffrent units in your hospital

I was just wondering what are the policys for floating in your hospital?

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.

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

Specializes in Med-Surg, OB/GYN, L/D, NBN.

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.

When census on unit is low we float.

P_RN, ADN, RN

Has 30 years experience. Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

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

Has 40 years experience. Specializes in med/surg, telemetry, IV therapy, mgmt.

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?).

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.

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

Has 11 years experience. Specializes in Critical Care, Emergency.

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!!!

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)

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

Tweety, BSN, RN

Has 28 years experience. Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

I work trauma med-surg, we float to med-surg, cardiac PCU, telemetry, skilled nursing and rehab, gyn, and rarely to post-partum (we used to float there more before they came up with an on-call system). BGasically everywhere but crtical care and progressive stepdown units.

If we're given an assignment we're uncomfortable with, it's up to us to speak up.

We keep a float list and float in rotation. If we have travel nurses, which we don't right now, they are the first to float.

prenurse

Has 1 years experience. Specializes in ED.

I work on a med-surg unit currently, we are always being pulled to other units: OB, ER, PEDS, PCU, ICU, Telemetry. We have a book that is kept showing which nurses were pulled when/where. We go by the book on who's turn it is to be pulled. I am going back to the ER Jan. 1st and down there nurses don't go anywhere; they are never slow and never have extra nurses.

If you do not go to a unit when you are pulled they can write a variance for insubordination. (sp?):) unless you have valid reason why you don't want to go; like a speciality unit that you don't feel comfortable with.

SmilingBluEyes

Has 20 years experience.

I work in a closed unit, meaning we don't float. But we do get low-censused if there are not enough patients, so it's a double-edge sword.

Mississippi_RN

Specializes in Med-Surg, OB/GYN, L/D, NBN.

I work in a closed unit, meaning we don't float. But we do get low-censused if there are not enough patients, so it's a double-edge sword.

I would rather float... I have told them repeatedly that they can send me off the unit to work but don't send me home... LOL.. Don't mess with my money. I live 30 minutes from work and if I don't get the time and get sent home... I end up in the red.

Tweety, BSN, RN

Has 28 years experience. Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

I work in a closed unit, meaning we don't float. But we do get low-censused if there are not enough patients, so it's a double-edge sword.

Our women's floors don't float either, except post-partum floats to gyn and gyn floats to pp. L&D and nursey doesn't float. ER nurses don't float anywhere either.

I might add that ICU nurses don't float to med-surg and visa versa.

veegeern, BSN, RN

Specializes in Internal Medicine Unit.

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.

This is basically the same way that it works in our hospital except that our PRNs are usually floated off the same log. An exception would be one that has specialized experience over the nurse whose turn it is to float. I'm on an Internal Medicine Floor. Most of the patients in the ICU/CCU are ours, so when a nurse needs to be pulled to "the unit" they are usually pulled from our floor. Sometimes that means that a non-medical nurse is pulled to our floor to work. If we have to go to somewhere like Peds/OB/L&D/Post Partum, then we generally take VS, give PRNs, etc... Also, our surgical floor is really good about weeding out patients with routine care and giving them to a surgical nurse that is pulled to their floor.

SmilingBluEyes

Has 20 years experience.

Personally, I like the closed unit. If I get low-census'd there is always the opportunity to make it back up in just one shift where all hell is breaking loose. I hated floating in my other hospital---I was never much use to them, and usually just wound up pushing meds and the minute OB got a patient, then I had to go back.

I am not really interested in working in foreign areas; I have enough to deal with in doing LDRP and GYN as well as newborn nursing. It's enough variety for me.

HappyJaxRN

Has 9 years experience. Specializes in Transplant, homecare, hospice.

They float us out based on acuity of our pts and based on the number of transplant pts we have. I haven't floated since July of this year. Swweeet. I hate floating because I feel backwards where ever I go...A lot of times tho, I'll have a better night if I float out. If we get any transplants tho, we are usually floated back because not anyone can be a transplant nurse. A float nurse usually takes our med/surg pts.

We have a float book that we go by and we take turns floating. Altho, if you're PRN staff, you always float first no matter who's in line to float next. That kinda stinks....but I'm not complaining....(not a PRN'er :) ).

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