Floating? I need your comments!

Nurses Safety

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Hello, all,

I'm putting together a best practice presentation for my hospital staff, and I'm collecting nurses's thoughts about floating. If you could, please respond with a one- or two-sentence answer to the following scenario:

"You come in for your usual shift, and you've been asked to float to another unit. Although this unit has patients of similar acuity level, it's been quite some time since you've cared for the types of patients assigned to this unit (e.g., you work on the neuro floor and you're floated to tele or you work in med-surg and are assigned to ortho). What are your immediate thoughts and concerns about this assignment?"

Thank you!

Specializes in Med/Surg,Cardiac.

Last time I worked I got pulled to psych for 4 hours, ED for 4 hours, then the surgical floor for 4 hours. They sent me where they needed help but as soon as I got done with my assignments I'd get brand new everything. I certainly don't mind helping out but I was exhausted after helping out 3 whole floors. Especially since I've only been at this facility since May.. I love my job though!

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I personally work med surg prn at my hospital so I never know which unit I will work until I get to work. I find that the person floating has to have a positive attitude about floating and that goes for full time staff that have to float also. In some ways I think all staff should have to float enough to get over the fish out of water feeling. Getting over that feeling comes with experience.

Starting the day with a positive attitude is very important. Attitudes are contagous. Your attitude can make or break a day. A negative attitude can make your and all your co-workers day miserable so if one finds oneself with a negative attitude upon learning one is being pulled it may be well to take a few minutes to calm down before arriving on the assigned unit.

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Specializes in Hospital Education Coordinator.

What is the policy regarding competencies for this unit? Are special certifications required?

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Thanks everyone! Y'all are great. KelRN, I think I'll use your exact quote in my presentation. :D

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**bump**

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My initial reaction? "UGH!!!!!!!!! I'm going to have a terrible night because I'm going to get the patients the other nurses don't want."

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I'm a float nurse and I float to a bunch of medical units in the large hospital I work for

This can mean I'm on neuro for 6 hours then go somewhere else or stay there or go to rehab or cardio etc there's about 28 floors I can potentially go to between2 hospital sites

It IS difficult. When I go to a brand new floor my first few questions are:

Where is the clean supply room med room etc

What are the policies of the floor/routines for example some floors you must chart twice if you work a 12 hour shift one as "8" hrs and one as 4 hrs on another floor each nurse has to write a blurb about her pts at night for the resource nurse in the morning

Who can I ask for help? Usually I target the nurse working in the same hallway or room area as me

It's difficult to be a new nurse and a float nurse especially when you come to floors that aren't receptive to new people in general.

Also it's common that the float nurse will get passed the heaviest abd most complex load no kidding! Therefore I agree with the poster who says you need to have a good attitude abd be up beat

It might pass to be sour on your own regular floor for a shift but a float nurse doesn't have that option we meet so many people each day it can get ridiculous

Hope this helps!!

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Specializes in Trauma, Critical Care.

"I don't want to go. I hope I don't stay the whole shift." Concerns over my assignment and if it'll be appropriate (I.e if I went to neuro ICU, I would be uncomfortable with ventricular drains) and I would also want to know how to get a hold of the doc/NP on that unit if something happened.

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Specializes in Med/Surg/.

Editor2rn I can give you some insight here(LVN)as I have floated to almost every floor in a large hospital. ICU,CCU,TELE,M/S,Ortho,Neuro,PP,nursery,Oncology,rehab. Some of these are not specialty but when you go to their floors some routines need to be checked to make sure they do not do things so different. Others are specialty and as such I always wanted my foot in the door and I will tackle anything. When they need you they will usually be nice to you. Take CCU when I first started going there. I am not bashful. I always tell them I have never been. I could do all medical things as a M/S Pt but did not know monitors etc. The charge nurse was always available. If I had to do something I had never done they taught me. I would get the Pts. that were getting ready to get moved out. So learning could be over days or weeks. I was comfortable. ICU-Cold Turkey there.Charge Nurse had begged me to come help for about 2 yrs. I worked upstairs and she was my neighbor at home. I always refused when they called the floor(NOT QUALIFIED) Finally one day I said ok. Understand I am a strong nurse,know my limits and have no problem speaking out. Most of these people I knew some better than others. I simply told them I know nothing and if they want me down there not a negative word will be said or I will never come back. The Head Charge nurse took me under her wing and taught me everything I needed to know. They shadowed me whys and wherefores. I ended up working my 40 hrs down there for 11 mos along with my reg floor(workaholic in those days. All the rest were similar but never did anything I wasn't comfortable with until I became comfortable. When I quite they cried in the office. Apparently there were 4 of us who did all of this out of 800 nurses. Through the 80's 90's I continued all these places and was always comfortable. I started agency in 92 and went all over the state(500 mi radius) and worked in many of these areas also. But now here is the but. I am, along with thousands of my constituents , the exception to the rule. Most nurses feel very uncomfortable outside of their realm. Today it will be much worse then back then. Then the nurses were very willing to teach and help you start from scratch. Today NO. So if you do use a float pool. Get what preference they will feel comfortable with and have those specific people float to those specific areas. It is their right to decline any assignment they feel not qualified for. But unfortunately most are too afraid to stand their ground for fear of reprisal. It takes a strong nurse to get out of their comfort zone. Those charge nurse of those units need to understand they have to guide them the first few times as their routine will be a little different in most cases. You don't take an ICU nurse and put her on the floor and expect her to perform up to par, Although I have known 1 that did. Sorry this is longer than you wanted..I just couldn't put this in a couple of sentences.:o))

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Woot, I bet my load will be easier than the crap I get on my own unit! (And it usually is.)

It's all about attitude. I can do anything for one shift. I'm not afraid to look stupid and ask questions, and usually get to learn a little something by seeing how other units do things differently from my own.

Only thing I don't like is I'll usually end up turning in circles because my body is oriented to going one way for this and one way for that on autopilot. I've done multiple spins in a hallway trying to figure out where to go. :)

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i was assuming that you were talking about a nurse who is employed by the hospital and just happens to get pulled somewhere else.

however, the hospital where i used to work as a nurse intern had an agency that staffed nurses just to float or fill in gaps where there was a need. the nurse might be on our floor for one day or she might be there for several months. either way, i was shocked at the way they were treated.

for example, i had one of the agency/float nurses ask me to fetch one of the "regular staff" nurses to help her do something. when i found that nurse and told her the agency nurse needed help, her response was:

"i have my own work to do. she's getting paid twice as much as me so she can get her own stuff done."

they really were the black sheep. nobody really talked to them or socialized with them during lunch. they were downright jealous that they were doing "the same job" and getting paid less. i was always extra nice and helpful to those nurses because i saw how they were treated and they were always grateful to have at least one ally. i once asked one of the agency nurses why the other nurses didn't just go and work for the agency and "get paid double" and i found out that many of them WANTED to, but the agency had an agreement with the hospital that they wouldn't hire any nurses who had been employed by the hospital until they had been separated from the hospital for at least one year. it made sense because if that rule wasn't in place then the hospital would lose it's nurses in a heartbeat!

i'd HAVE to get paid double to be an agency nurse that floated. besides all the instability....they'd have to pay double just for me to put up with the way i'd be treated! it really was elementary.

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My initial reaction? My goal is everyone still be alive when I leave!! Need more coffee.

In all seriousness, FML non-withstanding, the "who" questions are great ones, and

we had a "survery" as part of our performance reviews on who wanted to cross train

and where. If a med surg nurse has a deep seeded desire to be in the ED now and

again, it was the time to say it, and get oriented and cross trained. So to present to

"floating" conjures up anxiety in some, but "cross train with the ability to float when needed" is

much better.

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