Floating Issues

LindaMarie76 · Mar 23, 2005

At my hospital we have divisions. Let me elaborate:

Critical Care is comprised of CCU, ICU, and CVICU (1:2 ratio)

Step-Down is comrprised of IMC and CVIMC (1:4) ratio

--- no PCTs ----

Telemetry is telemetry (1:8) with two PCTs for the floor

Med/Surg (1:8), Surgical Telemetry (1:7), ER, L&D, Post-Partum, Peds

Critical Care and Step-Down and Telemetry are considered one division. This means that our unit nurses frequently float to step-down when there is a need. Every once in a blue moon will a unit nurse have to float to telemetry.

When critical care needs help, every rare once in a while will we get a step down nurse to help us, and even then, that nurse will have to be assigned the less acute patient (obviously)

Step Down nurses are more readily floated to telemetry

Unit nurses are NEVER floated to med/surg or surg/tele or L&D, PP, Peds. If a nurse is cross trained in ER, he/she can be floated there.

Being floated to step-down is a major cause for complain at my institution. We're working on limiting the division to critical care ONLY. But this means that us critical care nurses will be responsible for ensuring an adequate staff, and if not, we'll just have to triple up.

I was recently at a conference in San Diego (CRRT - it was awesome) and learned that many hospitals (including Canada) do indeed ship their unit nurses all over the hospital.

I personally feel this is a dangerous practice and couldn't fathom risking my license under those circumstances.

Your best bet is to find a magnet hospital and apply there.

Best Luck and I hope I didn't ramble too much,

Linda

Hello everyone! I haven't been on here in a very long time but it's good to be back. Seems like the forums are as active as ever. My question is (sorry if it's a bit long): What do your hospitals do regarding the floating issue? Where I work, ICU staffs the rest of the hospital (most often Stepdown and M/S) due to poor retention, poor scheduling, etc.
Rarely is the favor returned. We'd like to be a closed unit but administration always finds a reason to float us - sometimes relentlessly - if our census is down. Yesterday, in the first 4 hours of the shift, we experienced 3 codes, 2 deaths, a transfer out and couldn't even chart before the supervisor was walking through to find out who was going to Stepdown.
Moral is very low. Nurses that have been there 15-20 years are resigning and our manager seems to think that any warm body will do. In the two years since she "took over" (as she calls it), she has failed at appropriate hires 100% of the time. Most of her prize employees have quit and the one or two that remain cannot carry their weight.
Well, I could go on forever but in the interest of preserving sanity, if you have a solution to the ever-present threat of floating to unfamiliar areas, please send me a reply. It's a very hot topic in my unit right now.
Thanks, PC

pricklypear · Mar 25, 2005

We have the same problem. I work at a fairly small (200 beds) hospital and those of us in ICU have come to think of ourselves as the float pool. They will float one of our nurses regardless of the acuity or activity in the unit. God forbid if someone on tele or med-surg has to take more than 7-8 patients. I used to work on a surgical tele floor at a much bigger hospital and frequently had 10-12 patients with 1 aide. At the larger hospital, if we (very, very rare) got an ICU nurse as a float, they could return to the unit if they had admissions or a crisis. We don't have that option, no matter what is going on. Some of us would like to be a closed unit, I would. It would mean that people would frequently be called off during low census, and we would all have to be willing to cover on short notice. I think it would be worth it.

BadBird, BSN, RN · Mar 25, 2005

Where I work, ICU nurses cover all ICU areas, the floor nurses cover medical, surgical, etc...

RNforLongTime · Mar 26, 2005

Where I work, ICU nurses cover all ICU areas, the floor nurses cover medical, surgical, etc...

Where I work, my ICU (surgical/trauma/cardiac) is staffed at the bare minimum, we are very RARELY floated out. If we are it's usually to the MICU. But we CAN be sent ANYWHERE in the hospital, whether its to a med/surg floor or mother/baby or even the ER or PACU. Our hospital is so short on beds at times that they'll keep the PACU open and either keep post-op pt's there until a floor bed or ICU bed opens up or even bring pt's there from the ER until a floor bed becomes available. The hospital is planning on adding another 100 beds in the next year. They can't staff the beds they have now. I don't know where they think they'll get nurses to staff another 100 beds. :eek:

PCloudy · Mar 26, 2005

That is so true. We have to walk through a hard hat construction zone to get to and from our cars. I wonder what OSHA would think about that?

Anyway, we have only the one ICU but we're going to move into the next tower when it's finished - supposedly in April 2006. They have been telling us it will be in 18 months for about 10 years now. At least they poured the foundation today.

We have to float out to almost every department but rarely does anyone float in. We want to be a closed unit but the stepdown management is so bad that they can't keep staff. It's easier to use us. I am one of 2 people that also works ER so I freq float there. I'd much rather do that than to go to the floor and have 6-8 crazy patients to deal with plus eMar.

At least ER is eMar free right now. I'm trying to get PICC certified so that I can venture out some and, hopefully, get into something a bit less hazardous than bedside nursing.

My manager is soooo helpful. She came in at 1030 today and left at 1215. She worked hard for her $. We should all be so lucky.

Robinr1958 · Mar 26, 2005

At my hospital we have divisions. Let me elaborate:
Critical Care is comprised of CCU, ICU, and CVICU (1:2 ratio)
Step-Down is comrprised of IMC and CVIMC (1:4) ratio
--- no PCTs ----
Telemetry is telemetry (1:8) with two PCTs for the floor
Med/Surg (1:8), Surgical Telemetry (1:7), ER, L&D, Post-Partum, Peds
Critical Care and Step-Down and Telemetry are considered one division. This means that our unit nurses frequently float to step-down when there is a need. Every once in a blue moon will a unit nurse have to float to telemetry.
When critical care needs help, every rare once in a while will we get a step down nurse to help us, and even then, that nurse will have to be assigned the less acute patient (obviously)
Step Down nurses are more readily floated to telemetry
Unit nurses are NEVER floated to med/surg or surg/tele or L&D, PP, Peds. If a nurse is cross trained in ER, he/she can be floated there.
Being floated to step-down is a major cause for complain at my institution. We're working on limiting the division to critical care ONLY. But this means that us critical care nurses will be responsible for ensuring an adequate staff, and if not, we'll just have to triple up.
I was recently at a conference in San Diego (CRRT - it was awesome) and learned that many hospitals (including Canada) do indeed ship their unit nurses all over the hospital.
I personally feel this is a dangerous practice and couldn't fathom risking my license under those circumstances.
Your best bet is to find a magnet hospital and apply there.
Best Luck and I hope I didn't ramble too much,
Linda

Linda,

Our hospital has been discussing attempting to become a magnet hospital. Currently, unit nurses are frequently floated out to med/surg and telemetry but med surg and telemetry nurses are never floated in to us...(major negative morale issue). What would make it different if we obtained Magnet status?

Thanks,

Robin