Floating Policy

[Ami_J]

I was wondering what everyone's floating policy was, and how you like it? Does it work well?

I am on a board to work out the problems in our policy, particularly our floor being dumped on.

I work on a 16 bed pediatrics unit, our policy says we are a part of a "cluster" the cluster is Peds, L&D, Postpartum, nursery and special care... for Pediatrics we only float to postpartum. One of the main problems is that we float to them, but they don't float to us if we need extra help. It's a one way cluster.

Another problem is that L&D and postpartum take priority over our own units needs. If they are short staffed they will pull us and we will have to turn children away on our own unit.

We float so often that we can pretty much count on being floated each weekend we work, and in the summer when our numbers are down we might float 2-3 times/ week.

What do your hospitals do that might work better for us? Any limits on the amount of hours you are required to float? Anyone get paid more for floating? Anyone have any ideas that I could bring up at our meeting? Also, if you feel you have a policy that would work well, please share it with me... PM a copy if you can.

Thanks!

[matchstickxx]

Funny...At my hospital, peds and NICU always seem to pull staff from postpartum. They seem to be the "preferred" units when it comes to getting extra staff. I know how frustrating it is to be floated out of your home unit...a lot. One thing my hospital did was to create an incentive program for nurses who didn't mind floating and would go "out of turn". They sign a contract and after 3 months they receive a small bonus for going "out of turn" if their home unit is overstaffed and someone needs to be floated to another unit. At the end of the three months, they are given the option to sign a new contract or to opt out and go back into a regular rotation of turns. It doesn't totally eliminate floating for those who don't want to float, but it does cut down on the number of times they have to float. Also, the receiving unit benefits by having a nurse who choses to be there and won't be miserable and mopey for the entire shift.

It is much cheaper to pay these small incentives than it is to replace a nurse (or two) who has left because they are so frustrated with the floating situation.

Also, the unit managers came to an agreement that there would be no pulling on certain holidays (Christmas, Mother's Day...). If necessary, the unit managers and assistant managers would come in and work to fill the holes.

It's not perfect, but it is better than what was going on three years ago.

Good luck.

[NurseLatteDNP, MSN, DNP, RN]

We have to write down every time we float on a flow sheet in our nurse managers office and we rotate. Then, if someone has to float again, we look who's turn is it to do it this time. That way, we all float the same amount of times.

[Ami_J]

Wow that is a good idea! I am for sure going to bring that up. I think that would maybe work for our unit... at least a little, because there are some people that don't mind floating.

We take turns the same way... we write down the date of the last time we floated and then it's the next persons turn... now they changed it to float based on hours floated... so if you have 12 hours and everyone else has 20... then you are the next floated! But the problem is when a person doesn't work much, they might be floated 2-3 times in a row.

[Tweety, BSN, RN]

We have a "float list" and take turns floating.

We only float to units that float to us. For instance we used to float to post-partum or Gyn, but they didn't have to float to us. They've stopped that. The clusters take care of themselves.

[htrn]

We have a float list that keeps track of who floated last. A float doesn't count unless we were there for atleast half the shift - so if you go for 3 1/2 hours, you don't get to write your name on the list and can get floated again the next time they need someone. We float out according to turn after our staffing requirements are met, which means that the CNAs and LPNs float a heck of alot more often than the RNs.

We end up doing alot of sitting for confused or disabled patients or acting as a CNA/LPN when we go as most of us are not comfortable taking a med/surg team - and we are subject to recall at a moments notice. We would have to be incredibly over scheduled on a shift for an OB nurse to take a team out on med/surg.

We also cannot go into any 'dirty' rooms - I work OB, obviously by my name - but they still try to stick our staff in to sit with a patient with something nasty to babies. There is a bit of a misunderstanding as to our refusal to go into certain rooms or do certain things, it is often perceived as us not wanting to help and not us actually protecting our patients. They don't look at it from our point of view - When we float out we have to be able to RUN back to the birth center, grab some hand gel on the way, and catch a baby.

We do tend to do alot of floating to the detox center but we can write a letter to HR stating, for personal reasons, that we cannot float over there.

[all4schwa]

we keep track by date, in addition, anyone in overtime or signed up for bonus pay (when it's in effect) is the first to float. so, when i pick up extra and float, plus take my turn in the rotation, i sometimes float twice a week. we would get $3 more on the hour if we have to float out of out cluster, but since icu is in my cluster that doesn't happen. not a chance...