Floating

[Patricia116]

I am a critical care nurse working in CCU. I know that "floating" is a necessary evil for nurses; however, I would like your opinion on a couple of issues related to floating. Our unit is going to be meeting to develop solutions and your input would be very helpful.

Scenario: Census low in CCU, nurse finally gets opportunity for "y time" which is voluntary time off at our hospital. Unfortunately, the Skilled Nursing Unit is down a Patient Care Assistant(PCA went home sick at 0800, shift started at 0700).

Supervisor calls in RN who is on "Y time" and floats her to the SNU to perform as a PCA. Meanwhile, a PCA is in CCU doing EKGs and One Touches, while aforementioned RN is making beds, bathing and toileting patients on the SNU.

1. Does this make any kind of sense to you?

2. Am I wrong to believe the PCA should have floated to the SNU and the RN remain at home? It is not unusual for the CCU to work down a PCA. Or, if RN comes in, she works in CCU, PCA floats to SNU?

P.S. There were ICU nurses out on Y time; however, staffing office states, "ICU nurses don't float to SNU". Excuse me??

3. Do you think ICU nurses should receive preferential treatment over CCU nurses?

I guess my primary issues are RNs being treated as unlicensed care givers as if we are interchangeable; ICU nurses being treated preferentially over CCU nurses; and, floating RNs out of critical care units to perform as PCAs while the PCA remains in the CCU.

I guess you can tell I am frustrated. I appreciate your input.

[Gldngrl]

I would look at the floating policy to ensure that it does say that only CCU nurses are floating to certain units and that ICU nurses are exempt from such floating and then I would look to see the job description of the RN in both the ICU and CCU settings. In most every hospital I've worked, both settings care for critically ill patients and often times are caring for "each other's" patients as borders or overflow patients. If the description is similar for both units, I would make copies of the floating policy and job descriptions and discuss it with your nurse manager first, arguing that the current hospital practices are discrimatory and request equal treatment. Document your discussions and go up the chain of command if you do not get a response. If you are practicing in a union hospital, perhaps you can file a grievance as well. I would think that there would be a financial concern with floating nurses to perform PCA work, rather than hiring PCA's, etc. I would also recommend getting the support of your coworkers as well. Let us know how things work out. MMB

[healingtouchRN]

This is what my CCU does with the sticky issue of floating. We have a Float rotation that allows the date & where they went be placed into a log, kept with our schedule. That way it's even who gets floated. Charge Nurses do not float, except in the rare occasion when they close our dept for census issues. They did recently for 10 days over the spring break & stripped our floors & really cleaned up (JCHAO is coming soon). They did the same to all the other units, one at the time, & placed their staff with us or us with them to accomdate the census. But we recorded this so we don't have staff bickering (as much). As for "stand by", this is when the census drops, & nursing service has no needs for us @ that moment, we have a standby list as well. The RN can stay on stand by (we get $10 per 4 hours on standby) & agree to come in ASAP when called when we start admitting. We take turns for this as well. Charge RN's can do this but usually dont' because we like to get our hours in. I know floating is a pain, I personally only like to float to cardiology or CVICU or ER where I have expertise. But that is not the policy with our nursing MALDISTRIBUTION in AL. I hope this helps, remember attitude is everything!

[rn-medic]

mmb--understand the frustration!! u also have had the "luck" of being pulled to other areas to help out, and some of the reasons were....you know what you're doing/the other people always b---- and you don't/the staff likes you and my all time favorite....i know you'll take care of all the problems! just call me supernurse..or sucker. depending on day and time, i'll answer to either.

[healingtouchRN]

we do have one nice thing about floating, after 5 successive pulls/floats we get $50 bonus, plus whatever overtime is accrued & if its to a critical needs area (the units NOBODY wants to work on like neuro or hematology) then there is a bonus there too! Every little bit helps. I still would rather pull overtime in my own little dept.

[pickledpepperRN]

An RN floating replacing an unlicensed care giver or LPN MUST advocate for patients as a condition of licensure. I don't know the regulations in Ohio but the principal is the same.

N

If a PCA, NA, UAP or whatever you cal the person does not perform the entire nursing process the RN is responsible.

A floating RN is responsible for the entire nursing process and may NOT ignore any data, symptom, or behavior that needs evaluation or intervention.

[Patricia116]

Thanks to all of you who have replied to my post. As requested, I would like to update you on how things are going on my unit.

The Clinical Manager held a staff meeting on Monday and effective immediately we are a "closed unit". PCAs may still be floated, but RNs and LPNs will not. We will have to staff our own call-off's (this is something we always did anyway since we rarely had anyone float into our unit).

The decision to close our unit followed closely a meeting that a group of nurses from our unit had with the Nurse Executive and the VP of the hospital. We made our position very clear. Of course, we are pleased with their response.

I will let you know how things progress.

:)