Floating

[Crush]

So I work float pool but an interesting topic came up yesterday while I was on a med- surg floor. Thought it might be a good topic to discuss.

So a nurse from a psych unit was also floated but he had not done med-surg in more than 15 yrs. No orientation to the unit or equipment.

Anyhow, that sparked a discussion at work and obviously there were 2 sides.

1) If you have RN/LPN then you are fair game and expected to float regardless.

2) They should give an orientation at least before expected to float to other units. Not a full orientation but some kind of training/re-training. Especially if float nurse has no experience with that floor or has not worked that area in several years.

[Sour Lemon]

So I work float pool but an interesting topic came up yesterday while I was on a med- surg floor. Thought it might be a good topic to discuss.

So a nurse from a psych unit was also floated but he had not done med-surg in more than 15 yrs. No orientation to the unit or equipment.

Anyhow, that sparked a discussion at work and obviously there were 2 sides.

1) If you have RN/LPN then you are fair game and expected to float regardless.

2) They should give an orientation at least before expected to float to other units. Not a full orientation but some kind of training/re-training. Especially if float nurse has no experience with that floor or has not worked that area in several years.

1) is ridiculous. Anyone floating to an area with no experience or orientation should only be utilized in a supportive way ...help with vitals, answer call lights, etc.

[Crush]

I know when I started float pool I was oriented to equipment utilized on all the floors and got an orientation of sorts on the floors I am expected to float to.

[klone, MSN, RN]

Agree with previous poster - by virtue of being an RN, they are competent to act in a supportive manner. They should not take a patient assignment until they've been fully oriented to the unit. Further, there may be special equipment or procedures for which a nurse may have to show competency, per Joint Commission guidelines, before being asked to do it. So floating an RN to a unit she's never been to is probably a JC violation.

[dream'n, BSN, RN]

How about the hospital have some of the overstaffed OB-GYN doctors 'float' over to Cardiology to see patients? All MDs went to Medical School so they should be able to function just fine out of their specialty, right? The Neurologist could handle Nephrology and the Pulmonologist could work easily for the day in Orthopedics.

Seriously though, I think floating is as dangerous for nurses as it would be for Drs. Why the ANA hasn't dealt legally with such issues (along with staffing ratios), I don't know

[brownbook]

Uh, yeah.....I love to float, have floated all my career. When I work a unit I love to have floats and welcome them. Duh..... the average psych nurse cannot function as a bedside nurse on a medical unit. If I were the psych nurse I would refuse the assignment or get a written agreement that I was to do no more than answer call lights and take vitals. Maybe a few more things...but you get the idea.

If a psych nurse were assigned to my unit I would only assign them to the above duties.

That this was done at your hospital makes me think I would start applying somewhere else. Did the poor nurse even get shown where the staff bathrooms or break room was....ridiculous!

[dream'n, BSN, RN]

Agree with previous poster - by virtue of being an RN, they are competent to act in a supportive manner. They should not take a patient assignment until they've been fully oriented to the unit. Further, there may be special equipment or procedures for which a nurse may have to show competency, per Joint Commission guidelines, before being asked to do it. So floating an RN to a unit she's never been to is probably a JC violation.

It wasn't at my hospital. I was an adult Oncology nurse sent to L&D, Telemetry, and the ER without any orientation. And was given a full load of patients on Telemetry and ER, even though the last EKG I read was in nursing school and I wasn't ACLS certified.

[klone, MSN, RN]

It wasn't at my hospital. I was an adult Oncology nurse sent to L&D and Telemetry.

That doesn't mean that it wasn't a JC violation, just that your hospital did it anyway. But yes, it is a violation if there are special competencies required on a particular unit.

[SaltySarcasticSally, LPN, RN]

I'm a new grad Tele nurse, been on my own maybe 2 months? I've already been floated to oncology and ICU step down. Those units are new, mine is not, so everything is different. No orientation to those units, just wing it and go is what my hospital does. Thankfully the charge nurses on both units had mercy and gave me easier patients. Oncology was so different, I had to ask a lot of questions because we rarely get onc patients on my Tele floor.

It was a bit unnerving but not much I can do with out being unionized.

[NurseSpeedy, ADN, LPN, RN]

I work for a large staffing agency and we are expected to float to units that we would be competent. A psych nurse is only allowed to work in psych per their policy. A med surg could float to tele and then psych if they are CPI certified. Nurses in higher levels of care could float to these floors as well.

Psych is a whole different animal than med surg. I worked outside of acute care for about 7 years before returning (had done 8 years prior). So much had changed. To ask a psych nurse to wing that kind of shift after being out of it for that long, oh heck no. That's ridiculous and unsafe. The hospital just wanted a warm licensed body to make the numbers look right with no regard to the potential consequences.

[CCU BSN RN]

I've floated within other telemetry floors (our float cluster, if you will) several times in the 5ish years I was a telemetry nurse.

I've cried at least 50% of those shifts. I hate floating, I don't even know where to find a flush or how to access the Pyxis, and why the heck are all my CHF patients seemingly about to flash? And what is the RT's number on these floors? How does their intern/resident/PA/NP structure work? Who is covering them? Do they have an NP for stupid crap but you call the hospitalist for everything else? And what's the code to the med room again?

No one has time to answer these questions, that's why you were floated here in the first place, because they're absurdly short-staffed.

So, if an experienced nurse gets unbelievably overwhelmed floating to floors very similar to her own...can we all extrapolate from that how awful it could potentially be for someone to float to a care area completely foreign to them? Because I can, and it sounds like a terrible idea.

[MelEpiRN]

Yeah just because I'm an RN does not mean I've kept up in fields not my own. When I had my baby I couldn't believe how much had changed in the world of L&D in the 17 years since I had been exposed to it. I can't imagine anybody would think it's a good idea for me to actually float to that floor for a day. Yikes!! I'd be happy to answer call lights and take vitals and that's about it!