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.

[herring_RN, ASN, BSN]

I learned not to say. "I'm not comfortable floating to that unit."

the supervisor then asked if my shoes were too tight.

When I said, "I'm not competent to be assigned mental health patients, but will go help a competent RN with any tasks needed."

So I floated. The charge nurse seemed fine with me taking vitals, helping patients bath, and doing many other tasks.

[GeminiNurse29]

Psych nurse here and even floating from different security units to Geri psych is a challenge. For instance, maximum security units are usually more black and white on what's acceptable and what's contraband while there's more grey area in minimum security.

Would it be right or fair to float a dialysis nurse to labor and delivery? Heck no.

At the minimum, there should be some orientation and competency check off. Or myself personally, I'd refuse it.

[3ringnursing, BSN]

At one of the ICU's I worked in a small hospital that was circling the drain after losing it's heart program had a no float agreement.

The ICU was at times dead as a doornail - 3-5 pt's tops. Other times we could get busy enough that though we had open rooms, we had not enough staff to fill them. Sputter, rally, sputter, rally ...

This situation long before I started meant that the nursing staff were being used as the hospital float pool. Naturally this engendered resentment.

They had enough, and the agreement was the nurses didn't float, and could be called off - but everyone had to take call once a pay period. You got $1.50/hr while on call, but if (when) called in you got time & a half.

I was the primary earner in our family back then, which meant I needed all my hours. I agreed to float to med-surg/cardiac, and ER a few times. On the med-surg floor I was given 12 pt's. I'll never know how I managed to assess and pass meds on those shifts. The ER wasn't so bad (we weren't a level 1 trauma facility) but I eventually left before the hospital itself collapsed completely, as it was barely holding on and the writing was on the wall in large bold letters.

[NurseKatie08, MSN]

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.

Yikes, on your own two months and already floating? We have a rule that new staff cannot float for 6 months, which is at least a little helpful. Also, all of our med surg floors are specialized to a certain extent. My unit is the only unit to take liver/kidney transplants, and we'd never give a liver or kidney transplant patient or some of our specific hepatobiliary procedures (a Whipple for example) to a float. Similarly if I floated to Onc, I wouldn't get a patient receiving chemo, and if I went to cards, I wouldn't get someone who just had a cardiac cath or something.

[Julius Seizure]

Yikes, on your own two months and already floating? We have a rule that new staff cannot float for 6 months, which is at least a little helpful.

My first job was a new grad residency. It was six months long, and at the end of it, you were "safe" from floating for 30 days. After a month of being on your own, you were fair game. Maybe that was after a long residency program?

[MelissaPendergraft]

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

That's the thing...they would NEVER think of asking a physician to do that, but they have nurses do it. But at my hospital, you can only be floated one level down, and take patients. Otherwise, you task only.

[squishyfish]

I'm a psych nurse who is often floated to medical units. As a float nurse from psych, I function as a resource. I don't take a group of patients. I answer call lights, pass meds, do admissions/discharges, and basically just help out however I can. I worked on a telemetry unit several years ago but I'm rusty with IVs, so I agree that if I were to take a group of patients, I would need another orientation.