Floating

[RN/Mom]

the hospital i work at routinely floats licensed and non-licensedstaff anywhere from 4-12 hours depending on hospital-wide staffing needs. i don't have a problem with floating 8 hours, but i have always questioned the safety of floating only 4 hours, especially since i am receiving a full load of patients on each ward (which, for an lvn at my hospital is typically 5-6). plus, when we float for "4 hours," it's really only about 3-3.5 hours we will be on each ward caring for a given set of patients due to our break time and travel/walking time within the hospital.

from a patient safety standpoint, the 4 hour floats have always made me very uncomfortable. it is very difficult (and often impossible) to thoroughly check orders, make sure interventions are being carried out correctly, adequately assess each patient, complete any necessary teaching, and provide anything approaching holistic care to my assigned patients. more often than not, i have to be 100% task-oriented and just go on what i get in report in order to "get the job done" within such a short period of time.

besides the patient safety issues, i also don't see how the 4 hour floats are conducive to patient satisfaction. there are many patients who have 6 different nurses caring for them in a 24 hour period, as there is also a tendency for the "difficult" patients to be assigned only to float staff.

do most hospitals routinely float staff for such short periods of time, or is the facility i work at unusual? again, the 4 hour floats are routine in that they happen every day and during every shift throughout this hospital - not just when staff leave early or come late.

thank you for your input! :)

[KelRN215, BSN, RN]

I think the 4 hour float thing is a product of hospitals that utilize both 12 and 8 hour shifts. When I worked in the hospital, the floor did 12s and 8s, and there was always at least one person who worked 11A-11P. At least, ideally there was.

4 hour floats routinely happened from 7A-11A, 3P-7P and 7P-11P. If the floor was understaffed for days but they knew that someone was coming in at 11, they didn't want to pay anyone extra to come in at 7 when another floor was overstaffed and was going to give someone the day off. So, that floor would float someone to the understaffed floor and when the scheduled nurse arrived at 11, she took over that person's assignment and that person went back to their floor and took admissions.

A patient would never have 6 nurses in a day, but they could easily have 4. (One nurse from 7A-3P, that nurse goes home then someone working a 12 hr day shift picks up from 3-7, an evening nurse picks up from 7-11 and then the overnight nurse takes over at 11.)

[tntrn, ASN, RN]

We float for four hours often, but I think that is the least of the concern. Floating NICU or labor nurses to places they never have worked is very unsafe. The less time we are there, the less problems we can create.

[RN/Mom]

I think the 4 hour float thing is a product of hospitals that utilize both 12 and 8 hour shifts.

That makes sense, as our hospital does have nurses working both 8 and 12 hour shifts.

This happens so often lately that I have very little job satisfaction. Unless this is the norm at most hospitals (in which case I won't be able to escape it), I'm thinking I may not apply as an RN at the hospital I am at currently -- that's how much I hate it!

Thank you for your reply! :)

[RN/Mom]

We float for four hours often, but I think that is the least of the concern. Floating NICU or labor nurses to places they never have worked is very unsafe. The less time we are there, the less problems we can create.

At least we are only floated to floors where we have similar training. We would never be expected to float to the ICU, but ICU nurses do occasionally float to med-surg floors. Does your hospital require L&D and NICU nurses to float to med-surg and other ICU floors? That seems crazy!