Floating to diffrent units in your hospital

Nurses General Nursing

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I was just wondering what are the policys for floating in your hospital?

When I worked in Peds we were a "half closed" unit. We could float out (assuming we had the luxury of 2 RNs to start out with) but other nurses could not float in and care for pedi pts. Occasionally if we were really stretched a nurse might float in as "extra help" but the peds RN was resposnible for all meds, fluids, assessments, and charting on pedi pts. If we had a young adult, the floated nurse could do that. Generally the result would be me still providing total care for way more than safe # of pts, stressed to the gills, and a floated nurse sitting at the desk commenting on how nice peds is, so easy, nothing to do... Then telling her co-workers how easy the peds nurses have it!!

Ideally peds nurses would be floated to Maternity for nursery, PP, or GYN pts but any floor was fair game- Med Surg, rehab, or transitional care most often, occasionally psych, and occasionally ICU/CCU where we got our turn at being "extra help"

The one policy I hated (I think unique to peds) was that PRNs didn't float! Peds PRNs considered themselves exclusively peds nurses and refused to float out. I understand that to a point but very unfair when I would be floated out as a fulltimer, often happened to be 4 hours into a 12hr shift when I already knew all the peds pts! (to quote an above poster "booooo!")

Now it's nice in the OR, completely closed we just get extra days off, and I love extra days off!

Specializes in med/surg, telemetry, IV therapy, mgmt.
I personally feel floating those out of their familiar spectrum is dangerous to the patient. . .We float on our floor which contains OB, GYN, L&D, WBN and SCN. These are areas in which I have knowledge to work and care for patients. Other than these areas I would refuse to go and hope I still have a job in the future. The problems I have had with floating is you get to other floors and I feel as though they dump the patients they know they do not want.

My response to this as a supervisor was to point out that basic nursing is still basic nursing. A blood pressure on the OB unit is pretty much the same as taking a blood pressure on the medical unit. The same goes for answering lights, giving bed pans, taking people to the bathroom, giving medications and taking care of their IV's. The very specific stuff like checking someone's fundus in PP or wedge pressures on a patient in ICU are something that should be done by the regular staff of those units. They should have the wherewithall to know that, and if not, then the float needs to page the supervisor and tell him/her that the staff is expecting you to do something you have no knowledge of how to do. Do you tell the supervisor you feel you have been given patients the regular staff don't want? Did you tell the supervisor you felt dumped on? I would defend you and get after the regular staff. I let staff who do that know that I wasn't going to put up with it, that they were getting a float to help them out, they were anxious about it and they were to make the float feel comfortable, otherwise I guess they didn't need the extra pair of hands that badly. They didn't have to know about the rules I had to follow with regard to the acuity. On the other side of that coin is the burden a float is to the unit they are going to and they make it clear they do not want to pitch in and help to the best of their ability. That has nothing to do with abandonment and everything to do with insolence, attitude, insubordination, and basic old childish pouting. When you come back from a two week vacation you are faced with a whole assignment of new patients you've never seen before. You never know what you are going to encounter when you walk into a patient's room. What do you do? Basic nursing until you learn about their other more specific needs. Floating is not a whole lot different when looked at that way, special needs of a particular unit aside. Most everything done with a patient begins with basic nursing care and we all learned how to do those basic things.

By the way, board of nursing aside, walking off the job is viewed in other professions as job abandonment and grounds for immediate dismissal in most places. Why should it be different with nurses? I find it hard to understand people's refusal to compromise, especially when their job in on the line.

Specializes in Critical Care, Quality Imp, Education.

I work on a renal tele unit and we can be floated anywhere, including the ICU/CCU or PACU, even on occasion to the ER. When us Tele nurses are sent to the ICU/CCU, we are usually given the low acuity patients.

However, we're becoming a closed unit beginning on 12/11, thank God! :)

Specializes in most of em.

Hmmm, floating.........not a favorite topic. It is really hard to get out of your comfort zone to float. We have special groups within nursing that nurses can float to. For instance: CCU, telemetry and intermediate cardiac float within their group. THen the "general" nursing areas such as Med/Surg, Ortho, and Oncology float within their group. ED and OR are on their own. E am told this was for competency reasons, which seems to work pretty good. I think it is better for the patients.

ON a RARE occasion nurses will float to other areas, but it is not required. If you are out of your "zone" then you are not expected to work independently, OR the patient load is adjusted to your level of competence.

Bottom line is the patients get cared for.

Happy Day!!!!:nurse: :nurse:

I loved floating from floor to floor and from hospital to hospital, but it's certainly not for everybody.

My last job had a rational policy that floated among med surg or among womens' and childrens or among the specialty units. That eliminated the awful shifts where an ICU nurse would be caring for neonates for the first time since nursing school or someone from the pulmonary floor would find herself in pediatric ICU for a shift from hell. Cross training was offered for anyone who agreed to float, and there was a small increase in hourly pay for doing so.

Specializes in LDRP.

We can only be floated to other cardiology units. There are 5. two medical cardiology floors, cardiac surgery icu, cardiac surgery pcu, and ccu. Each shift, it is determined if there are any "needs" in any of those 5 units, which units have excess staff for their census, etc, and if necessary, we can be floated. But only to other cardiac units.

I work prn on my floor. If our census is low and it's my turn to float, I have the option to go to the other floor or to stay home. However, those who are staff with benefits have to float when it's their turn.

Specializes in Critical Care, Emergency.

AT OUR FACILITY, IF ANYONE HAS OVER 15YRS(IN TERMS OF HOURS), THEY DON'T HAVE TO FLOAT, NOR DO THE CHARGE NURSES, EVEN IF UNDER 15 YRS. NOT SURE WHAT I'D RATHER HAVE TO NOT FLOAT. :confused: :wink2:

Call me nuts but I usually love to float every once in awhile. It gives me a chance to meet new staff. Learn how things are done on other floors. I am generally only expected to do what they know I am familiar with doing, and I get to learn a new thing or two.

Everyone takes turns floating, except charge nurse, since our charge position is split between 2 nurses, they have to take their turn floating.

No one seems to mind floating on this unit. In fact, morale is very good at this facility. Smiles and cheery hellos are still abundant. People help one another. Generally, it seems to be a good place.

Specializes in CCU-ICU, Informatics.

In my hospital the ICU (where I work) is self staffed, we do not have to float to other units but if we are cut for a day due to low census we may let nursing services know if we are willing to work on another floor if we want to keep our hours. I will not float. In the ICU I am in complete control of every aspect of my patient's care from calling labs to doctors to giving baths. I am not comfortable giving up that control to a charge nurse on the floor who doesn't know my patient from Adam.

In our hospital travellers float first and since we always have travellers, I never have to float. Our unit (NICU) has to float to PICU, peds or heme-onc. We take floats from all those units, plus mother baby.

I think forcing nurses to float is the stupidest thing in nursing. Basic nursing is not something most of us do anymore. In my unit, a lot of the nurses have never worked in any other specialty or they have been in this specialty for 10 years or more. How competent do you think they can be on an adult medical floor? Yes, they can take a BP, but normal BPs for our patients will be something like 50/30 with a mean of 41. Yes, they can give meds, but our doses and drugs are not the same. They just don't have the basic knowledge of pathophysiology for those diseases anymore, let alone the knowledge to deal with the specialized equipment or family members. How much confidence would you have in an adult nurse looking after your 18 month old without having any peds experience? Or a peds nurse looking after your 82 year old grandma without any recent med-surg experience? I just don't understand why we expect nurses to be able to do this. Can you imagine asking a doctor to do that? "Well, I know you're an OB/GYN, but we're short in cardiology and it's just basic medicine right?"... Would never happen because we recognize that specialists are not generalists. Nowadays most nurses aren't generalists either.

For nurses who enjoy floating and feel they have the experience to do it safely, I say good for them. That just isn't the reality for all nurses and expecting it to be is ridiculous. I've personally seen several patients caused harm by having float nurses.

Specializes in NICU.

I work in the NICU and I'm kind of glad it's not a "closed" unit. For one thing, it could mean mandatory overtime if we're really busy, and I am not so much into the whole overtime thing. For another, there are some nurses who don't want to stay home without pay, even for one shift, so it's nice to have the option to float if nurses are needed elsewhere.

We only float to the newborn nursery, pediatrics, and PICU. They try to give us babies in peds and PICU, but it doesn't always work out like that. When nurses from those units float to us, we give them "easy" assignments. I don't mean they'll be sitting around all night - I mean that they get the relatively healthy babies that are getting ready to be discharged, things like that. Sometimes we'll give the PICU nurses a little bit more to deal with - IVs and CPAP, maybe. On the other hand, when we get floated to PICU, we'll get vented babies and toddlers. I once got a fresh trach! But we don't want the float nurses to be uncomfortable or scared, so we don't give them vented babies when they come up to work a shift by us.

No one really likes floating, so luckily we rarely have to do it - like once every 2 years, seriously. Maybe if we floated more, we'd be more comfortable with it?

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