How do you Handle Floating?

deeDawntee, RN · Aug 14, 2007

It is a huge issue for nurses in hospitals, so much so, that the Union in the hospital where I work negotiated floating 'rules' to make it less stressful. We have a sister unit or often a few units that are closely related in pt population and scope of practice that we are expected to float to when it is our turn. Those units are usually close in physical proximity as well, so through floating and just meeting on the floor, we tend to know each other. You are not expected to float outside of your primary work area and your secondary area(s) unless you agree to it.

Nurses who have reached their 10 yr anniversary never have to float unless they agree to it. For instance, as an ICU nurse, I only float to ICU's... it has really helped in the stress and unhappiness around floating in my institution. Another reason that I think every hospital needs a Union for their nurses.

classicdame, MSN, EdD · Aug 14, 2007

One facility where I worked allowed you to float only within your department's "sister" units. For instance, critical care nurses only went to ICU, IMC and emergency. Pedi nurses only went to Post partum and Nursery. Once you were oriented to those sister units you felt more secure.

ICRN2008, BSN, RN · Aug 14, 2007

My hospital can float us to any "acute care" area, including the cardiac care unit. I have floated to the medical unit, the surgical unit and the cardiac unit. They usually try to give us an easy assignment when we float, although I've had neurosurgery kids, heart transplant kids (a few weeks out of surgery), etc.

I absolutely hate floating, but now that I've been there six months I am eligible at any point. I think that my hospital should increase the size of its float pool or work with the units that are consistently understaffed. At the very least, every nurse who is eligible to float should be given a brief orientation to each area that he/she might go.

allele, LPN · Aug 14, 2007

Our cardiovascular surgical stepdown unit typically floats to pretty much any other unit...with the exception of maternity or any non-inpatient unit. We do go to the ER, but only as "helping hands". Anyway, the rule is that any new nurse (either a new grad OR a just hired person with any type of experience, doesn't matter) doesn't float for a year after hire, which is very nice for comfort level. The supervisors hate the rule, BUT they respect it and don't ask us to break it. It's nice for the newbies. Otherwise the per diems always float first, then the staff in rotation. I typically float only once every 12-18 months or so, and it's usually to the ICU, thank goodness! They're very good to us when we float and we always end up with their patients anyway, so they're usually close to our level of competency anyway! :)

EmilyUSFRN, RN · Aug 14, 2007

Wow, I'm a new (read 1 month or so) nurse working in peds and as part of orientation we are floated to the floors in which we will be expected to float (PICU, NICU, mom baby, newborn nursery) and pretty much the first night off orientation we are floated b/c we are now in the lineup of float turn taking.

We probably have someone float every night (our NICU has staffing issues and we were told that extra pm staff was hired because of the need to staff the NICU esp. when they increase in size within the next few months) but at least there are some guidelines-- in the NICU, we are to take feeder growers, no big problems with the babies. in PICU, no ventilated kids, essentially floor status or a stepdown type status, etc. so even though we float a ton, they do try to make it easy on us. Thank goodness, right?

agent66 · Aug 14, 2007

When i started many years ago, I worked out of a large pool that covered minuses and sick calls. I therefore knew my shifts I had to work but no idea where i was going on any given day. Half the time I would do 4 hours here and four hours there and then another four where-ever i was needed. Yes it was a little stressful then, BUT... I got to meet a lot of people and was exposed to a lot of different areas/situations, so in the long run of things i think it was a good thing. Now I simply do not float, I pull rank every time, and hand the junior a kleenex on the way out and wish her a good shift. We have no set "rules" except that the junior floats if they are considered competent enough to do so, which I believe the time is 3months, their probation period. I am not being unkind, just after almost 20 years, my days of floating are done. :lol2:

Karen · Aug 14, 2007

I actually like to float because its a change of pace from my regular floor and I get to meet new people or see nurses I haven't seen for awhile. It is a great chance to see new things and explore other areas. I don't think you should float until you are comfortable on your own unit for new people that would be stressful. Sometimes it is necessary to float newer nurses to balance the experience mix. However, its important to speak up because the people don't know you. Be clear to the charge nurse what your limitations are or if you feel you are beyond your scope of practice. I always try to be kind to floats as well, they remember that when you float to their floor.

JennaRN1006 · Aug 14, 2007

I am in 8 months where I work and when I came in that morning, we saw the sign that said one nurse had to float. We simply put the names in a hat and drew them out, that way it is fair. However, the next time we float, I wont be asked if I'm one since I just did it. We keep a notebook with a running tally. I think it is fair and makes sense. I work with pts who have urological cancers, and was floated to the breast and lady partsl/ovarian ca floor. They were very nice to me and gave me fairly good pts, which was nice. LOL. It was a really good experinece for me to float for the first time!!

prmenrs, RN · Aug 15, 2007

The worst part about floating is the "sneak attack" feeling: you go in w/your mind set one way, and then get your little applecart totally trashed! It's even more distressing if you've been on for a day or 2, working w/a family/pt, have planned out what you want to accomplish today...WHAMMO! You're it! Then when you get to the floor you're floated to, your frame of mind leaves much to be desired! Makes for a miserable shift!!

I learned, eventually, to preset my mind: "YOU could float today!!!". I try to think that every single day I work. Then if I do have to float, it's not such a big deal.

Only going to "related" areas, Critical Care areas, Med-Surg, Mat/Child health just makes sense. If you send a NBN RN to CCU, no one is going to have a good day, so why do it?

@ my current job, I only have to go one other place, Mother-Baby Unit, and then I only take care of babies and breastfeeding. I can live w/this.

fergus51 · Aug 15, 2007

I am a traveller so we float before staff. Since there are so many of us, the staff never floats. I dislike it because they send us nicu people to peds and picu areas and 17 year olds aren't the same as babies, but I take my turn and try not to complain too much. I didn't mind working when I had to float to newborn nursery/postpartum, but peds patients aren't my thing. I handle it by just doing the best I can. I have had to negotiate a bit with assignments (NO, I will not take the admit!), and overall it's been ok. Not great, but I have yet to leave feeling really upset.

I do think it has a lot to do with the nurse's attitude. I've seen people complain endlessly about their float when they haven't even gone to the floor yet.

RNsRWe, ASN, RN · Aug 15, 2007

Floating is part of the job. I'm employed by my hospital, not just my unit, so if I'm needed elsewhere, I go!

For new nurses (new hires, not just new grads), there's a three-month period that starts after orientation in which you are not floated. That gives you time to get comfortable in your own skin on your own unit. After that, you are floated as needed. That doesn't mean you are thrown to the wind, LOL, if you are unfamiliar with the area in which you're going, you get a less unit-specific assignment. For instance, if you don't know what to do on vents, you're not going to be assigned one. You get admissions just like anyone else. However, it doesn't always work out for the best that way; sometimes the float assignment will create quite a bit of stress. Overall though, not a big deal.

The exception is areas of the hospital where you have to have X amount of experience before going there, such as ICU and OB. Not sure what their criteria are, LOL, since you can't get OB experience until you float there, right? They're hardly EVER short anyway; it's mostly ICU that's shortstaffed and pulling from everywhere else. And then, hey, beggars can't be choosers when it comes to asking for floats!

There's a float sheet on every unit, where it's a list of names in rotation and when your turn comes up, you go, period. Of the people on that shift at that time, when a float is needed, whoever was floated most recently stays and whoever floated "earlier" goes.

I don't mind floating; I like seeing different things and different patients. I've been to every unit in the hospital from ED to rehab (both physical unit and substance abuse). I don't know why some people get so freaked out about it, personally....why are they afraid to learn something new? How are they going to expand as a nurse?