How do you Handle Floating?

[FranEMTnurse]

I know in our local hospital floating is done a lot, and the administration has no problem with it. I know of one particular new RN who was so stressed she left the nursing field. I could see she was overwhelmed. That happened when I was in training.

[anc33]

My first experience with floating happened right as I got off orientation at my first job. They sent me to ped bone marrow transplant of all places. For four weeks I had studied nothing but adult neuro and then, bam, I am taking care of a sick three year old. Thank goodness it was only four hours of my shift. However, I did grow to like floating after awhile. It broke up some of the monotony and I learned a lot of new stuff.

[fergus51]

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?

Let me explain why: because floating and taking a full assignment which includes a patient group you're not familiar with doesn't generally give much time for learning anything. I have floated to units where half of the nurses there were floats. Who was I going to learn from? The other non-peds nurses or the actual staff nurses who never had a single second to spare? If I were a parent, I wouldn't want a float with no peds experience "learning" (aka winging it and hoping nothing goes wrong) with my sick child. If that was an effective way of learning, that's how we'd train new nurses. Floats often don't even know what they don't know. That's scary. I've seen it happen in our unit too. We have to watch the floats like hawks because they do things without even realizing how dangerous they are. My fave was the float taking out an 1100gm baby and giving it a bath without any heat source. She definitely learned something that day (after causing that kid's temp to drop so low that the thermometer wouldn't even read it).

[all4schwa]

I dont mind floating. Sometimes it's good to get away, see how other units are doing things and catching up with nurses i know on other units. The key is not being afraid to speak up when you dont know where something is or anything r/t pt care. Really, that's the key to nursing anywhere.

In our hospital, we are divided into clusters. I work in neuro step down, so I float to any other stepdown (advanced care is what we call it in my hospital) or ICU. Sometimes it's nice just to get off the Neuro floor where my team is likely to be A&O is refreshing! If we go out of our cluster, we get an extra $3 on the hour. If we get double bumped (our unit gets two float nurses that cant go to ICU for one of ours that can), we get $3/hr extra for that too. We keep track of our float dates and everyone who is 90days past orientation takes their turn. However, anyone who is in overtime, has signed up extra duty, or is earning a PRN rate goes first.

We have a recognigtion between employees known as a 'Superstar.' If a coworker writes you up for doing a good job, you earn a 'no-float pass,' takes 5 of these to not float.

Complicated eh? I understand how it could get sticky, and I've seen nurses become unraveled over floating and I really dont know why. I dont like having to float 4hrs into my shift, or only for the 1st four, but I get over it...

[FireStarterRN, BSN, RN]

I love floating, I never get a difficult assignment, I'm deeply appreciated, and I enjoy getting to know people from other departments.

[EmmaG, RN]

As often the only RN working and having to be in charge every night, I LOVED to float. I prayed I'd get to float.

[prmenrs, RN]

Be careful what you pray for, Emm!!

[EmmaG, RN]

Be careful what you pray for, Emm!!

I seriously don't mind it.

Back in the dark ages, I worked as a graduate nurse for months before taking the boards and then waiting 6-8 weeks for results... prior to the boards, I floated every other night I worked, to nearly every unit in the hospital. It was an incredible experience, and I am certain it helped me on the tests.

[07302003, ASN, RN]

Although I like the experience of floating, I HATE floating for four hours, having two different assignments on two different floors. It's not fair to the patients, not good for continuity of care, and when I am floated from 1900-2300, all I do is the 2100 med pass +/- dressing changes, there's not time to assess all patients thouroughly and chart. (And I don't trust some nurse's assessments.) I also dislike bad attitudes from other nurses working the floor I'm floated onto when I have a question or need them to swipe me into the med cabinet because my badge doesn't work - happens way more than it should!

[meownsmile, BSN, RN]

I hate floating. We usually get the screws when we float, worst teams, hardest patients. Its really rediculous.

[Daytonite, BSN, RN]

In one acute hospital where I worked for many years as both a staff nurse and as a supervisor, floating was handled on a rotating basis. A "float" list was kept on every unit and you knew when it was your turn to float. The supervisors (of which I eventually became one) always seemed fair about the float assignments. They first floated the float and prn nurses before the regular staff. Consideration was always given to the unit the nurse was being floated from and to. We tried to keep nurses within certain areas (critical care/ER, med/surg, peds/rehab). We also had several staff nurses who were specifically cross trained to work in areas such as L&D, ER and ICU and they were sometimes asked if they would float to those areas when the need was great. It was also an enforced guideline that floated nurses were to be given easier patient assignments by the staff of the unit to which they floated and to make the floaters feel welcomed. When I first transferred to the IV Team I was constantly being floated back to my ICU Stepdown unit when they were short staffed, something that had never been done to anyone else on the IV Team. To boot, I would get called away to start IVs!!! Some of the other members of the IV Team were scared to death that they would also have to float--most hadn't worked on a unit in years--and complained to the head nurse about the unfairness of it. Eventually, the head nurse of the IV team had enough of it. I never said a word. My floating was stopped. When I was promoted to a supervision position, I was pulled from supervision a couple of times to work in CCU. Still, I loved working for this hospital and stayed there for over 8 years. They were all good people to work with.

In another large acute hospital in which I worked, we had restricted floating. Because there were 6 medical units, the staff nurses could only be floated within those 6 medical units. The same went on within the intensive care grouping and the 5 surgical units group. This was, however, a very large tertiary care center.

I have to mention that I also worked for a hospital where the nurses were unionized. Floating went on all the time. If a nurse refused to float, it was considered insubordination and they could be fired. The union had no power to save their jobs because the issue of floating was not part of the nurses negotiated contract at that time.

[RNsRWe, ASN, RN]

Let me explain why: because floating and taking a full assignment which includes a patient group you're not familiar with doesn't generally give much time for learning anything. I have floated to units where half of the nurses there were floats. Who was I going to learn from? The other non-peds nurses or the actual staff nurses who never had a single second to spare? If I were a parent, I wouldn't want a float with no peds experience "learning" (aka winging it and hoping nothing goes wrong) with my sick child. If that was an effective way of learning, that's how we'd train new nurses. Floats often don't even know what they don't know. That's scary. I've seen it happen in our unit too. We have to watch the floats like hawks because they do things without even realizing how dangerous they are. My fave was the float taking out an 1100gm baby and giving it a bath without any heat source. She definitely learned something that day (after causing that kid's temp to drop so low that the thermometer wouldn't even read it).

Ah, I see what you're saying. No, I agree with you that those were hardly reasonable situations to expect someone to be happy with. That's not what I was talking about; I meant learning because the regular staff could tell you things, show you stuff PRN during the shift while in the care of your own patients. If half the nurses are floats, well, clearly there's a problem! And in no case should someone without a clue be taking care of peds....that assignment was foolish.

I've floated to the ED to be an extra set of hands; that is, an RN license available to help but with the understanding that I was not familiar with the unit. I could hang fluids, start IVs (lots), give meds, start intake forms. I did learn alot, and helped alot, without being in a position to hurt anyone. Same with floating to other units: taking an assignment to give a reasonable burden to the regular staff, but not taking someone that one of the regulars ought to have!

I hear from co-workers that they've experienced what you're describing, too, but it seems more the exception than the norm. Honestly, the biggest complaints about floating AREN'T patient safety concerns, but that the nurse "doesn't like to leave her unit". Well, that's the part I just don't get. I LIKE getting opportunities for a change of scenery, change of patient types, change of routine. Some of my co-workers can't function without the regimented routine they've had for 20 years, and I feel sorry for them; they are so stressed with every float it borders on the absurd.

The only thing that bugs me about floating, really, is if they split my shift and I have to spend four hours on one unit (taking report, assessing, passing meds, dsg changes, charting) and then have to figure out how to get back to my unit on time to do it all over again. A double patient assignment is NOT fair, in my book, but it does frequently happen.

[gt4everpn, BSN, RN]

well i work in ltc as an lpn, i float cuz i'm perdiem, they only place i cannot float to is their hospice unit, and honestly i don't wanna float there now!, its stressful, seeing that ltc is 40 residents and they all need their meds plus peg feedings, etc... the list continues, but i manage!