How does your unit determine who floats?

[BiscuitStripes]

I started on this unit first week of March. I got 4 weeks of orientation and because I was new they didn’t float me initially. They decided at my 3 month mark I was okay to float. 

So I got float yesterday and was told today I’m next to float again. I asked how I just floated yesterday. I was told it goes off float hours for the year and I now only have 12, thus am the lowest. So basically I’m going to continue to float until I effectively make up 6 months worth of floating when I didn’t even work here or was eligible to float. 

Every other hospital I’ve known goes off who hasn’t floated in the longest. How does your hospital do it?

[adhazelett, LVN, RN]

My facility apparently doesn’t have a float policy and there is no taking turns or float pool. It’s basically whoever the supervisor wants to pull and has led to a mass turnover. We had one nurse simply walk out because she, like myself, is the designated floater for our shift. I have yet to comprehend why as we all are trained the same but not treated the same. Preferential or discriminatory treatment- which? 

[MaryB7, BSN]

I have worked at around 20 hospitals now and I can tell you that you may never find a facility where you get equitable treatment. Many managers are poorly trained, have no interpersonal skills, were burned-out as bedside nurses, or just are there for the money. As a less experienced nurse, you may not understand that many shifts are just a matter of surviving while trying to provide the best patient care that you are capable of. I have spent weeks in a PAPR with no breaks and no real assigned unit. I have worked travel assignments that were advertised as a PCU job, but I floated every shift. Until you are the one making the decisions, you have to either be the best nurse you can be where you’re at or seek employment elsewhere. There really isn’t much else. No matter what, be a lifelong learner. Be the best caregiver you can be. Treat your patients like you would want to be treated if that were you laying in that bed. Educate your patients to the best of your ability. I recently wrote a paper that showed that 25% of Afib patients couldn’t explain what Afib was and only 9% of all of those patients understood what their prescribed anticoagulants were for. Do you think those patients will be safe when they are discharged?

[Tweety, BSN, RN]

That system makes no sense.  

Where I work, the scheduled charge nurse doesn't float but otherwise we jot down the date someone floats and rotate through everyone.  We also do the same in that new grads don't float for three months.

[adhazelett, LVN, RN]

FIRST OF ALL…I am far from “inexperienced”. I have been a nurse for 30 years. 
SECOND: this kind of treatment, from my employer AND from MaryB7 in this thread has made me STOP caring and I have completed a second degree in order to LEAVE this discriminatory profession. 
THIRD: if I’ve done nothing, I’ve spent most of the last 30 years trying to educate not only my patients who generally don’t give a damn, but also my co-workers. 
So, before you start spouting like my employer, step off. Apparently, you didn’t fully read it or are only seeing what you want to… which is what I generally experience- nursing has always been ‘eat their own’. Not a profession I would recommend to anyone. 

[DavidFR, BSN, MSN, RN]

I work in a large cancer institute so when we're floated we're going from oncology to oncology so that kind of makes things easier. It is still an issue though with some nurses who have a preference for medicine or surgery, don't  like haematology, don't have ICU experience etc.

I'm based on clinical trials. I'm exceptionally floated to medical oncology (I.e. chemo, radiotherapy, palliative care), haematology or BMT units. I prefer not to go to surgical areas but will if absolutely necessary. I refuse ICU or paeds due to not being sufficiently experienced in those areas.

We tend to go on personal preference. I have a colleague who hates haematology so I'll go there in her place and then she might move for me to another area the next time. We're a small, cohesive, mature team so we manage to sort it out between ourselves who moves when the phone rings. Professional adults should be able to do that, however if there's conflict or certain people trying to avoid their turn then it's for the manager to decide based on who's turn it is and if they're suitably experienced for the required area. I think most qualified RNs should be able to adapt to most general medical or surgical areas, however for the more specialied areas (ICU, ER, OR, dialysis, paeds for example) you shouldn't just be expected to float there if you've no relevant experience. 

[HiddencatBSN, BSN]

Travelers float first then it’s by who floated most recently. I think there’s a minimum you have to be on the floated unit for it to count (iirc 2 hours). There are exceptions- if a unit needs someone who can take an assignment and not just be a helper it has to be someone cross trained (we’re a peds ED and float to adults and since it’s outside of our specialty we don’t take assignments unless we have previous adult experience) and that can mean they float out of order a lot.

[adhazelett, LVN, RN]

OK….I work in psych- and I want to stress AGAIN- WE ALL RECEIVE THE SAME TRAINING, from orientation to annual. However, we are not all treated the same when it comes to floating. CERTAIN nurses absolutely REFUSE to float while others don’t even get a choice. And travelers are generally within the refusing group and it’s just ALL accepted. This is not a unit issue, it’s a facility issue and management as well as administration is apparently willing to lose half the staff due to this and other issues we’ve been dealing with lately. All I can hope for is finding a job within my new career so I can write about it and not have to live it. 

[Hannahbanana, BSN, MSN]

On 6/25/2021 at 12:00 PM, MaryB7 said:

I recently wrote a paper that showed that 25% of Afib patients couldn’t explain what Afib was and only 9% of all of those patients understood what their prescribed anticoagulants were for. Do you think those patients will be safe when they are discharged?

Where did you write this? How did you get those numbers to show it? 

I actually believe this could be true. One thing that would help, one of my personal hot buttons, would be if we and docs stopped calling it “blood thinners.” I just hate that. This makes people think about watering the milk or putting turpentine in the paint. Anticoagulation doesn‘t “thin” the blood like that, does it?
Everybody knows what a clot is. If you say “Anticoagulation, that means decreasing clotting, your blood doesn‘t clot as easily,” then reinforce the idea of clots in their fibbing atria being a bad thing, they get it a lot faster.