mid-shift floating

[StudentNurseSteph, BSN, RN]

does anyone know of a study that shows that mid-shift floating decreases patient safety.. our hospital is trying to enforce mid-shift floating now which i find rediculous.

Thanks in advance!

[mommyX2]

I think that anytime there is not continuity of care there is the chance that negative outcomes will occur. With that said I can also understand the challenges when staffing floors. Do you keep the nurse who has been with the patient for the last four hours or do you take a nurse who will be with the patient for the next eight?

[StudentNurseSteph, BSN, RN]

i work 7pm-7am.. but there are also 8 hour shift people that come in at 11... the hospital is saying we (the 12 hr shift people) if it is our turn to float should give up the patients we had for 4 hours to float to another floor.. so i am looking for a study to help support us with why mid-shift floating is unacceptable.

[mommyX2]

I agree that if patients are already assigned and under the care of the 12 hour nurse that the assignment should not change but unfortunately so many nurses hate floating and can't look beyond what is best for the patient that I doubt hospitals will change the protocol. Now, in regards to literature, there is a lot stating that anytime there is patient handoff that the risk for errors increase. Those types of articles can back up your argument since everytime one nurse reports off to another nurse it is considered a "hand-off" and it is widely documented that hand-offs are detrimental to patient care.

[BittyBabyGrower, MSN, RN]

We do this also. If we come in at 7p we will have an assignment for 4 hours and if it is our turn to float at 11p we go. Is it ideal, probably not, but I am not aware of any studies like what you are looking for. Unless you can get the whole house to change their practice, then I think you are stuck.

[whipping girl in 07, RN]

i work 7pm-7am.. but there are also 8 hour shift people that come in at 11... the hospital is saying we (the 12 hr shift people) if it is our turn to float should give up the patients we had for 4 hours to float to another floor.. so i am looking for a study to help support us with why mid-shift floating is unacceptable.

So those who have the audacity to work an 8 hour shift always have to float, while those who toe the line and work 12 hour shifts never have to float?

Honestly I have issue with floating ANYWAY if the person floating has not been trained in that area. Just because you have a pulse and a license does not mean you are qualified to work anywhere that employees nurses. I've worked as a critical care float, floating between 4 critical care units and a stepdown unit. I was cross-trained to each area. I was paid more to float. And I sometimes had to float mid shift if one unit got busier, usually from stepdown to one of the other units because they could have a higher nurse-to-patient ratio.

When I floated mid shift on nights, I usually handed off 2 or 3 patients to other RNs, having done the assessment, possibly the bath, the chart check, depending on what time maybe the MAR check, etc. The RNs who picked up my patients could do a quick assessment and pass meds for the rest of the night and they were likely in pretty good shape. Then I'd have to go to ICU and take a new admission (or 2) or pick up the other patient for a nurse who's 1:2 load needed to become 1:1 and play catch up all night, and likely admit another to boot. It sucked, so the reward was more $$$.

[Tait, MSN, RN]

This thread kinda makes me wanna say "suck it up"...but being a 12 hour RN that floats mid-shift on occasion I can understand the frustration.

However, staffing is like shaking a magic 8 ball. Shake it and hope for the right side of the octagon. A balance between patients, money and staff satisfaction, it is hard for me to say that I would never want to float. I do feel, as a med-surg nurse, that I am capable of moving from unit to unit (with exception of critical care), I enjoy meeting other staff, and often find that understaffed units are fairly helpful with unfamiliar crews. However I have also been dumped isolation/PCA heavy teams while other nurses sat in the back and chewed on snacks and cruised the internet. But in the end that isn't an issue of floating and helping, but of the unit itself.

To the OP I did not have much luck searching specifically for studies supporting the dangers or benefits of mid-shift floating.

Best of luck,

Tait