Floating Policy Help Needed

RoadRunner · Dec 12, 2002

We try to do that in my facility about three years ago and the proposition was actually stopped by the union (don't get me started on this one....).

IMO, it would have been a great way to help nursing shortage among CC units. I wonder if that is the main reason of the proposition in your case.

Keep us posted would you?

OrthoNutter · Dec 16, 2002

That kind of policy sounds like a fantastic idea....similarly, I think there should be some sort of policy in place which allows non-critical care nurses to be floated only to non-critical care areas. Of course, making allowances for those nurses who have the necessary experience/desire to delve into these areas.

In my organisation, it is in our employment contracts that we can be floated anywhere within the hospital in times of extreme acuity, regardless of experience or comfort level working in other areas. I've been informed that I've been seconded to critical care over the silly season and I'm definitely "not happy, Jan!"

But that's how life goes in this place...

nimbex, RN · Dec 16, 2002

we initially did only float to the ICU's. Here's what happened. I've worked CCU for 6 years now. A patient with a HR of 50 with a BP of 90/40 is not only a norm but a goal in a CCU. Floating to SICU, HR in 120's, CVP 18, wedge of 18, BP 140/88.... I'm calling the Doc to get meds to drop these numbers and rest the heart.

Wrong answer, the above can and usually is normal, unless an AAA with tighter parameters....

We found that a cardiac nurse and surgical nurse are two different entities.... with two VERY different knowledge bases and comfort levels.

So we made the CCU and CCU step down sister(floating) units and the MICU and SICU sister units.

Unless there is a plan to train the nurses.... a surgical nurse floating to CCU taking care of a complete heart block with a rate of 30 will scare them to the enth degree... while a CCU nurse looks at it and says yep.... they're fine.... so what? and it harrasses the MD's too!

Just food for thought... hell, I'll take ANY ICU any day, but I've cardiac surgery experience that my peers don't and floating to cardiac surgery scares them beyond belief.. it's not cardiac... they're surgical.

If you have clinical ladder, use your ladder nurses as training support to develop a training seminar, brief but full of hand outs.... Most nurses, if given advance training will be more likely to get buy in from... then just floating them... which will give you more support through your process.

Also consider survey's with the ICU nurses... with feedback from them, you're more likely to get buy in from management.... after all, decreasing turn over should be a goal for EVERY manager.

Good luck, take care

RNonsense · Jan 6, 2003

We have CC floats in our hospital...I'm a bit confused by you enquiry. What is the policy now? Do they actually send CC nurses to wards? Or *egads* med-surg floats to CC areas?

ValWai · Feb 16, 2003

It's nothing personal. And I am a nurse in dialysis and I wonder if my mother was admitted and was having a heart rate of 30. So, is she all right? I mean judging my own mother as a daughter. I agree that "We found that a cardiac nurse and surgical nurse are two different entities.... with two VERY different knowledge bases and comfort levels." But is it some kind of defensive mechanism.

HazelLPN, LPN · Mar 17, 2003

Our hospital has floating "clusters" where critical care nurses float only to the ICUs, surgical nurses only float to surgical floors, and medical nurses only float to medical floors and everyone can float to the ER but nobody floats to the OR. If there is a crisis situation or emergency need as determined by the nursing supervisor, then it is possible for a non cluster nurse to be mandated to float out of her cluster. Also, a nurse may volunteer to float ourside of her cluster if she is to be floated but there is no need for her in the cluster. When volunteers come down from the floors to the ICU they usually do a great job. We have a practice calld PIP (partners in practice) where a nurse from the floor teams up with a nurse from the unit. That way the float nurse does not take her own assignment . Usually they take 3 patients who are on a 1:2 care. She functions more as an extra pair of hands but that way they can participate appropriate to their skill level. This is also how we handle our nurse techs and NAIIs who work in the unit. Ocassionally, an experienced floor nurse may take her own assignement if she feels comfortable or if we have low acuity patients to give her ( or him)

JACook1 · Sep 4, 2003

We have 5 units, MICU/CCU, SICU, NTICU, & Step-Down. When you are oriented to our hospital as a CC nurse, you must be able to float in this cluster if your home unit is overstaffed and other units need help. It works fine, but most other units hate floating to neuro-trauma, they think we have crazy patients...

Jaime A. Cook RN,BSN,CNRN