Nicu/peds float - becoming competent

[m0lasses]

So, I have a lot of questions and just need general support as a newer pediatric float nurse working in NICU. This is a long one!

Do you have floats in your NICU? What assignments do they take? How do you train them? Can they expand their skills and knowledge while continuing to float? What makes a competent, great to work with, float? Did you float before moving to NICU?

I'm a new float nurse working in level III as a float to nicu, peds, family birth. I worked in med surg for nearly two years before starting my job in peds float pool just over six months ago. I've probably worked only about 20 days in NICU after about 15 days of orientation there. I love the nicu but am struggling to feel competent. I miss having people ask me questions and feeling like a resource For other nurses. I am also terrified of being seen as incompetent and untrustworthy if I ever make a big mistake.

As a float, I only take care of lower acuity babies: feeder-growers, high-flow, IVs, hypoglycemia, apnea, etc. I did minimal training with a "NICU nurse" to learn to troubleshoot bubble CPAP and assist "NICU nurses" with micro-premies , procedures, etc, although almost all the core staff will ask other core staff over a float every time.

Do your floats take any higher acuity kiddos or get more training? Do you view your floats as skilled and trustworthy? Is there a feeling of separation in your float vs core staff team? I feel like there is a bit of a chasm between the "floats" and the "real NICU nurses". In other words, I am JUST a float. Any advice on how to get over this?

I know it takes time, though our very experienced floats have expressed still feeling this way. What advice do you have for me as a new float?

[HyperSaurus, RN, BSN]

Our floats take strictly feeder/growers only, unless they have spent a significant amount of time with us and feel comfortable with a little bit more. For us, that means room air, PIVs with antibiotics, very stable. They only get 3 days of orientation, which really isn't much at all. Yes, there is a definite separation between floats and core staff, but that's ok. We appreciate that they are helping us out, and they appreciate when we try not to give them tough assignments.

[NicuGal, MSN, RN]

Same as above unless it is one our staff who have gone PRN or worked in PICU, then we give them more complex kids.

We appreciate PRN people, and we give them easier assignments

because honestly, if one of uour

kids were kind of sick and got really sick and intubated/etc we would have to reassign that patient if you haven't been fully oriented to vents etc.

And I think there is a separation only because you don't have a home base and aren't there all the time. We try not to be like that but it does happen. Hang in there!

[karnicurnc, MSN, APRN, CNS]

Agree with the above comments. Our float pool receives about 3-4 days of training and take the feeder/growers. The most experienced floats can take slightly more complicated kids, but that takes time. Once you get the hang of taking the feeder/growers, try to observe and ask questions of the nurses taking care of the sicker infants. That shows curiosity and motivation to learn new things. Try to be patient.

[m0lasses]

Thank you!