No more floating!

[wjf00]

The hospital I work at is currently in contract negotiations with CNA. One proposal put forth is to end involountary floating. If this were to become part of the new contract, it would be (to me) a very important leap forward. I would be ECSTATIC! This has to be by far my number one disagreement with common hospital practices. Does anyone else have the same thought? Anyone disagree? I can't imagine the hospital telling the Neonatologist that "we are down a Cardiologist today so we are floating you to Tele". Nor can I imagine an electrician showing up at the job site only to be informed that "two of the plumbers called in sick today, so you will be fitting pipes today". I would gladly trade pay and benefits to be done with this unsafe practice. When Pediatrics hires a new RN from a Med/Surg floor they get a month or more of orientation, but when I float maybe once every 3-4 monthes I get the same assignment with "zero orientation". I am considered 'a pain in the butt' by management, and a 'bad nurse' when I refuse a full assignment as a float. So whatever happened to "patient advocate' anyways?

[UM Review RN, ASN, RN]

I concur. There's also no such thing as "the patient's really a Tele patient but hasn't been moved from CCU." The other nurses might offer to "help" with the patient, but frankly, if something bad happens, whose signature and whose license is on the line? Yours.

Encourage your hospital to cross-train, and encourage them to have you select areas that you are capable of floating to, if your hospital MUST float you. I would be qualified to float to Med-Surg or Tele, but not ICU, CCU, Pedes, OB, or ER.

If they want me to do more, they have to train me.

[TazziRN, RN]

We are part of CNA and we have that in place. You can only float to units you've been trained in, or where you're willing to go. Problem with that is, if you refuse to float, then you get sent home.At our place floating is almost always done because the home unit is overstaffed, not because the float unit needs help.

[Tweety, BSN, RN]

Good luck.

Floating is a double edged sword for us, as sometimes it's our unit that nurses float to. Often we float to other units as well. We have no ratio law, so if people didn't float the poor nurses on the floor would be stuck with an unsafe ratio because we have not on-call for certain units, and no mandatory overtime, and they can't make you stay at the end of your shift, and most of us ignore the phone calls when asked to cover our unit when they are short.

I would hate to think a unit with a low census calls nurses off while I have a high ratio. But as I said, we're not California.

[UM Review RN, ASN, RN]

I would hate to think a unit with a low census calls nurses off while I have a high ratio. But as I said, we're not California.

So you're saying that if the OB unit is short, you would want to be floated there if your unit has an "extra" nurse?

Even though you're not qualified as an OB nurse?

I've seen some units keep their budgets down by deliberately understaffing. Makes them look good, but then the units who spend the money to staff the unit pay---their nurses are constantly floated off.

The whole concept of floating just doesn't make much sense to me, since there are plenty of agency or pool nurses who want to float around and have that variety.

[Ann RN]

So you're saying that if the OB unit is short, you would want to be floated there if your unit has an "extra" nurse?

Even though you're not qualified as an OB nurse?

I've seen some units keep their budgets down by deliberately understaffing. Makes them look good, but then the units who spend the money to staff the unit pay---their nurses are constantly floated off.

The whole concept of floating just doesn't make much sense to me, since there are plenty of agency or pool nurses who want to float around and have that variety.

"...the units who spend the money to staff the unit pay..."

In every hospital I have worked in, whatever unit gets the floated nurse pays for that nurse. It comes out of the receiving unit's budget and not from the budget of the "floated from" unit.

"...plenty of agency or pool nurses..."

They cost the hospital more. Do you really think the hospital would use agency or pool nurses when there are "extra" nurses on staff?

[TazziRN, RN]

"...the units who spend the money to staff the unit pay..."

In every hospital I have worked in, whatever unit gets the floated nurse pays for that nurse. It comes out of the receiving unit's budget and not from the budget of the "floated from" unit.

"...plenty of agency or pool nurses..."

They cost the hospital more. Do you really think the hospital would use agency or pool nurses when there are "extra" nurses on staff?

:yeahthat: :yeahthat: :yeahthat:

[Noryn]

The way most hospitals use floating is very unsafe. At one of my old hospitals we could be floated anywhere (I was a CCU nurse) and others could be floated into our unit. More than 1 time I have seen a nurse in tears because she had to come to the intensive care unit because it can be intmidating. We also had one floor that was ran very poorly and if you were floated and missed one little part of computer documentation that nurse manager was all over you writing you up.

I personally think that mandatory overtime and floating could be avoided 95 percent of the time if you run the unit/hospital correctly. If you take care of your employees and show them appreciation most of the time they will reciprocate by coming in extra and helping out. There needs to be a repeal of the law that states once a nurse takes a role in administration such as a manager, they can no longer do bedside nursing. There isnt a law like that? You should could have fooled me

[UM Review RN, ASN, RN]

"...the units who spend the money to staff the unit pay..."

In every hospital I have worked in, whatever unit gets the floated nurse pays for that nurse. It comes out of the receiving unit's budget and not from the budget of the "floated from" unit.

"...plenty of agency or pool nurses..."

They cost the hospital more. Do you really think the hospital would use agency or pool nurses when there are "extra" nurses on staff?

Let me clarify. The units who staff well, "pay" in terms of cutting themselves short to staff other units. I've seen situations in which nurses were floated off of my unit to the point that "everyone is short." So everyone has to pay in terms of manpower. It's a very unfair system, to my way of thinking.

And of course the agency or pool nurses cost more! They should! They're qualified for those units. Just as when I'm floated to Med-Surg, I get paid my Tele salary regardless of what the MS nurses are paid.

What I was trying to get to--and forgive me if it doesn't seem to be coming out the right way--is that nurses who are not qualified to work certain units should not be expected to float to those units, period. Regardless of the cost, the units that are understaffed should try to staff with qualified nurses, not just any nurses.

[santhony44, MSN, RN, NP]

I personally think that mandatory overtime and floating could be avoided 95 percent of the time if you run the unit/hospital correctly. If you take care of your employees and show them appreciation most of the time they will reciprocate by coming in extra and helping out.

I agree completely. It's a pretty simple thing but lots of managers never grasp it. Don't play mind games, don't get off on power trips, back up your staff, give them their requested shifts and time off if at all possible, treat them fairly, let them know what's going on, etc. And yes, occasionally giving a hand, filling in, and so forth- you'll find that your staff will, for the most part, do what is needed.

Also, treat the staff who float into your unit well and fairly. Don't write them up for every nitpicky little thing. Don't dump all the patients nobody else wants on them- especially not all in the same shift! Unless they've been to your unit frequently and can function just as well as your regular staff, don't give them the first admission or the postop rolling in the door two minutes after report ends. Don't treat them like idiots if they don't remember what "routine" vitals are on your floor or don't know where everything is. Don't assign them to work with the staff member least likely to help them out. If at all possible, give them a lighter patient load or lots of help. Don't just say that you appreciate their being there, show that! If someone is ordering out food, include the float nurse.

I've done float pool in the past. Some floors were great- so appreciative, and showed it; others treated you like a bother if you asked a question, dumped every complex or difficult or isolation patient on you, etc. You don't want to go back there!!

[Dorito, ASN, RN]

I used to be floated to many units. I guess as long as I had resource staff there I didn't get too concerned. Mostly I just started IV's, passed meds etc but there were a couple of times that I was thrown into some pretty hairy situations....floated to ER with one other nurse on Labor day! (3 codes and multiple patients!) Another time I was floated to the nursery but had no resource person. I told the Supervisor I wasn't willing to work there without orientation or another person with me....she sent me home (which was fine with me) and I've still got a license!