Floating nurses - page 2

I have an issue I really need to get input on. I manage several large telemetry and PCU type areas. Staffing is usually tight...however, once in a while the clouds part and the census in the ICU... Read More

  1. by   BadBird
    I absolutely hate floating which is one of the reasons I chose Agency. My thought is is you wanted to work MS then you wouldn't be an ICU nurse.
  2. by   OC_An Khe
    Floating is a long standing problemwith in the hospital nursing culture. It probably stems from the days when vitrually all RNs were trained in the hospital setting and had extensive clinical expirience in all aspects of the hospital. That doesn't exist any more. Most RNs dislike floating, particularly when floated to an area they are not current on and in fact may have never worked in that specialty (med-surg is a specialty unto itself).
    On the rare occassion that we have to float an RN, that RN is typically floated without a patient care assignment. If the RN feels she is capable of assumming an assignment (it's the staff RNs choice) the floated RN can take a patient care assignment.
  3. by   tiger
    babs, just like to say that you must be a great manager to have this concern. i have had great managers but have also seen "don't give a sh*t" management. it is very demoralizing to regular staff to be floated or called unfairly. please, keep your present attitude. i'm sure your staff appreciate it. are you guys union. if so, there are no unwritten rules. janet
    Last edit by tiger on Jun 26, '02
  4. by   pappyRN
    Floating is what put me in the situation of getting injured. I CHOSE to work NICU because the patients are so small and I had some cervical spine degeneration that I preferred not to aggravate.

    I was hurt in a lifting injury and am permanently disabled and am now in chronic persistent pain. (You can read my story and my opinion of my situation by looking at many of the previous posts I have made).

    Floating put me in a situation which ended my income, my health, my career, and most pleasurable activities.

    I believe that any unit should self staff and strive to be as completely autonomous as possible. Take responsibility for the staffing in your own unit. Be loyal to it and take some ownership of it's problems whether it be staffing or other concerns. Let the staff be involved in it's problems so that they may become part of the solutions. They will feel as if they have more control over their situation(s) and it is a great way to develop camaraderie.

    Administration should serve as leaders by serving as advisers and guide the staff into coming up with solutions instead of making rules without their input and shoving it down their throats. Let the staff do their own problem solving and have inservices on conflict resolution. There will be less resentment of those in charge if you show your staff that you are just as committed as them by never asking them to do anything that you wouldn't also do yourself. I believe that fosters a lot of respect with the staff and in turn it show them that you respect what they are doing.

    Nurses shouldn't have to be the "jack of all trades" by being floated to floors where they are not familiar with the diagnoses, etc. Chronically understaffed units/floors should take this same approach and figure out why they can't get anyone to work on their division instead of expecting every other division to solve their problems. Deal with people who chronically call off on your unit but in a mature way that may help these persons to see how detrimental to the unit their actions are. Give them a fair chance to improve and if they don't then follow HR's policies for termination due to chronic absenteeism. Pay attention to staff who may have extenuating circumstances and try to help them with their situations in a compassionate, constructive way and as a team instead of being demeaning and suspicious. " A little sugar goes a long way". If the situation can't be resolved- again, use the HR policies already in place to deal with the situation.

    This method can and DOES work. The atmosphere should be one of absolute RESPECT for patients and coworkers, cohesiveness and cooperation as a team.

    There is way too much fighting, jealousy, and suspicion. Petty bickering is disruptive to the normal business of the unit. Cruelty, verbal assaults, fighting, character assasination, unfounded or second hand accusations and gossip etc. have no business being present and should not be tolerated without serious consequences. Mind only the business that you have been given permission to be a part of.

    Matters of workmen's comp., injury, light duty, and duties assigned to injured workers returning to duty should only be handled by the administrative staff due to the legalities involved. Staff who gossip about whether the employee is really injured to the degree of restrictions, interfere with what restrictions have been placed on the employee, or refuse to perform additional duties should be dealt with accordingly. Those who refuse to pick up any extra work assigned because they do not feel that the employee is as limited as her restrictions should be reminded of their job descriptions and counseled as to the disruptive nature of their actions. There should be consequences in place for their insubordination as this behavior is extremely disruptive to the normal business of the unit. Administrators should not discuss the employee's limitations or situation with employees over whom they have supervision if it in any way violates the returning worker's right to confidentiality. They should however, be available to listen to the employee's concerns. It should be known and stated clearly up front that there are some matters that are not in the control of the employees. That should be handled early on as the staff begins the work to set up their model for the unit's business and policies.

    Even though I worked in a pediatric hospital I never felt competent to work on Hematology/Oncology or with Adolescent/Teens. The only real experience in that age group was with my own kids. Teen patients used to play jokes on the "pulled" nurses like switching ID bands etc. Actions that could have resulted in horrible consequences but in their youth and immaturity they never thought about that part!

    If the staff can not come up with an acceptable policy which avoids pulling one thing is for sure- "double pulling" (ICU to Tele, Tele to MS) should not be allowed. Pulled nurses should not have to take pt assignment but should serve only as extra help- vs, meds, etc.

    Good luck with a universally difficult situation.

  5. by   laurako
    One of the rules of nursing is being flexible. I am currently a Med Surg charge nurse, cross trained in all fields of nursing. I have been pulled to, wherever I am needed.........wherever. Nursing is NURSING. Is taking care of a a patient on a balloon pump more important than basic wound care on an ulcer? Is recovering a patient from surgery more important than handing a newborn to it's mother? Nursing, is NURSING, it is all important, and as far as I am concerned, none of it is demoralizing. How is knowing more units, and more nursing not beneficial?!?!? The ability to float between units, and care about people is a gift. I think most nurses are just comfortable in their own settings, but if they would take a "float" as a challenge, a challenge to do, everything, and ALL things ,just as importantly, it wounldn't be such an issue. I don't agree with the "pull" heirarcy, and being charge nurse, I try to send each of my nurses to the different units with enthusiam, and an attitude of knowledge expansion is the best.
  6. by   laurako
    Oh, and a suggestion in orientation of a new employee? 3 weeks on their "home" floor (unit), and at least 3 shifts on 3 different units..... it would be very beneficial. The new employees expecting to be pulled, is not as bad as if they were never oriented.
  7. by   fergus51
    Laurako, I don't think any area of nursing is more important than another. Most people I know (including myself) don't like to float to areas they feel unsafe working on if they have to take an assignment and the legal responsibility that comes with it. If managers want nurses to be nurses and function everywhere, they are going to have to put more than 3 shifts into the proposal. That said, floating nurses and using them in a capacity they feel safe in is rarely objected to. That can be a fun challenge.
  8. by   mother/babyRN
    3/4 of the staff on our OB unit has left and happily been accepted at other facilities due to floating....No one floats to delivery however busy they are and management forgets or puts aside the fact that things can and do happen in an instant in maternity...It isn't all about birthing babies...If the census is low, leave peope where they are or do not give them flak if they are uncomfortable accepting assignments.. I am one of the people who have "jumped ship" after 20 years at one facility...Now, due to the extensive float policy, my facility has lost over 200 years of valuable delivery experience.....That is scary.....All this to make people float elsewhere to conditions that are so bad the people there are leaving as well.....
  9. by   CCL"Babe"
    This has been a BIG issue in my dept. Our census has been down for some time now. Several physicians have left, leaving us with fewer cases.
    We have been getting pulled to same dept at other facilities with in the system. This did not go well, some of us did not want to go to the other hospital, especally when they were fully staffed already.
    Now those of us who don't want to go the the other hospital in question get pulled to other units with in our hospital, but we only go to units that we do not take pt assignments. ie endoscopy, PACU, IV team.
    If my dept gets an emergency we can go back to our own dept.
    We all rotate through this - part timers, PRN and full time staff alike. As a part timer now I'd be pretty upset if I always had to be the one who had to go. As it stands we all go somewhere once a week.
  10. by   karbyr
    Think you are way off base imo. The time for a learning experience is in the classroom or orientation process, not when you've just been handed a full assignment that your license demands you take knowledgeable care for. I have worked med-surg on and off throughout my career. I have no business in an ICU where I don't know the protocols, the meds or the other nurses well. I also do not belong assisting a woman in labor, as i have no recollection of the proper presentation from nursing school, let alone the meds, doses or protocols. If a patient in one of those areas was having a common side effect from one of the drugs, I would not recognize it as such.......................makes me damn dangerous in those situations, which I am not in my own specialty.............................think about who you want at the bedside for yourself or a loved one.
  11. by   Briern
    Floating in the facility I work at has really taken a wrong turn. OR nurses, ICU nurses, Med/surg nurses, ER nurses are given a choice when census is down to either float or be OC. Ob, however, has to float. No choice. We have become the prn pool for the entire hospital. That wouldn't be so bad if hospital policy was adhered to. Policy states that nurses who float to another unit are not to be given pts. We should pass meds, start iv's, help with baths, ect. Policy is not even looked at. We are given pts and expected to behave like we have been done a favor! There are several nurses that are very close to leaving. They feel that their licenses are in jeopardy. I wonder if risk management is aware of the liability that the facility faces by not following it's own policy.
    Last edit by Briern on May 18, '03
  12. by   layna
    Thanks to everyone for input on this subject! I am currently involved in the development of a float policy for our OB nurses. I do believe that floating guidelines need to be in place for the patients' sake. Nurses floating to other units should NOT be given an assignment unless they are currently practicing as a primary nurse in that unit (some of the nurses here do work in more than one unit on a regular basis). I also believe that with the help of the staff, there needs to be a clear guideline in place for the RN's who are floated related to what they can and cannot do- I found a great list of things like this in a Perinatal Compliance book I recently bought. We need to address the "floating fears" as mature adult professionals so that the needs of patient, unit and RN are met as best as possible.

    If any of you have some written floating guidelines and want to share, please PM me. I would appreciate it. Thank-you!
  13. by   yeyirn
    Finally, I'm here....

    Anyway, I was browsing the net in search for some things about being a 'floater'. It dissapoints me a lot because of the reasons mentioned from the previous responses. But I'd like to verbalize more on the aspect of uncertainty and uncomfortable when being assign to another unit.

    Our managers here just ignore that issue. They would always deny our needs. Probably because they themselves doesn't have the chance to be a floater. I hope that this will be addressed properly by the administration.

    I'd like to reiterate further but, let me just adjust first...for being part of this discussion.


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