Nursing home staffing and floating question

NotFlo · Mar 14, 2009

In my experience, yes, this is totally normal. If they need someone to fill a slot, they will float any warm body to fill that slot.

CapeCodMermaid, RN · Mar 14, 2009

Part of nursing no matter where you are is floating. It stinks but no matter where you work you usually end up doing it.

Atheos · Mar 14, 2009

Somebody please help me accept the reality of LTC nursing.
Is it normal practice for a facility to float an LPN to an unfamiliar floor (when that LPN is the only nurse) on a 40 bed unit? Is it normal for the facility to not give 2 sh**s that the LPN has never worked that floor, doesnt know the residents and has the responsibilities of meds, tx, charting and MD visits, not to mention any emergencies...

Do you really expect a nursing home to orient you to each and every unit, floor, resident in the building?

What, say a week orientation on each group?

If you are an LPN, RN, CNA, or whatever you should be able to work on any unit in the same LTC facility.

Now, if you are a new grad you shouldn't be expected to float yet but any experienced staff member should be able to. This is nursing... some times you are going to have to float.

caliotter3 · Mar 14, 2009

On my first job, I was cross-trained on all of the units so I was able to be assigned to any of them. But I was never put in the position of going to a unit on short notice without proper orientation to that unit. I guess I was lucky in that respect. In contrast a couple of the nurses who had been there for years would call out sick if they saw their name on the schedule for anything but the only unit they would work in. One got told off by the DON and was threatened to be fired the next time she called in "sick" because she didn't like where she was assigned.

CapeCodMermaid, RN · Mar 14, 2009

What is there to cross train? Meds are meds..treatments are treatments and patients are patients whether they live on the dementia unit or the rehab floor.

Nascar nurse, ASN, RN · Mar 14, 2009

I often have to remind staff.. you were not hired by east/west wing.. you were hired by the facility.

Fancy Face · Mar 14, 2009

I know all of this. Yet I get so nervous to float, I am slower at meds/treatments/charting when I don't know the patients, My whole day gets thrown off, and I am so nervous I may make a mistake. How can I deal with it.

CapeCodMermaid, RN · Mar 14, 2009

The same way you deal with anything else. Go slowly and pay attention to what you are doing. Don't let your nerves get the better of you. Floating makes you better in the long run.

NotFlo · Mar 15, 2009

When I was a new grad I had a 3-11 job on a busy rehab unit at a nursing home. I always had the same floor, and hated and dreaded floating. I had to float maybe once per month.

3-11 didn't work so well for my family, so after about a year and a half I got a job on 7-3 at another nursing home. This nursing home had four rehab floors and two long term floors. The only catch was the only opening was for a float position, covering everyone's days off. I was so desperate to get on days that I accepted the position.

It's been a challenge, that's for sure, but like Cape Cod Mermaid said, I really do think it's made me a better nurse overall. I'm not as afraid of of the long term units as I was previously (although I'll still take rehab/subactue over long-term any day!) and have developed organizational skills that get me through 8 hours on any unit in the building. Of course, it's easier now, after being there a year, because now I know every single floor and patient in the building.

The fact of the matter is that no single nurse should ever have 40 patients on days. The most I've ever had is 30 and that is really pushing my to my limit.

achot chavi · Mar 15, 2009

Normal is such a subjective word, havent seen much "normal" in my years of practice- but thats nursing!!!

It is difficult to float to an unfamiliar floor- once did it to a 48 bed alzheimer's unit- took my sweet time, asked tons of questions, checked the names of patients a hundred times, did my best, kept lists etc, even so the CNA's complained that I was slow and not as efficient as their regular nurses- almost made me cry- but instead I took a deep breath, finished the shift, was proud of my work,

Thank G-d no real emergencies that would have really unnerved me.

Even so, floating a nurse who is unfamiliar with the patients is a prescription for disaster and our solution was to have all our nurses over the course of a month, get oriented to all the units so we have available floaters who at least got some sort of orientation from the head nurse- I highly recommend it.

All the best,