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Split-Shift Floating

Travel   (2,610 Views 16 Comments)
by CameToSlay CameToSlay (Member) Member

703 Profile Views; 34 Posts

I am currently on an assignment where I am sometimes asked to switch units mid-shift (4 hours on one unit, 8 hours on another). Sometimes, I am asked to do this not out of an emergent need, but rather because an 8-hour shift staff nurse or per-diem nurse picking up a shift prefers not to work on a certain unit (and this facility has been short-staffed frequently as of late).

The split is done between a step-down unit, and a telemetry unit where the patient ratio can go up to 8 patients at night-- and that is the floor where nurses do not want to pick up shifts, so I have been asked to float there to pick up 7 patients and then receive an admission, after taking care of step-down patients for the first 4 hours.

I do not feel comfortable doing this again, as it is simply too much, and there is too high of a risk that something will be missed. I cannot properly assess and care for 8 telemetry patients (one of whom is always an admit) when I am always getting there late due to completing duties in step-down (and I refuse to cut corners, as this facility does audits). This floating mid-shift is never done by staff (I am on 12 hour shifts and they are on 8 hour shifts), and as there are no other travelers on my night shift, no one else is doing it.

My contract does have a float policy, but it does not specify mid-shift floating. I am planning to refuse the next time I am asked to float mid-shift to care for 8 patients because a staff nurse or per diem nurse coming in for their shift does not want to work that unit, and I am even prepared to be sent home for refusing (and also I don't think they would do that due to short staffing), as I feel strongly that it is that unsafe with those ratios. Have any experienced travelers encountered a similar situation? Any advice would be appreciated!(and please not just 'suck it up', as that is what I have been doing, and it is just unsafe to continue.)

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1 Follower; 3,220 Posts; 45,163 Profile Views

I'm not a traveler but I hate split shift floating.

However I can't understand the logistics of how you could be scheduled? Are you the only 12 hour nurse? How else would they work you into the schedule except for splitting a shift? I'm not trying to argue, my brains a little foggy and scheduling is hard.

Have a polite sit down with a manager or supervisor and tell them why split shifts is not working. Offer solutions to them. Are there other 12 hour nurses can you rotate with them? (Don't know if that would prevent splitting units?)

Can you change to 8 hours? I assume you prefer 12's but just to finish up this assignment.

Talk to your travel agency, let them know this current posting isn't working can they help?

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meanmaryjean has 40 years experience as a DNP, RN and specializes in NICU, ICU, PICU, Academia.

3 Followers; 7,551 Posts; 65,168 Profile Views

Tread carefully "Other duties as assigned" can come back to bite you. And blacklist you.

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2 Followers; 1 Article; 5,357 Posts; 45,221 Profile Views

Kaiser (the dominant chain in California) is notorious for floating travelers, often every four hours. That is just how the math works for them when all staff work 8 hour shifts, and all travelers twelve. Obviously this is not optimal for patient care, but it sure makes nurses efficient at being ready to report off every four hours. Which if you survive, makes you stronger and better organized.

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34 Posts; 703 Profile Views

Cali has mandanted max staffing ratios of 4 to 1 I believe. That would be fine. I am talking about 8 here.

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34 Posts; 703 Profile Views

Yes, I'm on 12s and staff is on 8s.

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72 Posts; 694 Profile Views

Cali has mandanted max staffing ratios of 4 to 1 I believe. That would be fine. I am talking about 8 here.

Are you in California?

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Have Nurse has 25 years experience and specializes in Med/Surg/Infection Control/Geriatrics.

15 Articles; 713 Posts; 8,070 Profile Views

Kaiser (the dominant chain in California) is notorious for floating travelers, often every four hours. That is just how the math works for them when all staff work 8 hour shifts, and all travelers twelve. Obviously this is not optimal for patient care, but it sure makes nurses efficient at being ready to report off every four hours. Which if you survive, makes you stronger and better organized.

Yes, and it's the patient who pays for it. Stick to your guns, Kid.

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82 Posts; 1,349 Profile Views

Report this to your recruiter, he/she should be able to help. If not talk to the nursing supervisor and explain to them the safety concerns. Once you address the issues of safety with them, they will find an alternative solution for you. Maybe this is something that needs addressing in reference to their entire system . Why would you be the only floating nurse in the hospital? Are they looking at instituting staff at 12 hr implements? It is a concern for your license and your and the hospitals patient base. Please address this issue now, it will become your problem if you do not address it with the people in charge of the facility. They probably do not even know what's going on ! Good luck, address it and stick it out😊

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Daisy4RN has 20 years experience and specializes in Travel, Home Health, Med-Surg.

1 Follower; 1 Article; 1,019 Posts; 6,717 Profile Views

I have been floated mid shift and like you do not feel it is safe. I don't quite understand why you are going because regular staff don't like that particular unit. Are they coming in extra and that was what they demanded prior to agreeing to come in, if not then it should not always be just you (at the very least the per diems should be going to that other unit). I would talk to the unit manager and also your agency to see what can be done. Is it possible to have your schedule changed to an 8 hour schedule so you would not have this constant trying to fit your 12's into the hospital 8's. Did you know they were on 8's prior to accepting the position, kind of strange they would do that. Either way I don't see how you can change the floating unless you just talk to them. I have actually been floated 3 times in a 12hr shift, when I told them I don't feel safe (and why) sometimes the unit would just allow me to be resource for 4 hrs etc without accepting a patient list myself. If you are not able to come to an acceptable understanding then I would let the recruiter and manager know how you feel and that you will not be coming back there. You may have to finish your contract but your recruiter may be able to get you out of it. Good luck!

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171 Posts; 4,888 Profile Views

I hate when they do this to me. It sucks. That said, it's part of traveling, most places, to float first, often (though not everywhere) for 4 hour increments. As far as central staffing is concerned, we are often not real people, only "Traveler Apples," and "Traveler Oranges," to be plugged in to any open space q4.

Though my current facility has a written policy to NOT automatically float travel first...guess what? I have done 4 hours in CCU, 4 hrs in IMCU, four hours in med surg...and NO ONE else on the unit floats. They just refuse. The charge calls them and says, "Hey, they're going to float someone...do you want to call off, and we'll float a traveler?" Yep.

That said, I'm making 50$/hr to staff's 27, so...I take deep breaths and suck it up.

I am LITERALLY on the schedule listed in a separate section under per diems as "Travel Oranges"...good luck!

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jrbl77 has 41 years experience as a RN and specializes in Med Surg, Parish Nurse, Hospice.

247 Posts; 8,746 Profile Views

This has not happened to me, but I have heard about it. A PRN nurse was floated between 2 hospitals about 10 miles apart during her shift. Work the first 4 at Hospital A and then get sent to Hospital B for the next 4 or 8. Hospitals A and B are owned by the same company. I can't even imagine trying to do something like this. Plus what happens if you are in an accident between hospitals. What is nursing coming to?

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