*The Float nurse* anyone care to share?

[Newgrad_STAT]

I recently finished 2+ months of orientation/precepted shifts for a full-time float pool position at a great trauma hospital, I have been through MANY different preceptors, picked up a few tips and tricks and learned to roll with the bunches.

I started floating on my own Friday (I'm currently doing my nights then I will switch to days in about 1 1/2 weeks). My first night shift I was booked on a neurosurgey floor with a step down unit... wooo a little different than I envisioned. Heavy Heavy floor... especially for a first timer. I had 5 patients + a new admission. Something about new admissions on nights that stresses me out like crazy (no business clerk) - I'm never 100% sure if I'm doing it right or if I've missed something important. Thankfully the staff that night was very understanding and beyond helpful.

My second night- I was back on a stroke unit- where I spent about 3 weeks orientating there. So, not so bad. Felt nice knowing the floor, the flow and some of the staff.

My Third night (Sunday)... whoaaaaaaaa. I was booked on a GI surgical floor. So prior to going into my shift I did a little research (thought I'd like to be "somewhat" prepared- didn't help at all LOL). Anyways, the floor was like night and day from everything else I've learnt. Very hard... I felt in over my head... I mean 85% of the meds, procedures, tubes, trains, pumps etc I've never seen. But I just did the best I could and asked lots of questions . It was a very busy night but somehow everyone else managed to fit in a 'nap' break. I forgot about the break and just focused on getting what I needed done. I was flying around like a bat out of hell. Also, they were short staffed on nights and had me a new nurse/new to the floor + another nurse from another floor who also has never been there... so one of the regular staff nurses was quite upset... friendly but upset. I just kept thinking "don't blame this on me I just go where I'm booked"

So, it comes time to give report to the oncoming nurses and I'm thinking this is all chinese to me. I tried my best... not sure if I even made sense. I let them know that "hey I am new, new to the float team and most definitely new to this floor- I tried my best and I hope I have not missed anything".

Might I add, I also stutter... and sometimes it is definitely more noticeable. I could only imagine what they were thinking.

And the funny thing is... each floor I go too the staff nurses there always stress how hard the floor is and the workload... but then I go to another floor and the workload is 10x harder.

The experience is out of this world... but so is the stress.

I keep hearing how a resource team/float team isn't good for a new grad but about 90% of us are or started out as one there.

I hear both negative and positive stories. I am beyond thankful to have landed this position and I try to focus on the positive and know that not every day will be the best day... but I will try my best since that is all I can do.

I just worry about getting to a new floor with an extremely hard patient assignment and not having any "nice" nurses to turn to for help. :uhoh21:

[sauconyrunner]

My personal opinion is that putting a new grad in a float pool is not a good idea. For this reason.. "I mean 85% of the meds, procedures, tubes, trains, pumps etc I've never seen." I don't Ever want someone who has never seen 85% of their job to be doing the job without help (not the RN next door, but focused HELP) if you are caring my my loved one, or well, anyone.

If I was on the floor, I would not blame you , but I would question the choice of putting you in what is a somewhat dangerous position. I mean if you are unfamiliar with 85% of the stuff, thats a lot of room to make some sort of error, without knowing it...as you have no one checking up on you like a preceptor would. If reporting off on your patients feels like speaking in Chinese, there are issues.

I am sure you are doing a bang up job...but I question the judgement of the people who decided a New Graduate would make a great nurse for float pool. I do wish you the very best!

[MN-Nurse, ASN, RN]

Newgrad_STAT said:

I just worry about getting to a new floor with an extremely hard patient assignment and not having any "nice" nurses to turn to for help. :uhoh21:

It actually sounds like you are doing great.

[Newgrad_STAT]

sauconyrunner said:

If reporting off on your patients feels like speaking in Chinese, there are issues.

I didn't mean that in general... I meant giving report on that floor. I was unfamiliar with their terminology and honestly did not have as much time as I would have liked to do a bit of background reading and give a thorough report. We were swamped.

[Been there,done that, ASN, RN]

I have 30 years of experience. I am in the float pool in a large corporation. I float to different hospitals.. within the corporation... to any and all units.. that need staffing. I am pulled after 4 hours.. to another unit.

See my previous thread on DIVERSITY and communicating with nurses that don't speak basic English.

I can BARELY keep up.

As a newbie... this is not the place for you.

[rn/writer, RN]

What doesn't kill you makes you stronger.

I can't overstate the importance of having professional Liability Insurance. If you don't already have it, get it. Before something goes wrong.

If this is something you really want, please, take the time to familiarize yourself with the policies and procedures for the facility in general and for each unit. I know--easier said than done. But important nonetheless.

This kind of immersion is not for everyone. If you're a quick learner and you like a challenge, you might just pull this off. Each time you re-visit a unit that terrorized you at first, it'll be a little more familiar. Eventually, you'll be much more well rounded than many nurses ever become, and you'll have a good overview of where you want to land as far as specialty area goes.

I hope that you find your niche and that you do well in the trenches until that time. Let us know how you're doing from time to time.

[dirtyhippiegirl, BSN, RN]

Not getting into whether a new grad should be in a float pool or not (does seem like you're holding your own, OP, congrats. I couldn't do it.)

but

as a fairly new nurse working on a burn unit, I have had more than my share of reports from float nurses who had no idea. I've taken report from nurses who all-out said "I have no idea what is going on with this guy's burns. I don't know where they are or what dressings are being used" to nurses who would simply read directly from the doctor's orders. In theory, I appreciate the nurse who *tries* "I don't work in burn but I think...xyz" but...at the end of the day, I appreciate honesty and the fact that the float nurse is even *there* to pick up the slack. I'm not laughing at you behind your back because you confused xeroform with mepilex or allografting instead of autografting.

If there's one thing that I have learned in my short nursing career, the hard way, it's to never take another nurse's report at face value. I'm double checking everything anyway against the order history...a ****** report isn't going to make or break my day.

[wooh, BSN, RN]

dirtyhippiegirl said:

as a fairly new nurse working on a burn unit, I have had more than my share of reports from float nurses who had no idea.

Hehe, when I float to our oncology floor, I always preface the history stuff with, "This is what I wrote down from report when I got her, and hopefully I got it right, but I don't have a clue what was said or what I'm saying, so if it sounds off the wall, ignore it...." before the stuff about, "They're on day x of week y of cycle z for some sort of cancer somewhere" ?

[newohiorn, BSN, RN, EMT-P]

I went to float pool in a large acute care hospital (1000 bed) with two and a half years experience and it was (and remains) a challenge. I float everywhere except ER (they use a different computer system and I haven't been trained) and I also have to float every four hours. As others said, the terror subsides pretty quickly as you go back to the same units but general uneasiness and anxiety remains for me. My background was 15 months on a spinal surgical floor as a new grad and then 15 months in neuro critical care--then straight to float pool. I asked for and was denied any training, being told that since I was a critical care nurse I should be able to float anywhere. Personally, I think that is ridiculous but they were not interested in paying me to train so into the fire I went. I STILL ask a lot of questions. Most of the nurses in our float pool have a decade or more experience so when they get me they don't get that breadth of knowledge. I use my charge nurses and I ask for help when I need it. I imagine they expect me to be a super nurse like the other floats, but I'm just not and I get along okay. I am polite, cooperative, flexible, don't complain, help out others when I can, and I find that almost everyone is helpful to me.

I personally do not think new grads floating is a very good idea, but I can picture a few folks I know personally who could have pulled it off so I am sure there is a certain segment of folks who can do it. Good luck to you--ask questions, ask for help, say a sincere thank you to those who help you (especially those techs who keep us from drowning) and remember to breathe.

[RosesrReder, BSN, MSN, RN]

I've been in float pool for 2.5 yrs dayshifts for all the sister hospitals in my city. It IS hard work. Seems like you are doing just fine. I love floating!

I started floating with only 2.5 yrs experience and it is tough but you learn soooo much. I embrace it.

[KelRN215, BSN, RN]

I would guess that the nurse who was upset to have you and a float nurse was not upset at either of you but at the situation. I worked on a specialty floor (pediatric neuro including neurosurgery and neuro-onc) for close to 5 years. We were always grateful for the help but the problem always was that there were certain patients of ours (kids with EVDs, kids with invasive epilepsy monitoring, kids on chemotherapy) that a float simply couldn't take care of and these were of course the busiest kids. I'm sure the nurse was more upset at the situation- in the case of my old floor, they just chose to not staff appropriately. They'd put 5 nurses on a nigh shift (when we needed 7-8) because "we haven't been that busy on Sundays" and then they'd get 2 sick calls and be completely screwed... calling everyone desperately to come in and then finally breathing a small sigh of relief when they were promised a float pool nurse or a float from another floor. People working that shift were glad to have the help and no one ever got mad at the nurses because they couldn't take care of our "busy" patients, but still upset at the situation.

[tigerlogic]

I'm a float CNA at a hospital now and starting nursing school in the Fall and of course floating is totally overwhelming-- but you're there, doing it, right now. So regardless of whether its a good idea or bad idea, you are there doing it right now. It seems to be a bit of a trend in my current hospital and I wouldn't be surprised if it becomes more common to have fewer specialty positions in the future. Right now, if census is low they sometimes close whole wings to try to cut the budget. That means those people either have to take their PTO or float--without float training.

It sounds like you're doing well and are aware of all the things you don't know yet. Keep asking questions and take good notes when you get report to pass that on.

Embrace it. Rock it.

And good luck!!