Time to Float!

Morettia2, BSN, RN · May 11, 2008

My first time being floated was to the ER, 1 or 2 weeks off orientation on 12/23/2007. I freaked b/c at my hosp. you arn't susposed to be floated until 6 mon. after orientation. I work nights and the Nursing supervisor said to me ,"oh you will be fine" I said, "um no I won't we have the busiest ER in North Jersey, and I am fresh off orientation". THANK GOD it was the slowest night the ER has had in over 20 years. I had 1 pt. I think it was my x-mas present. But I don;t really count that as a float. My first "real" time being floated was a month ago. I went to another tele unit. I work on a Interventional Cardiology Floor/CCU step down, so I knew it wouldn;t be so bad. I went up to the floor, introduced my self, and I LOVED IT!!! The tele tech on that floor was a friend of mine so I had an automatic "in", the charge nurse was amazing, and I even showed her a trick or 2, all the phelebotomists, random house keeping, CNA's and MD's knew me, b/c they were cardiac people. The charge nurse asked if I was ok and if I had too many pt's to handle, I had 4, I am used to 6 critical pt's. I said are you kidding me this is great, she laughed and told me she had started out on my unit 2 years ago and knew all the "stuff" I delt with every night. Giving report in the morning was PAINLESS, I was done by 7:20am which is unheard of on my floor. Every thing was organized, and the Unit Clerk actually did her job and entered everything, I even offered to help, she was floored and speechless that I offered. The CNA was also floored when I just started helping with PT. care with out question, she said you must be from C4. So I had a good float exp. and I know that every time th RN's on my floor get floated they always come back in a good mood. It's a change and you get to see how other floors function and operate.

Good luck

racing-mom4, BSN, RN · May 11, 2008

I have been floated out to Med Surge to help with a new admit. I have also been floated down to ER when they were packed full and needed just some extra hands for a few hours.

Last night though I floated to OB for an entire shift. I had wanted to be an OB nurse during my school, and somehow ended up in the ICU.

It was great though, I actually saw my 1st vag delivery, all the time in school the only ladies having babies were having C/S.

So it was a good night, they new I was floated there and had never "worked" a full shift there before so they were very nice and helpful, basically I just did what ever they told me.

jessi1106, BSN, RN · May 12, 2008

Wow! This is completely different from my hospital. We have a whole float nurse pool. The float nurses are in med/surge or tele "cluster" and just get assigned to the units that need them.

I can't imagine having to float so soon. Do you work at a small hospital?

Good luck to you!

DolphinRN84, MSN, RN, APRN, NP · May 12, 2008

I remember the first time I floated. I was a little nervous but everything worked out ok. I floated to a neuromed/neurosurg floor and it was alright, though I wasn't too crazy about it. I work permanent nights and it seems to be "easy" for us to float. I actually just floated last Thursday night. It was another med/surg floor and it was pretty hectic that night. I don't mind floating, just as long as I don't do it all the time.

Morettia2, BSN, RN · May 12, 2008

How Ironic I posted yesterday about being floated and I got to work last night and was pulled to the CCU. I think I put my foot in my mouth yesterday when I said I didn;t mind being floated. I got to the CCU, got report, ok I was the only nurse with 3 pt's all the other RN's had 2. No prob I am used to 6 pt's. I go to access the Pyxis, my EID # doent't work. I called the nursing supervisor and she told me I have to have one of the other nurses access the pyxis for me when I need meds..what a pain in the rear and I needed PRN pain meds for the 3 s/p OHT(open heart transplant) pt's, drips out the wazoo. Thank god I didn;t have a pt. with a Swan Gantz, or I would have had out like 10 cheat manuals b/c we don't deal with Swans on my floor and it is rare if a pt. on my floor has one. I got a great report from the day shift and one Nurse stayed till 9pm to help me out with a few things. Ok so I start, can't access the pyxis, ask the charge to do it for me she freaks until I told her what the Nursing Supervisor said. Ok not bad, all the pt's are on 1000 meds which is fine I am used to that b/c I work on a interventional cardiology/CCU step down.The tele monitors were the older ones which took a little manuvering but it's the same program we use on my floor, no biggie. OK so one of the nurses comes over and says I am going on break you are covering me. She had the 2 most critical pt's on the floor. So I ended up with 5 pt's in the CCU. So she goes on break, at 1am one hour goes by, ok so I give it another 30 min. She still isn't back, another 30 min pass. At this point the other nurses that went of break are already back on the floor and relieved the other nurses so they could go on break. I never EVER get a break on my floor, so I am used to that, but I am not used to having 5 CCU pt's 2 with Swan Gants that are the resp. of the nurse on break. so 3:30AM rolls around the charge nurse noticed that I still haven't had a break I have been running around and checking the nurses 2 pt's b/c their O2 keep desating to 70%, and on top of that I was checking my pt's too. Finally on of the other nurses says something, and finds the RN on break. It's 3:15am at this point. The RN comes back. One of the nurses had asked me a question and I must have repeated my self and the RN that came back from break called me a parrot and starting making parrot noises, OK HOW OLD ARE WE. I said I am going down to my floor to get something to eat b/c I felt like I was going to pass out b/c I didn;t have a chance to eat anything. I handed off my 3 pt's to the nurse, she was grilling me on th HX of the pt's. I sad to her, I don't work on this unit, you know I was pulled from C4. I told her what happened to her pt's while she was on break, she didn;t care. I have what I got in report, I have the HX is the bedside, here it is. She started going nuts. I said I am going to my unit to eat and i will be back, I gave her my extension to my unit. The charge nurse said to me, "go on break to C4, I know your pt's I will make sure they are ok". I went to my unit, when my nurse manager on my unit saw me he said, your ears and face are the same color as your hair, RED! I said I am fine but he got it out of me what happened. He used to be the Manager in the CCU so he knows all the nurses. At this point it's 3:40AM, I know I have to be back in 20 min. to do all the AM Labs, which is fine. But he said the RN you were covering took a 2.5 hour break and then belitteled you infront of the staff when she returned. That's unacceptable. I said please don't call up there I don't want to go back and have it be worse. He must have called the charge nurse in the CCU and talked to her. I came back to the CCU after shoveling my dinner into my mouth. I was back in 20 min. like i had told the nurse i would be.I am doing my labs.Then the charge nurse comes in the pt's room and says "angie, I need to talk to you", I am like great, and i am freaking out on the inside. She waited for me to be done drawing the blood. She pulled me aside and said, "I am so so sorry that you were treated like this. It was totally unacceptable for the Nurse to do that. You are here b/c we needed help. That nurse has a habit of being rude, and what she did tonight was wrong. She took advantage of you and your nurse manager on C4 is one of my best friends, when he told me everything that happened and how he had to pry it out of you I felt so bad that you were treated this way. Please don't take what she does personally." I said I don't, she also said, "you are an amazing nurse, and very indepent in the critical care setting, most nurses pulled here have a hard time. I am going to tell the day shift director about you, the nurse manager on your floor also told me you were looking to transfer into the CCU, and don't let what happened tonight give you the wrong impression of the unit." She said, "When you went down to C4 on your break one of the other nurses said that she would love for you to work on this unit b/c you were so friendly with the other nurses and staff and the pt's responded so well to you. Infact one of the pt's who dosen't respond to the nurses or MD's actually responded to you and let you do the treatments, you even got the pt. to get out of bed and do their own self care, which we encourge all the time and this pt. has been the most difficult." She said, "if you really want to work in the CCU I will help you get the position"..I was floored. After my shift was over, I said goodbye and the Manager got all my info, like my home # so the Director could call me...soo..I don't know if it was a bad night or what but I think I am going to apply for the position in the CCU..but that nurse left a sour taste in my mouth, oh well I love critical care and am not going to let one nurse ruin my exp.

DolphinRN84, MSN, RN, APRN, NP · May 14, 2008

Wow Morettia2..what a nice story. :) Thank you for sharing. I guess something good came out of that "horrible" night. Job well done!

BBFRN, BSN, PhD · May 14, 2008

As a former CCU nurse, I hope that the 3 patients you had were stepdown patients that were awaiting beds, and that the drips you were hanging were not pressors or other titrated meds.

I also have to ask why you would agree to watch 2 patients with SWANs? You have a license to protect, and that means you really should think about not taking patients that you are not trained to care for.

I just don't see any critical care nurse taking a 2 hr lunch (off the unit no less), when she has the 2 most critical patients, no less. Plus, she reports off to an unfamiliar nurse who has no critical care training, instead of one of her usual coworkers?

I also have to ask: what in the world were the managers doing in the hospital at 3:30 in the morning?

Morettia2, BSN, RN · May 14, 2008

As a former CCU nurse, I hope that the 3 patients you had were stepdown patients that were awaiting beds, and that the drips you were hanging were not pressors or other titrated meds.
I also have to ask why you would agree to watch 2 patients with SWANs? You have a license to protect, and that means you really should think about not taking patients that you are not trained to care for.
I just don't see any critical care nurse taking a 2 hr lunch (off the unit no less), when she has the 2 most critical patients, no less. Plus, she reports off to an unfamiliar nurse who has no critical care training, instead of one of her usual coworkers?
I also have to ask: what in the world were the managers doing in the hospital at 3:30 in the morning?

All of the night shift Charge Nurses on the floors are Nurse Managers. They have a permanent postion as manager and charge, I know it doen't make sense..I KNOW THIS..and during the day there is the Floor Director and a charge nurse. It took a while for me to get use to this system b/c in Pennsylvania, where I am from it's completly different. Any way, the 2.5 hour break was a major problem, and it has been reported. I know as a night shift nurse, some nurses take long breaks but tell us where thy are going to be and when to get them at the app. time. Believe me I was fuming and hence the reason my face and my hair became the same color. As far as the SWAN issue, at my hosp., if you ahev completed the mandatory 6 week critical care course, you are able to be pulled where ever the hosp. needs you. I said I am not comfortable with 2 pt's w/ a SWAN but it didn't make a difference. As far as the drips I titrate all the time on my floor, pressors, inotropes you name it I do it. so that wasn;t a problem. but I agree it's my license on the line, and THAT's WHY I have been looking for another job in another Hosp.

Miss Ludie · May 15, 2008

With less than a year experience you are certainly putting yourself in an untenable position.

Titrating on a stepdown on 6 patients? Taking on 2 critical care patients in addition to your own assignment. That is just not done. A one time 6 week course on Swan-Ganz, inotropes etc does not make you automatically invulnerable to mishaps. Please think long and hard because this might happen again and the next time.....you need to say NO.

s.maire.2126 · May 16, 2008

After my orientation on med-surg, I was floated as soon as I was eligable!! I've been floated everywhere!! Kinda scary, in my opinion. My best advise, is find someone that is helpful, be honest about any patient you're not comfortable with, don't be afraid to ask questions, and just do your best :)

jam2007 · Jun 24, 2008

is there a policy about how long after orientation you float? I have about 7 mos experience a rehab facilty and started a job on a busy med/surg floor where everythinh is different (charting is done on computers, sending off for tsts, checking labs...). I was asked to float 3 weeks after orientation and asked the charge nurse if I was supposed to (at my very first job it was 6 mos)..she didn't know but got someone else...do you think I shoud have tried to be a "team player" (I did tell her if I had to I would). I'm just nervous b/c I am new and don't want them to think that they hired the wrong person.