What other profession floats?

catrn10 · Jan 7, 2003

I am an agency Nurse now because of that very thing. I work in ICU only. Period.

JWaldron · Jan 20, 2003

The hospital I work at has a float pool for Med-Surg, Peds, Rehab, same-day surgery, endoscopy (recovery), Oncology, PCU (stepdown)and Mother-Baby (not L&D or Nursery). For PCU you have to be able to read the monitors, and for Mother-Baby you have to have neonatal CPR, and in Oncology you don't do the chemo; there is another group of nurses (Unit Comps) who float between the ICU, the ER and also PCU.

I worked in the regular float pool for 2 years, right out of school. It was a hell of a way to get your skills developement - no real mentor, a different area every shift, a different way of doing things in each unit (corporate culture, if you will), and I don't know that I would recommend that to anybody, but you do get a broad range of skills if you survive it. There are advantages to floating - the broad skill developement, you get to know everybody, you know what managers you DON'T want to work for and the ones you DO, you don't get involved in the unit politics, and you get invited to everybody's Christmas party, or at least, I did. When I floated, there was no float differential, but now there is; I believe it is a dollar an hour, but could be wrong.

Now there is something nefarious afoot, and we are suddenly being 'cross-trained' to work other floors (I work Rehab now). There has been no explanation of the reason for this, but it concerns me, because staffing and sups see Rehab as the float pool extension since we staff differently - our patients don't stay in bed, we don't give them bedpans, we get them up and ambulate them to the BR, or get them into their braces and w/c them there, many with a max assist of 2 EVERY TIME. And we have more and more really ill patients in Rehab, so our accuity is higher and higher. Floating us out, or even out aides, severly compromises our ability to provide quality rehab care. It seems to me they (the suits) are planning to not fill positions as they become vacant, and float people all over to cover them - we don't have enough as it is!

Savvy

BBFRN, BSN, PhD · Jan 21, 2003

I just learned yesterday that we will be cross-training with our "sister floor" (When or why GI became a "sister floor" to our Trauma floor, makes no sense to me). We will have to do mandatory shifts on the GI floor, and they will have to do them on our floor. Our NM says we have no choice in the matter. What a great idea- let's force people to float to another floor, forgetting about continuity of care, and make GI nurses work on a Trauma floor with no orientation at all, and see what happens.

JWaldron · Jan 21, 2003

Yeah, right. Unless the trauma is a GSW to the gut, GI sure isn't much of a 'sister' to Trauma. And even then.... It's kind of stretching for a relationship. A little bit of this reluctance on our part may be fear of the unfamiliar, but when 'unfamiliar' is because of poor to no orientation, that's another story. At the very least, let us remember to be symapthetic and helpful to the poor souls who get floated to us, and pray they are the same when we get floated to them - 'Nurses Mentoring Nurses' (from AMSN). As someone else pointed out, it will make us more valuable when we go somewhere ELSE. (But who can guarantee the same thing won't happen wherever ELSE may be?)

Savvy

cwazycwissyRN, RN · Jan 21, 2003

In the facility I used to work at if you questioned floating to another department, they would state "an RN is an RN" in attempts to make you feel that if you were a good RN floating from deptment to department should be easy. Then make it appear as if you were whinning, lazy or just a trouble maker. As I said, the facility I used to work at. I do believe crosstraining to another department to be a different story, if one has the desire to do so. My crosstraining sure looked good on my next job ap

Pediatric Critical Care Columnist · Jan 21, 2003

When our medical director tried the old "a nurse is a nurse is a nurse" chestnut out on us, we turned the tables on him. We suggested he might like to substitute for the neurosurgeon scheduled to do the crani on our brain tumor patient, or maybe he'd like to deliver a few high-risk infants. Shut him up for a day or so.

renerian, BSN, RN · Jan 21, 2003

I worked in a factory and we had to float to different departments to cover call offs. Worked different stations.

renerian

BBFRN, BSN, PhD · Jan 21, 2003

Originally posted by janfrn
We suggested he might like to substitute for the neurosurgeon scheduled to do the crani on our brain tumor patient, or maybe he'd like to deliver a few high-risk infants. Shut him up for a day or so.

:chuckle :kiss

kmaryniak · Jan 21, 2003

In Canada, if we are in a specialty area, there is no floating, period. If you work ICU, NICU, CCU, ER, PICU, telemetry, or acute oncology, no one floats in or out. Period. The only people who may float is from L&D to Post Partum (and vice versa), or between med-surg units. However, you are always ASKED if you want to go, not just sent. Why? Because we understand that it is UNSAFE nursing practice to send nurses to unfamiliar areas, without any orientation or previous exposure. That is why there are float pools, and overtime! Of course, I understand that the almighty buck always plays a big part in this, but to save a few bucks in overtime may cost you a few million in a lawsuit!! I work NICU in a pediatric hospital here in the U.S., and haven't yet been floated. When the time comes, I'll go to a pediatric med-surg, as I've had previous experience, and would be comfortable there. However, if they want me on PICU (where they send a lot of NICU nurses), I'm going to say no. I am not comfortable in an environment with foreign equipment, procedures, and medications that I don't know. I WILL NOT endanger a patient's life, just because they are understaffed. It is our right as nurses to refuse to be floated, and if we do not accept report (and therefore accept care of the patient), we are not abandoning anyone except administration!:angryfire Phew! I feel better! Anyone else?

fergus51 · Jan 21, 2003

Floating does happen in Canada. According to RNABC refusing to float is grounds for being fired because you are an employee of the hospital, not the unit. That said you do have the right to demand an orientation and refuse anything that you can't safely do, (like taking a patient assignment) and stick to tasks.

Pediatric Critical Care Columnist · Jan 21, 2003

Originally posted by kimmy2
In Canada, if we are in a specialty area, there is no floating, period. If you work ICU, NICU, CCU, ER, PICU, telemetry, or acute oncology, no one floats in or out. Period.

I beg to differ. I'm a Canadian PICU nurse who has floated dozens of times to unfamiliar areas, including antepartum, gyne oncology, newborn nursery, NICU, peds extended care, peds med/surg, emergency and MICU. As PICU nurses, we're in essence the hospital float pool because of our broad scope of practice. The guidelines say we're not supposed to take an assignment unless absolutely necessary, but 9 times out of 10 we've got one. Then when the $#!+ hits the fan, and we have to go back to PICU, we have to hand the patients over to another nurse. One charge nurse in NICU treated me like the substance that was spraying from the fan when I had to return to my unit almost right after morning coffee. After that I said I'd never go back there, that I'd rather do an evening on adult psych!

I left that hospital because of the floating (among other reasons). And it is only the PICU nurses who do this. MICU, CCU, SICU, emergency (peds and adult) and dialysis do not float. NICU only floats to PICU and are allowed to "pick" their assignment, ie a ventilated infant.

Of course it is unsafe, but the administration has no qualms whatsoever about sending a PICU nurse somewhere else, even if it leaves PICU short or tight. Orientation? "You have the five rooms at the far end of the hall. Med room is over there."
:angryfire

The hospital where I'm working now has a no-float policy. We do cover some shifts in NICU, but since we're a CV unit, a lot of the patients were ours before. They do things a little differently but are under the same manager, so not too differently. I have yet to be sent over there, but because of my vast floating experience and Gumby-like flexibility, I know I'll be fine! I won't be happy, but I will be fine.

Pediatric Critical Care Columnist · Jan 22, 2003

i forgot the best part about floating in manitoba. since 2001 it has been enshrined in the collective agreement under which the majority of manitoba's nurses labour that floating between facilities (!) :eek: is not only okay, but expected. in 1997 the province went to a regional health authority model, so now nurses are not employees of the facility but of the rha. initially it was thought that only programs would be moved about among the facilities in a rha, but no, they want individual staff members to go where the need is greatest. the articles in the collective agreement cover such angles as who pays for her parking when nurse nancy floats from hospital a to ltc home b, who is entitled to orientation and how lengthy it is to be, and other little details. i can't wait to hear that a picu nurse was floated to the geri-rehab ward at community hospital c. you gotta know it's coming!! :chair: