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Discussion

Your facilities position on using "float" nurses to psych?

Do they use nurses who work in all areas of the hospital on your psych unit? Do they have to be fingerprinted, go through MANDT training (or MAB or whatever aggression training you use)?

We're using these nurses a lot here lately and they have NO psych training whatsoever. Was wondering, legally, if they could sue us if they were injured in a code situation?

Are your hospital units considered "closed" to staffing?

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  • Expert

These are v. good questions. I work prn within a system that includes a geropsych unit in a general hospital. I work prn on the geropsych unit, am an experienced psych nurse, and have all the behavioral health certifications and inservices required by the behavioral health division of the system (I also work prn within the free-standing psychiatric hospital in the system). The general hospital with the geropsych unit has been running a low census lately, and the management there has decided that one response to this is to "cross-train" (BTW, that means hanging out on the psych unit for a shift or two ...) all the med-surg RNs so that they can fill in (and not just "fill in," but be in charge of the unit!) on the geropsych unit. I have asked both the house supervisor and the director of the geropsych unit about this same issue -- whether the med-surg RNs are all going to complete the two-day course on de-escalation and dealing with aggressive clients that the psych staff are all required to take before they can work on the floors, and all the other required specialty education that the regular psych staff complete, and I've not gotten any response ... (I'm guessing that means the answer is "no," but I think this is a really bad idea ...)

  • Author

Talked more with my UM today about this. All our float nurses have had the same background check that all other mental health personnel get, so that's good.

No other training though. There's talk about requiring them to attend our 2 day MANDT training but JCAHO is here now and no one is paying any attention to that idea, lol. Maybe after they leave.

They do need something. I figured agency nurses would have to have some experience to work psych, at least that is my experience. But I wasn't sure about hospital-based floaters.

Thanks for the feedback!

Where I've worked, the only float nurses who could float to psych were those who had worked there before, either as staff or as students who had made psych their last semester concentration spot, and they had to be willing to do it. We had a few names of people who would come to the psych unit, and we generally called them and made sure they were ok with it, and then would call the staffing office and say "so-and-so" is ok with coming here, and it would get arranged that way.

On the first unit I worked, it was closed to floating, either in or out...nobody was allowed in, and we were not allowed to float out (which I personally thought was silly since I wanted to keep up my med/surg skills)...I was not able to find a job on the unit here after we were restationed, and I took a job on the medical/oncology unit...and I did float quite a bit to the psych unit PRN. They told me that they had a list of people who were 'qualified to float'...to my knowledge that meant only that they were willing to work back there, because I certainly never went through any other background checks other than to work at the hospital. I did take the CPI training, but that was part of the requirements for Patient Safety Team, not because I wanted to float to psych.

Most of the time if they requested a float from another unit, that person would heartily refuse, at which point I was asked to float (which I did happily as I can't stand med/surg)...I don't work at the hospital anymore, since I took a job at county mental health, so I dunno if they've changed their policy or not.

  • Expert

I should probably also mention that my current employer is the only place I've ever worked in my long career where non-psych nurses were floated to the psych unit. This "system" that includes both the general hospital with the gero-psych unit and the free-standing (all-)psych hospital is, although non-profit, very focused on cutting every possible corner, saving every possible nickel, and doing no more than the bare minimum, which is why I'm only willing to work for them on a prn basis -- I consider this a temporary situation while I continue to look for a permanent position I'll be happy with.

Our psych facility hires new RN's all the time with aboslutely NO psych experience....usually older, coming from med/surg, OB, ER, etc etc.......

I thought that was the way it was everywhere.....this being my only psych job, as I also came new to psych....have stayed 4 yrs now and I am one of the few with psych experience now........go figure........

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