Reply To: Float or Flight?

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Salad H

I’m sure many other hospitals do this, but we are required to float within our “pod.” For example, if you work L & D you might float to pediatrics. If you work step-down you might float to cardiovascular or ICU (in my case). I have nightmares about floating. Not because I don’t want to broaden my experiences or go outside my comfort zone, but because floating can sometimes put a nurse outside their scope. For example, on our floor we don’t titrate cardiac medications…but if I float to CVU I am suddenly “competent” to titrate cardiac meds that I haven’t worked with since nursing school and am only slightly familiar.

If this was my family member as a patient and this was a nurse who may be competent in their own environment, but was suddenly practicing skills and using medications they are totally unfamiliar with…I would not feel comfortable!

Of course, I have “refused” assignments that I felt uncomfortable with…but this isn’t always possible. When I was in ICU they were going to give me an admit (I replied that “we are not supposed to take admits”). That concern was totally brushed off and in the end the admit never came…but I received a lot of backlash from some older nurses who said “oh, these younger nurses don’t want to take admits…” No, I don’t want to compromise patient care because you can’t give me an appropriate assignment. Are you going to back me up in court if I mess up? I doubt it.

In this way, floating is a huge patient safety issue. Unless, of course, you are a float nurse generally. That job is very difficult and I applaud those nurses because I certainly couldn’t do it!

I think a relatively “simple” solution would be to orient to the other units in your pod during orientation–even if it was for 2 days each or something. At least you would be semi-familiar with the staff and atmosphere. CNAs on other floors even have slightly different job assignments (some serve as double secretaries, some chart vitals and some don’t, etc. etc.)

Anyway…flexibility is certainly important. But, patient safety is more so and there has to be a “better way” to float!

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