Benefits?

Float nursing reduces healthcare costs and assists with staffing shortages while increasing patient safety and workload  (Bates, 2013, p. 197). A float nurse is responsible for working on different units throughout the hospital, and placement varies. As a nurse, when choosing to accept an assignment to float, it is beneficence, a moral obligation to act for the ideal outcomes for the patients and avoid harm. Floating to another unit can ease staffing ratios and reduce adverse events for the patient and staff (Kane-Urrabazo, 2006, p. 97).

Frustrations?

Nurses may have concerns regarding being inadequately prepared for no-resource staff, little preparation, and the high possibility of a mistake occurring (Bates, 2013, p. 198). There is typical anxiety due to unfamiliar units, unit-specific procedures, and inability to locate supplies which can decrease the job satisfaction of the float nurse.

Solutions?

It is essential for hospital management to ensure that the nurses are competent and prepared to float to another unit through assessment in order to prevent avoidable errors among the unit patients and staff, including for injuries and infections  (Kane-Urrabazo, 2006, p. 98). In order to promote the floating experience, the management should strive to improve setup and ease of communication when presenting staffing needs (Douglas, Pledger & Schulman, 2009, p. 34).  Nurses who float should be prepared by staying updated on their clinical skills and their scope of practice (Bates, 2013, p. 197).

In order to create a positive outcome, all nurses who are expected to float should be trained on the units to allow time for preparation (Bates, 2013, p. 198). To maintain job satisfaction and reduce nursing shortages, nurses should be given positive experiences through proper training and support resources (Bates, 2013, p. 198-199). There is a combined effort from patient, nurse and nursing staff to ensure a positive outcome with open communication, proper resources, feedback and encouragement (Bates, 2013, p. 197).

In the nursing career, floating to another unit is perceived to be stressful and unpleasant. We can assure good support, feel welcome, give orientation and assign a resource person. Float nurses should have critical thinking skills, which are beneficial to give competent care.

Floating:

• Helps to develop new skills and competencies
• Improves professional relationship and self-esteem
• Enhances professional network
• Helps to improve professional collaboration
• Establishes overall career development.

Floating opens a gateway for a mutually beneficial professional relationship which increases self-confidence.

The fluctuation of staffing patterns occurs due to several reasons such as annual leave, sick leave, occupational injury, FMLA, and so on. All nurses can agree that they are willing to serve the patient and are committed to fulfilling the mission and vision of the organization they work for. To satisfy the staffing needs, the existing policy needs to be revised by a committee.

Studies have reported that to improve the satisfaction of the staff, the policy requires the charge nurse on the accepting unit and floating nurse to collaborate and determine appropriate assignments. This would help the floating nurse to be familiar with the charge nurse, and the face-to-face communication will sustain until the floating nurse leaves the floor (ANA, 2016). The nurse is a caregiver. He or she shows the caring attitude towards patients and other people in work and in a different environment. This is where certain concepts should be considered, such as Watson’s theory of human science and human care, and Rogers’s science of Unitary Human beings. They provide a theoretical framework for nurses to create a caring environment (France, Fields, & Garth, 2004).

Caring is extended by administrative support for providing successful training and education, so nurses can respond to other units different than their home units. For example, if rehabilitation nurses are expected to float to telemetry units, the administrators and educators extend the support of additional training on telemonitoring of patients. The validated competency checklist will help the educator to know whether the staff met the requirement after the formal completion of training.

Low Census

Overcrowding of the Emergency Department is common. At the same time, just before the holiday season, there can be low census. On the low census day, staff may be allowed to take annual leave or Paid Time Off (PTO). It’s recommended to encourage staff members to use low census day to work on projects, allow them to do continuing education, quality initiatives and policy revisions. Shared governance and empowerment of staff can lead to success, which in turn promotes organizational success. The enthusiasm of empowered staff ultimately provides quality patient care.

Negative Consequences

The unfamiliarity of an environment provides anxiety and stress in hospital staff. Even the most experienced nurses may worry when they hear that it is their time to be floated. The anxiety and stress eventually passed to receiving unit by the float nurse may negatively affect the patient. This eventually causes tension within the patient, and could give them doubt in the hospital’s care or ability to provide adequate treatment.

Buddy System

Float nurses should be assigned a “buddy” to help throughout the shift. Apart from regular staff, the float nurse depends on the charge nurse of the receiving unit and the assigned buddy to complete their job. With this in mind, the floating staff needs to be formally oriented with the receiving unit (Davies, 2014).

References

ANA. (2016). From our readers…Creative staffing solutions for floating and low census. American Nurse Today.   Retrieved from https://www.americannursetoday.com/from-our-readerscreative-staffing-solutions-for-  floating-and-low-census/
Davies, K., (2014). Float assignments. Advance Healthcare for Nurses.
Retrieved from http://nursing.advanceweb.com/Continuing-Education/CE-Articles/Float-Assignments.aspx

France, N., Fields, A., & Garth, K. (2004). “You’re just shoved to the corner:” the lived experience of Black  nursing students being isolated and discounted: a pilot study.

Visions: The Journal Of Rogerian Nursing    Science, 12(1), 28-36.

Watson, J. (1999). Nursing human science and human care: A theory of nursing.  

Bates, K. J. (2013). Floating as a Reality: Helping Nursing Staff Keep Their Heads Above Bette

Case Di Leonardi (2011): Critical Thinking: Mastering The Art of Floating.
Retrieved October 2016 from https://lms.rn.com/courses/2039/page167.html

Water. MEDSURG Nursing, 22(3), 197-199.

Douglas, K., Pledger, R., & Schulman, C. (2009). Self-directed floating: flexibility and choice fuel workplace trend. Rn, 72(5), 32-35.

Kane-Urrabazo, C. (2006). Said another way. Our obligation to float. Nursing Forum, 41(2), 95-101. doi:10.1111/j.1744-6198.2006.00043.x