By Liz Leske
Floating is usually not a voluntary choice! However, per our contract (article 6.2) it is a necessary evil; everyone must float. There are no exceptions for seniority, Charge RNs or manager’s choice. All RNs within a clinical service area (article 5.12) are required to float to the other units in that service area. In the Peri-anesthesia services area where I work, we have 3 units in our clinical service area – SASS, PACU and Baker Day Surgery Center.
Each unit has some job duties which are the same and others which are unique to their area. However, the majority of the RNs in the three departments are trained to do all (or most) of the jobs in each area. We do have some RNs who do admitting only; others are trained in PACU only. That doesn’t exempt them from floating. We just don’t float them to areas in which they have no experience. Thus, a nurse who works at SASS and does only admits would not go to PACU. But she would be expected to float to the Baker Center Admitting area if need be.
How do we decide who floats and when? We keep a calendar on the computer which is accessible to all. When an RN floats, s/he is responsible for marking that float date on the calendar. Years ago, the least senior RN on each unit floated first. Since then, each unit has been floating RNs in rotation. (According to the contract, the equitable floating rotation is least senior to most senior. When a unit gets through the entire list in turn, they would start again with least senior nurse to most senior.)
In the Peri-anesthesia services we always take volunteers first. Occasionally someone does want to float and we let them! If there are no volunteers, agency/on-call RNs are floated (provided they have the experience. We can’t float a PACU nurse to the Surgical Admit unit if she doesn’t know what to do. That would be silly).
If there are no volunteers, and no on-call/agency RNs, then we refer to the calendar. The RN who is working that day and hasn’t floated for the longest amount of days previous is the one who must go.
We also take into account skills and ability. At the Day Surgery Center we see relatively healthy patients having minor surgical procedures. If one of the RNs from Baker floats to the main PACU, she is not expected to recover a patient who has had a thoracotomy (for example). Patients are assigned to the floating nurse commensurate with her skill and competence.
So even though most of us don’t like to float, we know it is not optional. And because we float our RNs in an equitable rotation, we don’t have arguments or rancor. And we usually appreciate our own units more after spending a shift “away from home!”