One of the things I love most about nursing is that there is always variety. Nurses can work in multiple settings and specialties. If you are a new grad or any RN considering what kind of nursing job to pursue, what shift you want to work, or what specialty you are interested in, a position to think about is becoming a float nurse.
In nursing, “floating” refers to moving from one unit to another. In some cases, nurses who are permanently assigned to a specific unit may be asked to float to another unit because of staffing needs. However, some facilities establish a float pool. In these facilities, nurses are hired specifically to float from unit to unit as staff needs require. Float nurses are utilized on an as-needed or PRN basis in many cases. This makes these positions great for nurses looking for a lot of flexibility; they also are great for new grads not wanting to “lose their skills!”
For nurses, being sent to work on another unit where patient needs are totally different than those usually encountered on their home unit can evoke stress, anxiety, fear, and frustration. Working with an unfamiliar patient population can ultimately threaten patient safety. Interventions may be within the nurse's scope of practice, but not within his or her acquired skill set.
A fantastic benefit of being a float nurse is that you will gather a variety of clinical experiences. Float nurses have the opportunity to work in multiple specialty areas and care for different kinds of patients each day. This helps to develop invaluable clinical assessment skills as well as sharpen skills in communication and teamwork. Float nurses work with a variety of colleagues and grow relationships with fellow staff members all over the facility. If you are a person that likes each day to be different and challenging, being a float nurse is definitely a job to consider!
When even highly competent, experienced nurses are asked to float to a new unit, their anxiety and uncertainty gets communicated to patients nonverbally. In an unfamiliar setting, even a simple task such as gathering supplies may become time-consuming, taking focus away from the patient and conveying disorganization. This directly affects face-to-face contact with the patient, which can in turn compromise quality nursing care. Nurses who lack unit-specific knowledge may not be able to answer patient questions or address patient concerns effectively, which also compromises their credibility and reflects poorly on them and the hospital. Even finding the correct person to ask can be difficult for the float nurse. If patients pick up on the nurse's struggle to adapt to an unfamiliar situation, they may feel unsafe, undermining the nurse–patient relationship. Prioritizing becomes a challenge and the nurse may become consumed with concern about making mistakes.
RNs have the professional right to reject or refuse any patient assignment that puts patients or themselves at serious risk for harm. When an RN is asked to float, that unit must be similar to his or her own and the nurse must demonstrate competencies specific to that unit. Placing float nurses in inappropriate assignments can put patients and healthcare organizations at risk and seriously compromise patient safety and outcomes. Ultimately, it’s your @$$ and your license on the line if you were to make a mistake. Do your behind a favor and CYA!!!
In general, units try their best to orient the float nurse, partner the float nurse with another experienced nurse to serve as his/her resource, and provide verbal and written information on the unit’s policies and workflow. From personal experience, I have found it extremely beneficial to ask the NOC nurse handing off report to me or any nurse for that matter helpful questions such as the location of equipment, healthcare team contact numbers, shift routines, codes to locked doors, specific required unit documentation, safety procedures, and unit-specific protocols. This helps me to feel more confident and less anxious, because there’s nothing scarier than feeling like a fish out of water!