Nurses’ Floating
Experience
Catherine Hennessy, RN, BSN
Nyack Hospital
Nyack Hospital
 Located
approximately 25 miles northwest
of New York City
 373 Bed Community Hospital (Licensed)
 Types of Patient Care Units









Medical Intensive Care Unit (11 beds)
Surgical Intensive Care Unit (11 beds)
Cardiac Stepdown Unit ( 30 beds)
Pulmonary Stepdown (23 beds)
Oncology (36 beds)
Medical/Surgical (37 beds)
Orthopedics (31 beds)
Pediatrics (23 beds)
Mother/Baby/Newborn Nursery (46 beds)
What is ‘floating’?
 Nursing
staff members are assigned to
work on a patient unit other than their own
in order to provide staffing to:




Cover sick calls
Increase staffing to ensure safe assignments
Meet emergency staffing needs
Provide flexibility in staffing
Who can ‘float’?
 All
nursing staff members who provide
patient care can float to any patient care
area in the hospital within their scope of
practice



Registered Nurses
Patient Care Associates
Administrative Associates
Where staff ‘float’?
 Nurses
‘float’ within ‘clusters’ (determined
according to scope of practice)



Critical care cluster
Medical/Surgical cluster
Mother/Baby OB/GYN cluster
 Governed


by Union Contracts
New York State Nurses Association (NYSNA)
1199 (Ancillary Staff)
Background
 Floating
to unfamiliar units common
practice in many healthcare settings
 Staff dissatisfaction/morale problems
related to floating
 Breaches in standards of practice
 Patient safety and liability for staff member
and facility
 Affect on patient satisfaction
 Increased turnover
Task Force Participants





Task Force Leader
Associate Chief Nursing Officer
Nursing Supervisor/Nurse Manager
Day/Night Shift RNs
Representatives from all patient care units
Methods
 “Floating





Task Force”
Literature Review to determine best practice
Reflective Journaling
Survey
“Floating Tool”
Resurvey
Task Force Recommendations
 Determining



Who needs to float??
Continuity of patient care
Patient safety
 Float


the need to float
Experience
Float is greeted on assigned unit by Nurse
Manager or Charge Nurse
Float tool is reviewed together
Floating Survey

The last time floated

 Name of nurse in Charge 
 Nurse Manager

 Co-workers

 AA
 PCA

 Case Manager

 Dietitian

 Patient Meal Time

Lounge Lock Combination
Code Cart Location
Medication Room Lock
Code
Clean Utility Room Lock
Code
My Break Time
Acuity of Assignment
Unit Floated to
Primary Unit
Staff Participants

Day / Night Shift
 Representatives from
all patient care units
 Positive and negative
attitudes
Results of Survey: Comments

Positive





Greeted by staff on
receiving floor
Felt needed on floor
Made difference on
floor felt part of a team
Had assistance from
staff on receiving floor
Assignment
‘reasonable’

Negative





Assigned most difficult
patients
Did not get break or
lunch
Got first admission
Did not know where
anything was located
Told ‘This is what we
deal with all of the time
on this floor’
Results of Survey (Pre)
Last Time Nurse Floated
50
45
40
Last Year
35
Last Month
30
Last Week
Yesterday
25
Today
20
15
10
5
0
Today
Yesterday
Last Week
Last Month
Floated Nurse Knew Change Nurse Name
Last Year
60
50
40
No Response
No
30
Yes
20
10
0
Yes
No
No Response
Results of Survey (Pre)
14
12
5D
4D
10
4M
ICCU
8
3M
MICU
2D
6
Mother/Baby
ICN
4
L&D
SICU
2
0
1
Units Floated To
18
16
5D
4D
14
4M
12
ICCU
3M
10
MICU
8
2D
Mother Baby
6
ICN
4
L&D
SICU
2
0
1
Name___________________
Unit______________
Ext______
Nurse Manager: __________________________________________
Nursing Supervisor: _________________________ Beeper: ________
Charge Nurse:
__________________________________________
Resource Nurse: __________________________________________
AA:
__________________________________________
Assigned PCA: __________________________________________
Case Manager: ___________________ Ext. __________Beeper: ______________
Physical Therapist: _________________ Ext. ___________Beeper: ____________
Respiratory Therapist: ______________ Ext. __________ Beeper: ____________
Dietitian:
___________________ Ext. ___________Beeper: _____________
Patient Meal Times: Breakfast:__________ Lunch: _________Dinner: _________
Combination numbers:
Medication room: __________________
Clean Utility Room: __________________
Staff Lounge:
__________________
Emergency Supplies Location:
Code Cart
Intubation Tray
Staff Members Names:
RNs: _______________ __________________ ________________ ________________
PCAs: ______________ _________________ _________________ ________________
Break Times: ___________ _______________ ____________
Resurvey
 Distributed
the same “Floating Experience”
Tool with two additional questions


Have you used the “Floating Tool?
Was it helpful?
Results of Survey (Post)
Resurvey Results Days
40
35
30
Yes Day Shift
25
No Day Shift
20
N/A
15
10
5
0
Nurse In
Charge
AA
Dietician
Lounge
Combination
Clean Utility
Room
Break Time
Assigned
Accuity
Was it
Helpful?
Results of Survey (Post)
Resurvey Results Nights
35
30
25
20
Yes Night Shift
No Night Shift
15
N/A
10
5
0
Nurse In
Charge
AA
Dietician
Lounge
Combination
Clean Utility
Room
Break Time
Assigned
Accuity
Was it
Helpful?
Results of Survey (Post)
Units Floated From (Post)
14
5D
12
4D
10
4M
ICCU
8
3M
MICU
6
2D
Mother Baby
4
ICN
L&D
2
Units Floated To (Post)
SICU
0
1
14
5D
12
4D
10
4M
ICCU
8
3M
MICU
6
2D
Mother Baby
4
ICN
L&D
2
SICU
0
1
Results
 Hospital
has hired nurses for a “Float”
Pool
 Decreased number of nurses who float
 Decreased overtime
Conclusion
 Continue
with Task Force
 Develop unit-specific “Float Tools”
 Utilize float pool
Thank You!!!
Thank you!!!