Case Study: Floating

To Float or Not to Float
Floating is a common practice that occurs in hospitals every day. Healthcare facilities use floating to deal with staffing issues when units are understaffed due to high acuity or census. This can leave the most competent nurse filled with dread, leaving their professional confidence and comfort behind. Floating is stressful and it contributes to nurse dissatisfaction and causes an increase in nurse turnover (Garrison, 2018). Nurses in general have chosen their particular field of interest and become comfortable and familiar with a certain population of patients. Therefore, nurses become fully trained for the specialty of their department. It is crucial for healthcare management to determine the competency of the float
As a nurse, Sally has the obligation to provide safe and effective care. Sally will potentially be exposed to medications, vasoactive drips, and monitoring equipment that she has never seen before and she should have some concerns.
Sally is accountable for using informed judgement to decide whether to accept the assignment. She needs a clear understanding of what the assignment requires to act on this accountability. Nurses have the professional obligation to raise concerns regarding patient assignments that put themselves or patients at risk for harm. The ANA maintains that nurses based on their ethical and professional responsibilities have the right to reject, accept or object in writing to any assignment.
Steps Used to Reach the Final Decision
In this particular scenario, Sally has worked in obstetrics for 25 years and has never worked in critical care therefore her critical thinking skills is geared toward obstetrics. Sally should not assume that she can give competent and safe care in the thoracic surgery critical care unit based on her experience. She has also been told that three other inexperienced nurses will be joining her in the critically short-staffed areas. This should indicate that any resources will be limited and the experience level is spread thin on the unit. Additionally, Sally needs to clarify the expectations regarding floating
By knowing the standards of care in their work setting, all nurses must protect the privilege of licensure (Marquis & Huston, 2017). A nurse cannot refuse to float unless the nurse can prove lack of knowledge for performance of assigned tasks or be protected by a union contract or polices that guarantees assignment in your specialty area only. Therefore, they cannot refuse an assignment on feeling of uncertainty. If a nurse is floated, they should inform the supervisor of any deficiencies in caring for the type of client in the new unit. The nurse should request and be permitted a clinical based orientation. Patient care areas where floating is a common practice need a resource plan, designated preceptors, and the float staff must meet competencies in the clinical area (Garrison, 2018).
Sally should also recall the difference between refusal to the take an assignment and abandonment. Her facility may have certain policies about the consequences of a patient assignment refusal. Abandonment occurs if she accepts the patient assignment and disengages without reasonable notification to the proper person. Sally should also review hospital policies to determine which unit nurses can float to and what competencies must be completed before floating to these