What Travel Nurses Ought To Know About Floating
Floating is a staffing policy that involves sending a nurse from their regularly scheduled unit to a unit that is in greater need of staff. Studies indicate that most nurses generally dislike floating. Therefore, it’s important for travel nurses to consider that most hospitals expect their travel nurses to float. Moreover, there are a host of unique floating related issues that travel nurses may not have encountered previously. In this article, we’ll discuss things that travel nurses ought to know about floating so they can approach the issue with confidence.
Primer On Things To Know About Floating As A Travel Nurse
First, it’s important to remember that many nurses do not have experience with floating. For example, some hospitals have policies stating that nurses from certain units do not float at all. Other hospitals utilize a system of voluntary floating such that a significant percentage of their staff nurses will never float. Therefore, this article will provide both basic and advanced information about floating as it pertains to travel nursing.
Are Travel Nurses Required To Float?
Many who are just getting started with travel nursing wonder if floating is required. Most hospitals do indeed require their travel nurses to float. In fact, travel nurses are the first to float at many hospitals.
Find your next travel healthcare job on BluePipes!
That said, many hospitals do not maintain such a requirement. Instead, travel nurses float in an even rotation with the permanent staff. In rare situations, some hospitals prohibit travel nurses from floating. These hospitals prefer to have permanent staff do the floating because they are experienced with the various units, processes and procedures.
Do Travel Nurses Get Orientation To The Units They Float To?
We’ve heard from very reliable sources that JCAHO requires employers to provide a minimum general orientation for every unit a nurse floats to. We’ve also heard that JCAHO requires documented proof that the orientation occurred. Unfortunately, we haven’t been able to verify either of these JCAHO rules. However, we do have them on good authority and believe they’re true. Please let us know if you have contradictory information.
We mention this because many hospitals do in fact provide an orientation for floated units. At the same time, many hospitals do not provide an orientation for floated units.
Where Do Travel Nurses Have To Float?
Hospitals that do float their travel nurses have various policies pertaining to which units they will float their travelers to. Here are some scenarios to consider.
Standard Travel Nursing Float Policy
The most basic float policy involves the traveler floating to a different unit of the same type. This is most common for Med Surg travel nurses. For example, a hospital might have multiple Med Surg units in different locations around their campus. The hospital will schedule travel nurses in the various units depending on need.
Create your free Travel Healthcare Resume on BluePipes!
Sister Hospital Float Policy
A Sister Hospital Float Policy involves the hospital floating their travel nurses to sister hospitals in the same region. For example, the contract between the hospital system and the agency might allow the hospital to float the travel nurse to any hospital in the same hospital network within 25 miles of the contracted hospital.
Expertise Float Policy
Some hospitals only float travel nurses to units where the travel nurse has verified their expertise and comfort with the unit. In this case, hospital staff will proactively ascertain the units a travel nurse is willing and able to float to. They might do this with assessment exams, skills checklists, or by simply asking the traveler.
Scope Float Policy
Some hospitals float travel nurses only to units within their scope of practice. For example, the hospital might float Labor & Delivery nurses to PostPartum and Mother Baby units.
Open Float Policy
In some cases, hospitals float travel nurses to any and every unit they possibly can. In this case, it often seems as though the hospital has no regard for patient safety or the nurse’s license. I’ve experienced instances where Med Surg nurses were floated to ICU, ER and L&D without ever having stepped foot in these units before.
When Do Travel Nurses Float?
Now that you have an idea of where you might float, it’s good to have an idea of when you might float. As you’ll see, there are some pretty interesting scenarios to consider.
Travel Nurses Are The First To Float
As we mentioned above, travel nurses are the first to float at many, if not most, hospitals. At such hospitals, PRN nurses are the only nurses that might float before the travel nurses. However, some hospitals incorporate travelers into their normal float rotation. Others will not float travelers at all.
Tired of filling out skills checklists? They’re free on BluePipes.
Floating At The Beginning Of A Shift
Floating at the beginning of your shift is a common, relatively standard scenario. Essentially, the hospital floats you to a different unit before your shift starts. The advantage is that you go through the normal shift rotation and you don’t have to shift gears in the middle of a shift.
Floating In The Middle Of A Shift
Of course, floating in the middle of your shift is another common scenario, albeit a less desirable one. Essentially, the hospital floats you to a different unit at some point after you’ve already started your shift. The disadvantage is that you don’t go through the normal shift rotation process. Therefore, the transition can be hectic and unorganized.
It’s important to know that this scenario happens quite often at hospitals where travel nurses work different shift schedules than the permanent staff. For example, it’s quite common for permanent staff nurses to work 8 hour shifts In California. However, most hospitals in California choose to schedule 12 hour shifts for their travel healthcare professionals. As a result, a travel nurse’s shifts will overlap the hospital’s normal shift rotation. This often results in the hospital floating the travel nurse to another unit. In fact, this issue sometimes results in hospitals floating travel nurses during every single shift they work.
Floating In The Middle Of A Shift To Another Hospital!
Perhaps the worst floating scenario is when the hospital floats the travel nurse in the middle of a shift….to another hospital! That’s right, it happens, albeit infrequently. Regardless, it’s important for travel nurses to be familiar with this scenario.
Here is an example from my own experience as a recruiter. I placed a travel nurse at a hospital in Northern California that was part of a larger hospital system. Shortly after the contract started, the hospital began floating him to one of their sister hospitals in the middle of his shift. If that wasn’t bad enough, they did not count his transportation time as part of his shift.
Free eBook: How To Negotiate Travel Nursing Pay
The poor traveler did this without mentioning it to me for 2 weeks. It wasn’t until I reviewed his time card that I realized what was happening. The time card was a mess. It had him clocking in at 7pm and clocking out at nearly 9am with no OT. We put a stop to that real quick!
Travel Nursing Pay For Floating
Many travel nurses wonder if there is a pay difference for floating, especially when they are floated to a different unit. For example, a Med Surg nurse who floats to ICU might wonder if they will get paid more for completing work that normally pays more. Similarly, an ICU nurse might wonder if the pay is less for floating to Med Surg.
In the vast majority of cases, there is no pay differential for floating as a travel nurse. That said, it’s always worth asking your recruiter. Moreover, if you are continually floated to higher paying units, then you should definitely bring this up with your recruiter. Both you and your recruiter have an interest in ensuring that the hospital is playing by the rules and paying for what they are receiving.
BluePipes: Professional Networking and Career Management Tools for Healthcare Professionals
What Can Travel Nurses Do About Float Policies?
As you can see, there are many float related scenarios that travel nurses must consider. Most experienced travel nurses will tell you that floating is a part of travel nursing. However, they will also tell you that there are actions you can take to ensure that your needs are met and your license is not threatened.
First, it’s not completely impossible to avoid floating altogether as a travel nurse. Of course, certain specialties will rarely if ever float. For everyone else, complete avoidance of floating will greatly limit your options. Therefore, it’s important to have alternative income sources, like PRN, if you choose to go this route. Additionally, you’ll need to have the travel nursing company add a clause to your travel nursing contract and the confirmation they send to the hospital indicating that you will not float.
Floating To Units Outside Your Expertise
Floating to units outside your expertise is perhaps the most troubling scenario for travel nurses. According to Kay Slane of Highway Hypodermics, one solution to this problem is as follows:
“Yes, you CAN and it is ADVISED to put into your contract the floors of competence that you will work or the floors that you absolutely will NOT work. Also, when you get to a hospital, go to the staffing office and/or the house supervisor and make sure that they know which floors you can work.”
Regardless of the whether or not you take steps in advance to prevent the hospital from floating you to units outside your expertise, we encourage you discuss these situations with your recruiter as they occur. One potential solution your recruiter can assist with involves skills checklists. For example, I once worked with a Med Surg nurse who was floating to various ICUs where she was not comfortable. After we had no luck working with the staffing office to stop it, we had the travel nurse fill out our ICU, CVICU and MICU skills checklists. Of course, the skills checklists demonstrated the nurse had little experience in these units.
Discover why travel nurses are calling us their “secret weapon”.
We then sent the checklists to the hospital letting them know that we were not comfortable having them float the nurse to the units in question. At that point, there was documented proof that we had informed the hospital of the situation. Of course, that opens the hospital to liability and they stopped floating the nurse to the units in question.
Recapping The Steps
The bottom line is that it’s important to communicate about floating with all parties at each step along the process if this issue is important to you.
- Ask your recruiters and the hospital staff you speak with about float policies.
- Reach agreements with nursing managers during your travel nursing job interviews.
- Communicate all agreements to your recruiter immediately after the interview.
- Make sure your recruiter includes the agreements in the confirmation they send to the hospital so you can hold the hospital accountable.
- Make sure your recruiter includes the agreements in your own contract.
- Communicate with the staffing office and/or house supervisor when you arrive at the facility.
- Let your recruiter know if you run into any critical problems so the recruiter can assist.
Again, you should expect to float as a travel nurse. However, that doesn’t mean you’re required to put patients or your license at risk. Ultimately, you can avoid the pitfalls related to floating with the right preparation and communication. As always, we welcome your feedback and any additional information that will help improve this article!
The simplest solution is to write “no floating” into your contract. Of course this requires you be upfront when interviewing for the job. Too many times hospitals think that just because you’re a traveler that you can float anywhere they want you to, this is not so. I once had a hospital try and float me to L&D, after objecting to this because my scope of practice is ICU, my contract was cancelled halfway through. So every contract now states “no floating”, and I don’t have a problem finding hospitals who honor this. The other problem is that hospitals instead of asking for a “float pool” nurse ask for a specific type e.g., MED-SURG, ICU, L&D, and then proceed to float you 3/4 of the time to a different unit; this is neither productive for the hospital or the nurse. The hospital usually has problems retaining travelers, and the travelers usually leave negative reviews of the hospital it’s a lose/lose situation.
Nurses can and should write into their contracts if they’re willing to float, where to, and if they do what their ratios will be. I give props to med-surg nurses who are willing to take a 1:5/1:6 ratio, I could never do this, my time management skills are prioritized differently given the complexity of the patient population I usually have. Don’t be afraid to put into writing what you want.
Remember that if something were to happen to your patients you will be judged by what your scope of practice is, not what type of unit you were floated to.