Floating, the relocation of nursing staff from one nursing unit to another, has remained a relevant problem over the years. Floating is a typical hospital practice used by most medical institutions when there is a lack of nurses at some units due to sickness, unscheduled leaves, or staff shortages. Hospitals believe floating to be a good practice since it allows hiring nurses without recruiting and, for some time, exactly needed by medical institutions.
However, patients are not optimistic about floating, as it causes some problems. When nurses float between units, they do not have time to develop a particular set of skills needed for a particular unit. In new units, nurses may be given tasks they have never handled before, resulting in poor patient care. The experts found a direct correlation between the level of floating and inauspicious patient outcomes, including nosocomial infections, mortality, and patient complaints (Hoffman & von Sadovszky, 2018). Moreover, the usual practice of educating new staff members on the approaches to patient care at a particular medical institution is usually skipped when floating takes place. When working in a new unit, nurses are often ignorant of how to deal with issues since practices at a new unit can be completely different from the ones adopted at the previous workplace. They are prone to making mistakes that jeopardize patients’ health and well-being, compromising the quality of patient care (Hoffman & von Sadovszky, 2018). Floating nurses might not address patients’ concerns, which leads to patients’ dissatisfaction with the hospital and their disappointment in the quality of nursing services.
Professional standards in nursing practice are determined by the Code of Ethics and state Nurse Practice Acts. In part concerning floating, standards aim to minimize the risks for patients when a nurse is moved from another unit. For this purpose, standards indicate that several issues be considered when a nurse is relocated to another unit. First, nurses’ competencies must be considered; the nurse may be relocated only to the branch where similar competencies are needed or to units with comparable clinical diagnoses and acuities (Brown, 2018). Second, a nurse can refuse to be floated if they feel that they do not have the appropriate skills for the proposed facility. For units where special nursing care is required, floating should either include some educational part or be abandoned for presenting a serious threat to the well-being of the patient (Brown, 2018). The Code of Ethics for Nurses states that if the care required is outside the competencies of the individual nurse, consultation should be sought or the patient referred to others for appropriate care (Brown, 2018). Thus, professional standards help to maintain professionalism in floating practices.
One of the critical roles in floating belongs to managers and nursing leaders as they are directly responsible for floating destinations; their roles depend on their qualifications. Nurse leaders perform leadership functions, including implementing facility changes and developing innovative methods for better patient care. Nurse managers are responsible for nursing practices, creating nursing teams, and overseeing their performance. Nurses and managers have to work out diverse approaches within their competence to provide high-quality care for patients.
Strategic planning allows managers and nursing leaders to foresee which medical units will be more suitable for floating their stuff. Choosing appropriate destinations ensures high-quality medical services provided by floating employees, which results in better patient care. Quality improvement and creating high-performance teams play an instrumental role in facilitating the floating process. Highly competent staff feels comfortable in any medical surroundings; professional services rendered by such employees contribute to good patient care and reduce the number of inauspicious patient outcomes. Both nurse leaders and managers have to work on improving interprofessional relationships and collaboration. When new staff comes to a specific unit, it is the task of nursing managers to see not only that they have duties within their competencies and that a new nurse can receive advice and support from senior members of the staff. The employees should be well-received at the unit where they are floated. The managers’ and nursing leaders’ task is to ensure a friendly atmosphere within the new surroundings so that the new staff feels comfortable there and wants to return.
To ensure professionalism throughout diverse healthcare settings, managers and nursing leaders should embrace some initiatives that will positively impact the quality of nursing services when floated. These initiatives include competency validating practices used for assessing nurses’ competencies in various medical fields (Muabbar & Alsharqi, 2021). Based on this assessment, nurses can be floated to units best suited to them in skills and medical experience.
Another initiative includes allowing the staff to choose their preferred floating destinations to make the most of their abilities. Managers’ and nursing leaders’ task is to ensure a friendly atmosphere within the new surroundings so that the new staff feels comfortable there and wants to return. In areas where specific nursing care is required, managers and nursing leaders may institute specific nursing floating groups that include staff with similar skills and competencies. Brown (2021) gives examples of successfully created sister clusters across two to three medical institutions. The nurses are transferred within the unit according to their established cluster (Brown, 2021). There is no need for specific training when floating, and the best care is provided for patients since nurses work within their familiar grounds.
A combination of two leadership styles – transformational and servant – would be appropriate to deal with floating. Transformational style is noted for a collaborative approach to introducing changes when each staff member – directly or indirectly – is involved in decision-making. Moreover, it is noted for encouragement and inspiration of staff members and tolerance of mistakes. This style would be especially appropriate for a unit leader from where a nurse floats to other working destinations since a transformational leader would consider the nurse’s wishes and abilities. Thus, they are more likely to find a medical unit to make the most of their abilities.
Servant leadership is characterized by a leader’s desire to share power and listen to others. Servant leaders are noted for actions aimed at facilitating the work of their staff; they provide excellent working conditions for the staff to do their job well. They evaluate the need of the team and try to meet these needs at all levels. A servant leadership style would be appropriate for leaders in the unit that receives a floating nurse. It would be the manager’s task to see that the nurses have all they need to do their job well and becomes an integral part of a team that performs well. Servant leaders would be willing to advise and help the newcomer with new surroundings, thus improving the quality of patient care.
References
Brown, T. (2018). Nurses are talking about: Floating and rapid response duty. In J. M. Paté (Ed.), Understanding the legal risks of nurse leaders: Part 4 (pp. 12-14). AAACN Viewpoint.
Hoffman, A., & von Sadovszky, V. (2018). Staff nurses’ perspectives of resources needed during floating. JONA: The Journal of Nursing Administration, 48(11), 580-584.
Muabbar, H., & Alsharqi, O. (2021). The impact of short-term solutions of nursing shortage on the nursing outcome, nurse perceived quality of care, and patient safety. American Journal of Nursing Research, 9(2), 35-44.