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Ask the expert: Floating RNs outside their service lines

HCPro's Weekly Update on the ANCC Magnet Recognition Program®*, March 4, 2008

This week a reader asks if it's typical for RNs float to areas outside their service lines. Read the response from advisor Meryl Montgomery, RN, MSN, director for the learning center and MRP® project director at Medical Center of Central Georgia in Macon, GA.

Q: Do RNs normally float outside their service lines?

A: In a discussion between bedside nurses and managers several years ago, Medical Center of Central Georgia decided not to float nurses across service lines or between units unless they are "sister" units. This was a tough decision at the time, but has been a strong satisfier for our nurses.

We do, however, have a flex pool of around 200 RNs who do cross between service lines. They must be assessed and complete a competency checklist for either critical care, medical/surgical, women's, etc. In addition, they complete a unit-specific first shift assessment to be oriented and assessed on unit-specific items. There is a minimum experience requirement depending on the areas they work in.

For example, between postpartum and labor/delivery units, the nurses receive full orientation and then are regularly scheduled (i.e., one to two times a month) to one of the units to maintain competency. We also match assignments to competency and skill level. For example, if a flex nurse works in a critical care unit but is not competent with intra-aortic balloon pumping or continuous renal replacement therapies, he or she would not be assigned to that particular patient or would be co-assigned only.

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