RNs Floating to Other Units

As a manager, I am sometimes asked to float RNs to other departments within our facility when the unit I manage is below census. At times, the RNs seem hesitant to float to other units and make comments about feeling the situation is unsafe. Can RNs be assigned to any clinical setting?  

• RNs enter the profession with the foundational knowledge to practice in any clinical setting; however, over time their experience enhances some competencies and others are not further developed. Therefore, not all RNs will have all the required knowledge, skills and competencies to safely provide care to all patient populations in all settings.
• RNs question and intervene to address unsafe conditions that interfere with their ability to provide safe, compassionate, competent and ethical care to those to whom they are providing care, and they support others who do the same (1).
• RNs advocate, intervene and participate with others, as needed, to ensure client safety (2a).
• RNs advocate and intervene in the client’s best interest, and act to protect the client, self and others from actual or perceived harm (2b).
• RNs contribute to the development and integration of quality improvement principles and activities into nursing practice (2c).
• RNs participate in the analysis, development, implementation and evaluation of practice and policy that guide delivery of care (2d).
• These expectations of practice guide RNs as they determine if an assignment is appropriate and safe for their patients and for themselves.
• When aspects of care are beyond their level of competence, RNs will seek guidance and assistance from a competent practitioner in the new unit and/or request a different work assignment. In the meantime, the RN will remain with the person receiving care until another RN is available to meet their care needs.
• Some factors which may provide a foundation for practice on a new unit include:
  • Understanding the daily routines on the unit;
  • Knowing the location of supplies and equipment, particularly for urgent or emergent situations;
  • Understanding the skills and competencies required to care for patients on that unit;
  • Being familiar with the role and expectations for practice of the floating RN. How is it different than a RN employed on the unit? Is there clear communication about who the appropriate person to contact with questions or support?;
  • Collaboration between the unit manager or care coordinator on the new unit and the floating RN to determine how to best utilize the skills and competencies as an addition to current staffing. Pairing RNs together may be a great approach to meeting client care needs while providing adequate support to the floating RN.

Can managers recall a floating RN if the RN’s home unit becomes busy and the originally scheduled complement of staff is required?

The most important considerations in any decision regarding the assignment of RNs is the safety of the patients in both units, and clear communication about expectations during this transition in care assignment. It is important that patients are cared for by a nursing care provider who has the knowledge, skill and judgment to best meet the care needs of the client. This may mean considering the RN who is floating as a temporary solution to the staffing need and having alternate RN options if the situation on either unit changes.

Employer policy should support you in this practice situation. The policy should address the process for floating staff from one unit to another ensuring sufficient nursing resources in both practice areas and having adequate support in place for the nursing staff to find this situation safe and beneficial.

CRNS Resources

Code of Ethics for Registered Nurses (2017)

Registered Nurse Practice Standards (2019)

RN Specialty Practices (2020)