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Do RNs have to float to units where they have not been trained or feel comfortable working? Is this legal?

Wednesday December 11, 2013
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Question:

Dear Nancy,

I work in a facility where we routinely float to other areas in the hospital. I am only trained in med/surg but float to monitored care and ER. I am by no means confident in those areas. We are told the charge nurse will read our strips.

Is this legal? Do RNs have to float to units where we have not been trained or feel comfortable working?

Norah



Dear Nancy replies:

Dear Norah,

Floating to other units unfortunately isa way of practice when facilities are short-staffed. Floating in and of itself is not bad. It is difficult when staff has not been oriented to a unit where they find themselves working.

Although your skills are in medical/surgical nursing, you could be oriented to these other units with an adequate orientation program that developed the new skills and patient care procedures to build upon your well-documented med/surg education and experience. You also might be oriented to some non-patient care responsibilities, such as taking orders off of doctor order sheets so the usual, experienced staff can provide patient care.

Employers retain the right to transfer staff to other units, since a nurse is not often hired for a particular unit for his or her tenure at that facility. However, without offering an orientation program for nurses who are floated to other units, the employer is risking a lawsuit by an injured patient. During the trial, the jury would not find it acceptable — with the help of the patient's attorney — that that no orientation had been provided by the employer to the nurse floated to another unit and that would not bode well for the employer.

Despite the potential liability the employer may face with this type of floating, you need to be aware you are responsible for your own actions and it is you who would face disciplinary action by a state board of nursing if you took an assignment that you were not competent to perform. As a result, you might want to speak with your nurse manager and CNO as well as the risk manager. Instituting a good orientation program would eliminate much of the fear you and your colleagues have.

If you are continually faced with this situation, are truly fearful that what is being asked of you is outside your realm of competency and no one in administration is listening to you, you can consult with a nurse attorney or attorney in your state who can advise how to handle this situation to reduce the risks to you and your patients.

Regards,
Nancy




Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.