This practice scenario has been developed to help nurses understand their responsibilities around floating.
Nurses Floating to An Unfamiliar Practice Setting
Q: I have been asked to float to an unfamiliar practice setting. What can I do to ensure I meet my standards of practice?
A: Floating to an unfamiliar practice setting to support the delivery of services is a common practice. Nurses are accountable to meet their standards of practice and code of ethics by providing safe, competent, ethical, and compassionate nursing care at all times.
When “floating” to an unfamiliar practice setting, it is recommended that you:
- Ask for a brief orientation to the area including access to specific policies and procedures related to practice setting.
- Ask for support of the nurses and other care providers who are familiar with the client population.
- Ask if it is possible to have an identified nurse that works in the practice setting to act as a collaborator when needed or be partnered with an experienced nurse for the shift.
- Establish a plan for regular communication with the charge nurse and/or nurse collaborator.
- Clearly communicate with staff throughout your shift what is within your individual scope of practice and what is not. For example, “I can give IV medications, but I cannot administer IV chemotherapy”.
- If you are floated to a particular practice setting on a consistent basis you may want to consider engaging with the appropriate clinical support person such as a nurse educator, to assist in developing competencies that may be required in that practice setting.
- Understand that each practice area may have differing policies related to competencies and interventions that can be performed by nurses in that specific setting or unit. If you are not sure if you are authorized to perform an intervention you should ask the nurses who regularly work on that unit for support.
Q. Can I refuse?
A: The refusal of an assignment in an unfamiliar practice setting is only justified when the risk of harm to a client is greater by accepting the assignment than by refusing it.
Rather than refusing an assignment, you should negotiate the work assignment with your manager. This should be based on your individual scope of practice and your competencies. Every nurse has entry-level competencies, many of which can be used in any practice setting (e.g., carrying out client assessments, taking vital signs, assisting clients in activities of daily living).
If, after you have tried to negotiate the assignment, you choose to refuse the assignment for any reason, you must:
- Inform your employer of the reason for refusal.
- Document the decision-making process in your personal notes and/or employer specific forms, not in client records.
- Provide the employer with enough time to find a suitable replacement.
For more information on a nurse’s duty to provide care, please see the Abandonment Practice Guideline and Duty to Provide Care Practice Guideline.
Q. How do I float and still work within my scope of practice?
A: Accepting the assignment to float does not mean you are obligated to practice beyond your competencies or individual scope of practice. You have an obligation to inform your employer when you are asked to deliver care beyond your competencies or individual scope of practice. You are accountable to know when and where to request assistance or additional support.
For further information on anything contained within this tool, please contact an NSCN Practice Consultant at practice@nscn.ca.
