Nurses Floating to Other Nursing Units
Q. I have been asked to float to other nursing units. What can I do to ensure I meet my standards of practice?
A. Floating to other units 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 and compassionate nursing care at all times.
When “floated” to an unfamiliar practice setting, it is recommended that you:
- Ask for a brief orientation to the area
- Ask for support of the nurses and other care providers who are familiar with the client population
- Ask if it is possible to be partnered with an experienced nurse for the shift
- Establish a plan for regular communication with the charge nurse and/or partnered nurse.
- Clearly communicate with staff 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”.
Q. Can I refuse?
A. Typically, nurses are hired by an organization and not a specific unit. As a result, you have a contractual obligation to provide care to clients within the organization, not limited to your unit.
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.
If you choose to refuse an assignment for any reason, you must:
- Inform your employer of the reason for refusal
- Document the decision-making process
- Provide the employer with enough time to find a suitable replacement
Rather than refusing an assignment due to a perceived lack of competence, 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).
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 level of competence. You have an obligation to inform your employer when you are asked to deliver care beyond your level of competence or individual scope of practice. You must recognize when you have passed the limits of your knowledge, skills and/or judgment. In addition, you must 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 firstname.lastname@example.org.