40: Float Pool: Sink or Swim

40: Float Pool: Sink or Swim

From Chicken Soup for the Soul: Inspiration for Nurses

Float Pool: Sink or Swim

In helping others we shall help ourselves, for whatever good we give out completes the circle and comes back to us.

~Flora Edwards

“Why would nurses volunteer for Float Pool?” I wondered. It was like being a substitute teacher, having to be resourceful in so many areas. I was not fond of a changing work environment, so I admired these brave people.

One evening, during low census, I was drafted to fill Pool shortages. Hesitantly, I left my fifth floor dialysis unit and headed for seventh floor orthopedics, where I stopped cold. The charge nurse was buried in a disorganized pile of papers. The unit clerk’s forehead flashed an invisible sign: “I dare you to speak to me.” The day shift staff darted in and out of rooms to beat the clock. I wanted to bail out.

After some time, a disembodied voice asked if I was the float nurse. Instructed to “Wait,” I stood around nearly twenty minutes holding my belongings. I already felt like I was sinking as I watched the commotion.

Frustrated, I took action and returned to the fifth floor, placed my dinner in the fridge, and printed out the Ortho census on that computer. I privately longed to stay, but returned to the seventh floor where the charge nurse had my assignment ready. She pointed me toward report.

I slid into the closest seat and took notes. There were no introductions; no one even acknowledged me. Hopelessly behind schedule, we all made a mad dash to the floor after report.

Back on the chaotic unit, I was trying to find a resource person when I heard a serious-looking nurse say, “Are you the float nurse?”

I was rescued! But my relief was short-lived. She wasn’t there to help me; she wanted me to help her.

Through visible grief, the nurse begged me to spend my shift supporting Mrs. Smith, a terminally ill woman. I would have wholeheartedly done this had I not been given a heavy assignment on a busy disordered floor. She was handing me an anchor. The Ortho unit and equipment were unfamiliar to me. I had six people late for meds already and I didn’t have an access code for medications. During report I’d learned that someone needed morphine ASAP. Someone else needed more IV fluids hung and the site was clotting. I was already drowning.

The nurse pleaded with me, but I knew Mrs. Smith deserved better than I could offer. I would be overextended and no one would receive good care. I gently explained I’d never met the dying woman and that she might feel more supported with a familiar nurse. With wide eyes and a new mission, the nurse ran off to change the assignment.

Still lacking resources, I returned to the fifth floor and used my code for meds. I also picked up supplies I couldn’t access or find on the seventh floor. I’d straighten out logistics later. Back on Ortho, I saw Mrs. Smith’s bed being pushed into a private room. I was relieved someone would meet her special needs.

My shift got no better. Nothing went smoothly; nothing was timely. Tasks were delayed while I sought information. I received a medication access code halfway through the shift. The previous nurse had let fluids run out so I had to restart IVs. I was behind schedule the entire shift and never did get that dinner I’d stored back on the fifth floor.

To make matters worse, working with unfamiliar orthopedic equipment required hijacking another nurse to assist. I hated to bother anyone, but I had no choice. When I did track someone down, help was given cheerfully. I just didn’t feel welcome to approach anyone since no one spoke to me.

My frustration paled next to the pity I felt for the patients expecting and deserving good nursing care. Being an unsupported float substitute robbed me of the opportunity to be the nurse I desired to be.

I staggered home after this awful experience, determined to effect change.

The next day I decided to write a thank-you note to the nurses on Ortho. Yes, a thank you note. Contradictory as it sounds, I had a plan.

Sending the note was easy. The hospital administration had recently implemented a system for relaying compliments and comments. Notecards displayed on suggestion boxes in each department read, “Let us know how we’re doing.” Visitors, clients, staff, and managers were encouraged to write comments, which were delivered directly to the hospital administrator. After adding a personal remark, she would forward the note to the appropriate department head, then to the manager or director of nursing, and finally to the employee.

I could have used this system to complain, but I knew it would be more productive to emphasize the positive. So I wrote about floating to Seven and being dependent on those nurses to share their Ortho knowledge. I named the people who had helped me, and thanked them. I complimented the compassionate nursing I’d observed. I named the nurse, a true advocate, who had been so concerned for the dying woman.

I knew their supervisors would acknowledge the nurses I praised. I hoped that would raise expectations. By saying the seventh floor nurses willingly helped floats, I set a precedent for all the nurses there, hopefully raising standards.

Next, I wanted to be sure floats had a positive experience on our unit. I told my coworkers about my dreadful shift and we agreed we didn’t want that reputation for us. In fact, we wanted fifth floor dialysis to be the floats’ favorite place to work.

From then on, we welcomed the float nurses right away and introduced ourselves, which generally surprised them. We created a buddy system, a place for personal belongings, and a designated communication slot for the floats. Assignments reflected the training and availability of the substitute. We treated that nurse like a guest and checked in often. Immediately following the shift, we all signed a compliment card, thanking him or her for working with us.

The results amazed us. With VIP treatment for our floats, the atmosphere felt like a holiday. All staff members were happier and less stressed. I’m sure this led to better patient care.

We received thank you cards from the floats for making them feel supported. Our staff received compliment notes from hospital and nursing administrators stating their appreciation of our special efforts to improve the work environment. Patients and visitors sent us cheerful compliment cards.

As an unexpected benefit, our Keep-the-Float-Afloat plan spread to other units. When one of our nurses floated, she returned with news of being treated very well, even on Seven. When Five and Seven became favorite places to float, I knew my plan had worked.

As we suspected, a supported float nurse rises to the top and everyone swims — I mean, wins.

~Elizabeth Rae

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