NEW YORK NURSE: April 2009

Ask the experts

Fear of floating

Q.: Our facility has suspended hiring due to the economy and now they tell me that I may have to float to another unit. Our facility doesn’t have contract language to ensure that I will be floated to an area comparable to the unit I work on a daily basis. Do I have to float or can I refuse? Will I face increased liability if an adverse event occurs? What can I do to protect my license?

A.: Since your facility contract does not contain specific floating language, your concerns are valid. Regardless of your fears, if you refuse to float you face possible discipline from your employer for insubordination. Also, when your RN license was approved by the New York State Education Department, it was understood that you had the minimum competencies required to safeguard the public. This means that you are expected to perform the minimal tasks expected of an RN in any setting.

However, you can take these steps to protect your patients and your license:

Ask the individual who is asking you to float what type of assignment you will be expected to handle.
Tell the supervisor if you don’t feel comfortable with the expectations, due to your personal competencies.
Although this will not excuse you from floating, it may prompt an alteration in the assignment.
Proceed to the unit, connect with the individual handling the assignments, and review the assignment with either the manager or the charge nurse. Express your concerns to them and ask what can be done to modify the assignment to avoid areas that are unfamiliar to you.
Fill out a Protest of Assignment and, if possible, contact your committee member or nursing representative with your concerns.
Have the POA signed. Keep a copy, whether it is signed or not, and forward a copy to NYSNA.
Ask colleagues for their assistance during any tasks that may be unfamiliar to you or are beyond your personal scope of competency.

Your liability is high whenever you perform a task for which you have little or no training or in which you have limited competency. When you file a POA, the liability for an adverse outcome is shared with the facility. This is because you have documented the facts and demonstrated your concerns with management regarding patient safety.

You also can protect your license by maintaining your competency. Search out or ask for educational opportunities that will increase your competencies and purchase personal liability insurance to protect yourself in the event of an adverse outcome.

This is a sample of the questions NYSNA’s experts answer each day. The advice given is specific for the situation described and may not be applicable generally. If you have questions about your own work setting, it is recommended that you contact your NYSNA Nursing Representative or the Education, Practice, and Research Program, 11 Cornell Road, Latham, New York 12110-1499 or call 800-724-NYRN, ext. 282.