My initial response is that no one can MAKE you float. A charge nurse or a nursing supervisor might tell you that you have to float, but in the end, it is always your decision whether or not to accept.
The reason I am touching on this is because, one, I know of many travelers that have accepted a float to a unit in which they were uncomfortable, and two, I have been placed in that exact position myself. Most of the time, the traveler comes through the shift unscathed. However, what would happen if that were not the case?
When practicing nursing, especially as a traveler, YOU must always be the sole protector of your license. A charge nurse or supervisor mandating a float is simply looking for staff to fill their immediate need. It is your responsibility to let them know if you do not have the experience necessary to practice safely in the environment in which they wish you to work. When it becomes tricky is when your objection falls on deaf ears.
Let's look at the following scenario:
Your charge nurse comes to you and says that you need to float to the pediatric unit for the night (my own worst nightmare). You are expected to take a patient assignment, but are assured that you will receive "stable" patients. You tell the charge nurse that you have never worked with peds and don't feel comfortable with the float. She then tells you that travelers are always the first to float and that you MUST report to the pediatric unit to work (not a very nice situation, but one that might sound familiar to many travelers out there). What would you do in this situation?
First, remember that there is a difference in the things that we MUST do and the things that we AGREE to do. First, clearly state the reasons that you do not wish to float. It is not simply that you don't want to have to float, but that you feel uncomfortable with your ability to deliver safe care in an environment in which you have no experience. In a perfect world, that should be all that needs to be said. However, we all live in the real world where it is seldom perfect.
If your rationale does not change the mind of your charge nurse, work up the chain of command and contact the nursing supervisor. Once again, clearly explain the reason that you do not feel that it is safe for you to float to that particular unit.
If the nursing supervisor does not agree, then you have a few options. Unfortunately, the option most often chosen is to go ahead and accept the float; I would strongly discourage this. I know I worked hard for my nursing license and I assume you did too. Exactly how many times in your career do you want to put your license on the line and just cross your fingers hoping that nothing bad happens?
The next option is a bit of a bluff, but one that I have used successfully. If you have told the nursing supervisor your objections, and she still insists that you float, tell her that it is under HER responsibility that you are doing so. Inform her that to cover yourself, you will need to fill out an incident report in which you formally document that you informed her that you did not have experience in this area and believed the float to be unsafe. Tell her that it will then be HER responsibility should anything "bad" happen because you were made to float to a unit outside your scope of practice. In my instance, this was all it took for the supervisor to realize that her unsafe request might have grave consequences and she relented.
However, if this does not work, you must understand that filling out an incident report will probably not absolve you of responsibility if something bad were to happen. It's simply an effort to make the nursing supervisor accountable for a decision that she probably already knows is a bad one.
If everyone is still insistent that you accept the float, then you have a tough decision to make. You can try going further up the chain of command and speaking to your unit manager or even someone in administration. However, if neither the charge nurse nor the nursing supervisor has listened to your reasoning, I don't know that you will find sympathetic ears any higher up. You may simply have to refuse the float and accept the consequences. Even if those consequences were to be the termination of your contract, you will be able to secure another contract; if something bad happened while you were practicing in an area in which you had no experience, would you be able to secure another license if yours were revoked?
Travel nursing can be a wonderful profession, but it certainly requires independence above what is normally required of a healthcare professional. Often, YOU are the only one safeguarding your license and you have to be willing to stand up for yourself, especially when placed in a potentially dangerous situation. Above all else should be the desire to deliver your care in a safe manner.
Please feel free to leave a comment below for others to read if you have had a similar experience while traveling.
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Ask a Travel Nurse: What would happen if a traveler were MADE to float to an area in which they ...
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