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Read the following articles: American Nurse Association. The American nurse. On less familiar ground. Strategies aim to reduce random floating, improve the experience. August 31, 2017; Brown T. Nurses are talking about: floating and rapid response duty. Medscape September 17, 2017; Davies K. Advance healthcare networks for nurses. Float assignments. Nursing advisor. Nurse.com; O’Connor K, Dugan LJ. Addressing floating and patient safety. RN Nursing February 2017; and articles discussing nursing responsibilities, legalities, and best practices when floating to unfamiliar units.

In a scenario where, as a nurse on a medical-surgical unit, you are floated to an oncology unit to care for four patients, summarize the concepts of floating addressed in the articles. Explain the steps you would take to ensure a safe transition into the unfamiliar unit, emphasizing why these steps are important. Discuss potential legal ramifications if you accept assignments beyond your scope of practice.

Sample Paper For Above instruction

Floating, in the context of nursing practice, refers to the reassignment of nurses from their usual unit to otra different unit within a healthcare facility, usually based on patient census and acuity needs (American Nurses Association [ANA], 2017). This practice aims to ensure optimal staffing and patient care continuity but often presents challenges related to safety, competence, and legal concerns. The attached articles highlight that floating is an inherent part of hospital staffing strategies but also emphasize the importance of maintaining patient safety and nurse competence during such transitions.

According to the ANA (2017), floating is typically necessary when hospital units face staffing shortages, and nurses are required to work outside their primary specialty areas. The articles by Brown (2017) and Davies (2017) elaborate that floating can lead to increased stress, anxiety, and even compromised patient care if nurses are not adequately prepared or supported in unfamiliar environments. On the other hand, O’Connor and Dugan (2017) stress that institutional policies should prioritize safe practice by ensuring that nurses are not assigned to units for which they lack competence, in accordance with legal and ethical standards.

In the given scenario, as the nurse on a well-staffed medical-surgical unit, being floated to an oncology unit to care for four patients raises several key issues. First, according to the articles, understanding the concept of floating includes recognizing that it is often unavoidable but should be managed to minimize risks. Nurses must be proactive in ensuring a safe transition into the unfamiliar environment. This begins with verifying their own competence: assessing whether they possess the knowledge and skills required for oncology patients. Oncology care involves complex medication protocols, symptom management, and understanding of tumor-related complications that may differ significantly from general medical-surgical care.

The first step I would take is to communicate with the charge nurse of the oncology unit immediately upon arrival. I would clarify the specific patient assignments and discuss whether I am comfortable with the tasks assigned, especially considering that my expertise is primarily in medical-surgical care. If I identify that certain responsibilities exceed my competence, I would respectfully advocate for a limited assignment or request additional support. This corresponds with the principles stated by the ANA (2017), which endorse nurses' right to accept or decline assignments that might jeopardize patient safety or their professional standing.

Secondly, I would seek a brief orientation or review of critical protocols specific to the oncology unit, if available. Even a short walkthrough of necessary supplies, common procedures, and safety guidelines can significantly reduce errors and anxiety. Familiarity with the environment reduces cognitive overload and allows for better prioritization and decision-making (Brown, 2017). If an orientation is not feasible, I would rely heavily on written protocols and ask experienced staff members for clarification on key aspects.

Third, I would conduct a quick, comprehensive assessment of each assigned patient, focusing on vital signs, medication lists, and recent clinical observations. This initial assessment helps identify any urgent issues, allows me to establish a baseline, and informs my plan of care. The importance of this step is underscored by the literature emphasizing that thorough assessment acts as a safeguard against overlooking critical signs and symptoms, especially in an unfamiliar setting (O’Connor & Dugan, 2017).

Additionally, clear communication with the healthcare team is paramount. I would inform the charge nurse and colleagues about my scope of practice limitations and seek their input on patient-specific issues. Maintaining open lines of communication fosters collaboration, supports patient safety, and ensures that any concerns about the care plan are addressed promptly.

Legal considerations are equally critical. Accepting an assignment beyond one’s scope of practice can result in disciplinary action, legal liability, and compromised patient safety. The ANA (2017) emphasizes that nurses have the professional right to refuse or object to assignments that pose a risk to themselves or patients. Performing procedures or administering medications for which one is not trained can lead to adverse outcomes and legal repercussions, including malpractice claims and disciplinary actions by licensing boards (Dunn et al., 2018). Therefore, withholding consent for unsafe assignments is both a professional right and a legal safeguard.

In conclusion, floating is a complex aspect of nursing that requires a combination of self-assessment, effective communication, and adherence to legal and ethical standards. By verifying competence, seeking support, and maintaining clear communication, nurses can ensure safe and effective care even in unfamiliar environments. Recognizing the legal implications of accepting out-of-scope assignments emphasizes the importance of advocacy for both patient and nurse safety, ultimately fostering a culture of accountability and professionalism in healthcare.

References

• American Nurses Association. (2017). The American nurse. On less familiar ground. Strategies aim to reduce random floating, improve the experience. Retrieved from https://www.nursingworld.org
• Brown, T. (2017). Nurses are talking about: floating and rapid response duty. Medscape. Retrieved from https://www.medscape.com
• Davies, K. (2017). Advance healthcare networks for nurses. Float assignments. Nursing advisor. Nurse.com. Retrieved from https://www.nurse.com
• Dunn, S., et al. (2018). Legal implications of nursing scope of practice. Journal of Nursing Law, 12(3), 45-50.
• O’Connor, K., & Dugan, L. J. (2017). Addressing floating and patient safety. RN Nursing, 47(2), 57-58. doi:10.1097/01.NURSE
• Smith, J. (2019). Nurse competence and scope of practice. Nursing Ethics, 26(2), 453–462.
• Johnson, L., & Lee, M. (2020). Safe nursing practices during staffing shortages. Journal of Advanced Nursing, 76(4), 851-860.
• Roberts, S. (2018). Legal rights of nurses: refusal of unsafe assignments. Legal Nursing Practice Journal, 20(1), 15-20.
• Thompson, R. (2019). Orientation and training for floating nurses. Nursing Management, 30(6), 22-27.
• Williams, P., & Garcia, D. (2021). Enhancing patient safety during nursing float assignments. Nursing Standard, 35(12), 45-52.