Alleviating the Fears of Float Nurses

A unit-specific welcome letter eases anxieties

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Having to float to another unit is often stressful for nurses, whether they are new nurses or experienced veterans. There are lots of reasons for the anxiety: Float nurses may not know where supplies are located or who to ask for help. They may be accustomed to caring for a different patient population. A recent initiative completed on Cleveland Clinic’s main campus helps nurses feel more at ease when they work a shift on another unit.

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Documenting important unit information

Last March, Cleveland Clinic’s nursing institute launched a Retention Council comprising about 25 frontline nurses from across main campus. “We looked into what were the stressors for nurses that would prompt someone to leave our organization,” says John Davis, MSN, RN, FNP-BC, NE-BC, Nurse Manager of Cardiovascular Surgery Stepdown and co-chair of the Retention Council. “One of the things that came up was floating, because it’s outside what nurses are used to and it’s uncomfortable.”

The council decided to examine what specifically makes nurses apprehensive about floating and to find a way to ease their anxieties. “We asked frontline nurses what they don’t like about floating,” says Davis. “Many answered that every unit is set up a little bit differently and runs differently, even if they have the same architecture and layout.”

The Retention Council created a letter, individualized by all units at main campus, to help float nurses become acclimated and feel welcome. The top of the letter says, “Welcome to the _______ Unit,” with the blank line reading Medical/Surgical, ICU, Telemetry, etc. It lists the name of the float and their assignment, as well as the name and contact information for a nurse on that unit who will serve as their “buddy” during the shift.

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The body of the letter lists important information, including the following:

  • The location of supplies and equipment
  • The names and contact information of physicians and licensed independent practitioners on the unit
  • Any unit specific tasks (For example, a cardiovascular unit might offer educational classes for patients with heart failure on certain days that a float nurse wouldn’t know about.)
  • The names and contact information for nurse managers and assistant nurse managers on all shifts

Creating a smooth transition to a new unit

It took the Retention Council three months to gather information from each unit for the letters, then write and edit them. The letters were uploaded into nursing’s policy and procedure manual for units to access and personalize when a float nurse is assigned to their unit. The letter is delivered to float nurses as soon as they arrive.

“It has all the basic information, and is a good starting point for questions,” says Davis. “It has eased the nerves of nurses going into a unit they may have never walked onto before.”