Nurses Create a Model to Enhance the Float Experience

While some nurses enjoy the flexibility and diverse clinical experience of working in the float pool, cross-unit float nurses often complain about feeling anxious, alienated and out-of-the-loop. Last year, a trio of nurses at Cleveland Clinic created the Float Ally Model to improve the satisfaction of RNs and PCNAs who take on float assignments when their unit’s census is low or to fill staffing shortages. “The model is designed to give unit-to-unit floats the support they need,” says Angie Walden, BSN, RN, Assistant Nurse Manager, Nursing Floats at Cleveland Clinic’s main campus.

Development of the three-part model

Walden developed the Float Ally Model with Nikki Pistiolas, RN, and Jeff Knop, BSN, RN, Nurse Manager, Float Pools, as part of a Shared Governance Day Fair poster presentation. She began with a literature review on employee engagement of float nurses. “A common factor that came through is that people hated to float,” says Walden. “It was uncomfortable.” Float nurses often receive no orientation or resources to help them acclimate to the unit.

Walden, Pistiolas and Knop then brainstormed ways to improve the float experience and came up with a three-part model:

• A Float Ally – Units should assign a float ally for both RNs and PCNAs on each shift. The ally should be a team player with a positive attitude who is willing to serve as the point person for float nurses. Allies greet floats when they arrive and touch base with them two times during the shift.
• A Float Packet – When a float nurse shows up, the ally gives them a packet with a welcome letter and a Float Ally Guide. The guide includes the name and number of the float ally and a unit-specific checklist. It covers topics ranging from rounding schedules to location of the dirty linen chute. Next, the ally takes the float nurse on a brief guided tour of the unit.
• A Caregiver Celebration – At the end of the shift, the nurse manager or float ally gives the float nurse a written award called a “caregiver celebration” thanking him or her for coming to the unit and lending a hand in a time of need.

Pilot and Survey Results

The nurses piloted the Float Ally Model last spring on an organ transplant unit that has a high volume of cross-unit floats. Prior to implementing the model, they conducted a survey of RNs and PCNAs who have floated on the unit. The survey asked caregivers to rate their satisfaction in four areas:

1. Was the atmosphere on the unit friendly, open, accepting and comfortable?
2. Were you oriented to the unit by a staff member?
3. Did you feel supported by floor staff?
4. Were unit resources made available to you?

Overall, those surveyed indicated a 28 to 41 percent satisfaction rate in the float experience prior to the six-week pilot. Afterward, those figures rose to an 80 to 90 percent satisfaction rate.

In January, Cleveland Clinic began a second pilot of the Float Ally Model on six units. Walden hopes to get more feedback, including ways they can adopt the model as standard operating procedure, yet tailor it to meet the needs of specific units. She is optimistic the Float Ally Model will be implemented enterprisewide. So far, the model has been well received: Walden, Pistiolas and Knop’s poster presentation at the Zielony Nursing Institute’s 2014 Shared Governance Day Fair was named best overall among more than 100 entries.

“We want our floats to have the resources they need and not arrive at a unit hating it before they even start working,” says Walden. “Ultimately, not only will it help employee engagement, but it will benefit the patient as well.”

Photo Credit © Russell Lee