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Amanda O'Leary MSN, RN, NPD-BC
University of California, Davis Medical Center
ABSTRACT:
Background: Organizations often need to find creative staffing solutions in order to provide safe patient care.1 Creative strategies within existing programs provides cost positive solutions at an academic medical center. While new graduate nurses (NG RNs) are frequently hired into a specific home unit, there are some that join a float pool. Some hospitals have nurses from all different units that are pulled into float positions for the day, but at our institution we have a dedicated department of nurses that choose to daily float. The float pool started hiring new graduate nurses in September of 2013. From 2013-March 2022, 172 newly graduated nurses have joined our float pool to provide an internal ready-to-work workforce. Utilizing float pool-trained nurses reduces overtime costs and can save 2% to 5% of total nursing labor.2,3
Purpose: The purpose of this initiative was to look at hiring new graduate nurses into the acute care float pool, maintaining positive outcomes, supporting hospital recruitment goals while remaining cost positive.
Methods: Within our 625-bed academic level one adult and pediatric trauma center we have combined 24 medical, surgical, oncology and women’s pavilion acute care units that our NG RNs orient and develop in during their first year. The department educator arranges their orientation during the first eight weeks. Department leadership places the nurses on various units throughout the remaining year depending on the needs of the units. The new graduate nurse participates in a one- year new graduate nurse residency program alongside dedicated hospital unit hired peers. The new grads have the option of applying to vacant positions across the division and if hired, float pool supports the transition. The hiring department evaluates the need for additional orientation or ability to start full assignments.
Results: In 2020 and 2021 the acute care float pool onboarded 20 and 40 NG’s respectively, with a cost savings of $1,027,494.00 and $2,101,939.88 each year. In 2022, the cost savings are currently totaling $638,376.02 from our first of four cohorts. Of the 60 new grads hired over the past two years, 85% remain at the institution. In the Vizient Progression & Post Residency Survey at 12 months, PCR new grads scored above the national benchmark in satisfaction & commitment within their department.
Conclusion: Utilizing new graduate nurses in the float pool is an innovative, successful model that’s beneficial to the institution and the nurse. These nurses have the opportunity to seek out potential home units and “try them on”. Managers are given a chance to see how the nurse fits in with their unit. It’s the unit's decision if the new grad needs additional focused orientation. This remains cost-positive to the institution by reducing the amount of overtime and a reduction in potential temporary staff. With limited information in this specialty, additional research is needed in this area. While other facilities have begun taking new grads into their float pools, we look forward to additional hospitals following this model and utilizing new grad nurses in a creative way. Establishing proactive staffing programs can offer sustainable solutions.
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