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Case Study

How to Create a Supportive Work Environment for Float Nurses

10 Minute Read


The challenge

Many leaders struggle to grow and sustain their nursing float pools. Nurses and managers often view float pools as unstable and unpredictable, with limited professional development opportunities. Float nurses may also feel unsupported on their designated units. As a result, recruiting and retaining float staff is a challenge.

The organizations

  • Princess Alexandra Hospital (PAH) is a 1,059-bed, Magnet® accredited hospital located in Woolloongabba, Queensland, Australia.
  • Cleveland Clinic is a health system headquartered in Cleveland, Ohio, US.

The approach

  • In 2008, leaders at Princess Alexandra Hospital used government funding to upskill new graduate float nurses to prepare them for permanent positions on specialized units.
  • In 2014, Cleveland Clinic developed support unit-level supports for float nurses through a shared governance project.

The result

Since implementing their programs, PAH and Cleveland Clinic increased float nurse satisfaction and engagement. They also decreased labor cost by reducing reliance on agency labor.



How two organizations created supportive work environments for float nurses

Float nurses at PAH and Cleveland Clinic felt disconnected from nursing leadership and professional development opportunities available for non-float nurses. As a result, leaders created support structures for their float staff to increase retention.


The three components

There are three components critical to creating a supportive and welcoming environment for float nurses:

  • Component

    Create professional development opportunities for float nurses

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  • Component

    Integrate float nurses into nursing leadership structures

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  • Component

    Embed unit supports for float nurses 

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Both PAH and Cleveland Clinic have reduced agency spending and increased retention and satisfaction of their float nurses.

  • Agency costs at PAH decreased by almost 110,000 hours, resulting in nearly AU$4 million in savings. Engagement and retention of new grads increased, stabilizing the float pool workforce.
  • Leaders at Cleveland Clinic have grown and stabilized their float pools. As a result of embedding unit support for float staff, average staff satisfaction among float pool nurses increased 50%. The float pools have covered thousands of temporary relief hours in year. Those hours would have otherwise been covered by agency staff or overtime.

Our units are specialized, and our floats become expert generalists. When a specialty unit has an identified need they say, ‘where’s the float?’ because of the float’s familiarity and vast experience with a wide variety of patient care settings and needs.

Angie Walden, Assistant Nurse Manager, Nursing Floats

Cleveland Clinic

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