[fight fatigue]

We started team nursing 3 weeks ago. We are a 44 bed unit that manages, medicals, telemetry, oncology, and occasional step downs from CCU. We average 25-30 patients a day. We use to staff 7-8 nurses every day and four aides and 2 ward clerks. We would have 4-5 patietns of our own, the charge nurse would have 1-3 patients and would help out. We now staff five nurses for 24 patietns. Each team has 10 patients and the charge nurse has one. When our census is up the charge nurses takes her own team of 8 along with another nurse. The aides split rooms evenly so each has about the same number of patients. One ward clerk does all the orders.
This is not working and many of the staff are looking else where. Administration tells us that Most Indiana hospitals and other big hospitals are doing this and that we must adjust becasue TEAM nursing is here to stay. If this is true please let me know this will get better. How are your units set up? Our unit alone has made several med errors, lab errors, and entering order errors. Our patients are suffering some have even commented that this care delviery system is not working!!

[dazzle256]

Originally Posted by fight fatigue

We started team nursing 3 weeks ago. We are a 44 bed unit that manages, medicals, telemetry, oncology, and occasional step downs from CCU. We average 25-30 patients a day. We use to staff 7-8 nurses every day and four aides and 2 ward clerks. We would have 4-5 patietns of our own, the charge nurse would have 1-3 patients and would help out. We now staff five nurses for 24 patietns. Each team has 10 patients and the charge nurse has one. When our census is up the charge nurses takes her own team of 8 along with another nurse. The aides split rooms evenly so each has about the same number of patients. One ward clerk does all the orders.
This is not working and many of the staff are looking else where. Administration tells us that Most Indiana hospitals and other big hospitals are doing this and that we must adjust becasue TEAM nursing is here to stay. If this is true please let me know this will get better. How are your units set up? Our unit alone has made several med errors, lab errors, and entering order errors. Our patients are suffering some have even commented that this care delviery system is not working!!

Didn't they try this "team" nursing stuff about 8 years ago? It didn't work then ......I remember someone calling it assembly line nursing.

[Farkinott]

Team nursing (unless performed with full time staff used to working together) means the left hand doesn't know what the right hand is doing!

[Town & Country]

This is so bizarre ~ every place I interview, they are going to primary nursing!!!

[Furball]

Team nursing is useless....I just went thru the rounds of interviewing for a new job and I crossed off anyplace that uses it. If I were you, I'd start looking for another job pronto.

[Ruby Vee]

27 years ago, when I started nursing they were phasing out Team nursing in favor of primary nursing. Team nursing, where everyone works together, is a way to get more work done with fewer licensed staff. Unfortunately, it's pretty hard on the licensed staff. Not only are you responsible for your own practice, but you're responsible for everyone on your team. If you can't trust your team (and sadly, there are team members who are less trustworthy than others) you're in trouble. If you've got a great team, you can make it work.

The question you have to ask yourself (and answer for yourself ) is what kind of team do you have, and how far do you trust them. If you have a good, trustworthy team, it's a workable situation. After all, you can assign all the messy clean-ups to someone ELSE. But if your institution like many hires from the bottom of the barrel . . . I once worked with a CNA who took vital signs by ESP. Fortunately, I wasn't team leading the night that he charted normal vital signs on a LOL at 2 and 6 AM when her 24 hour Holter monitor showed VF ---> asystole at MN and the day nurse (me) found her cold, dead and rigor-mortised at 7 AM. The nurse who was lost her job for "failure to supervise".

If you can't trust your team, or don't want to give it a try, by all means, vote with your feet. Maybe if they lose enough nurses, they'll consider the Team nursing experiment a failure and bury it!

[skay]

At My Hospital We Have Been Doing Team Nursing For About 4 Weeks. Is It Working?????? Some Days Are Better Than Others! It Depends On Who Is Working With Who. The Nurses Are Still Confused About Their Role And Most Have A Lot Of Problems Delegating Esp. To Another Rn. The Teams Can Be As Big As 13 Patients To 2 Liscenced People That Could Be 2 Rn Or 1 Rn 1 Lpn. Everyone Thinks The Rn Should Not B3e Responsible For That Many Pts But In Primary Care 1 Rn Could Have 6 To 7 Pts And Resource A Lpn With 6 To 7 Pts. So What Is The Difference Really?

[fergus51]

I hate team nursing and won't work at a place that uses it. It is too confusing.

[skay]

Why Is Team Nursing Confusing? It Makes The Staff More Accountable For What They Are Doing Or Should Be Doing Such As Na, Rn Who Never Even Looked At A Lpns Patients When She Resourced Them. Rn Tusted Lpn Knew What Was Going On With The Patients And Would Seek Her Out When She Needed Help. Some Lpns Would Act Like Rns Except For Push Meds .

[fergus51]

Skay, in my experience it can be great if you are working with a good team. BUT and it's a big but, I found a lot of the time the left hand didn't know what the right hand was doing. There is too much room for miscommuncations about which team member will do what, when things will be done, etc.

I prefer primary nursing where I have my own patients and do everything for them. That way I know what's been done and what needs to be done and I can organize my shift accordingly and I don't need to worry about someone else and their duties. Fortunately I am in a specialty that allows for primary nursing.