OK, i feel silly asking...but what is team nursing?

HappyNurse2005, RN · Oct 27, 2004

Maybe I already know what this is and just haven't heard it called this. But what do you mean by team nursing? I see on the other thread it seems to cause some hard feelings.

Everywhere I have seen, the RN or LPN, depending, has her patient load of oh, lets say 6 patients on a med/surg floor. they do the meds, assessments, treatments, procedures, documenting, etc etc etc. they have a CNA or NA who does the AM care, toileting, linen changes, fills up water jugs, etc.

and of course, there is PT, respiratory, social work,etc etc.

I haven't seen anything else, except wheni wasin the PICU they didnt have NA b/c the nurse did that part for her 2 patients, too. Hmm...I dont know if i saw a NA in Labor/delivery either.i dont remember

so, what is team nursing and why is it viewed so negatively?

rose

purplemania, BSN, RN · Oct 27, 2004

The way we have done team nursing is this: The RN's and LVN's and a CNA are assigned a number of patients. The RN is responsible for doing all the assessments, plans of care, IV pushes, conscious sedation, blood transfusion, central lines, some procedures and planning patient education. The LVN does other procedures, gives PO meds and re-evaluates the patients. RN's hate this because they are responsible for a dozen patients. Even though the LVN is doing a lot, it is too easy to not know what is going on with a given patient and the LVN may not be trained to evaluate or intervene appropriately. The main problem is letting someone else share your work but not the responsiblity, and you are not able to control what is going on. It is hard to keep up with all those patients and to plan your day. The patients are confused too, as they have 2 nurses. We need to find another way to utilize LVN's to full potential.

purplemania, BSN, RN · Oct 27, 2004

The way we have done team nursing is this: The RN's and LVN's and a CNA are assigned a number of patients. The RN is responsible for doing all the assessments, plans of care, IV pushes, conscious sedation, blood transfusion, central lines, some procedures and planning patient education. The LVN does other procedures, gives PO meds and re-evaluates the patients. RN's hate this because they are responsible for a dozen patients. Even though the LVN is doing a lot, it is too easy to not know what is going on with a given patient and the LVN may not be trained to evaluate or intervene appropriately. The main problem is letting someone else share your work but not the responsiblity, and you are not able to control what is going on. It is hard to keep up with all those patients and to plan your day. The patients are confused too, as they have 2 nurses. We need to find another way to utilize LVN's to full potential.

URO-RN · Oct 27, 2004

At a place where I once worked we had RN (me), 1 LPN, or 1 CNA. We had 6 patients. Everyone of our patients received their meds on time, (of course, only when I had an LPN working with me to pass oral meds).

Sometimes, it was difficult if either the LPN or the CNA had a student or orientee with them.

But it worked out really well. :)

URO-RN · Oct 27, 2004

At a place where I once worked we had RN (me), 1 LPN, or 1 CNA. We had 6 patients. Everyone of our patients received their meds on time, (of course, only when I had an LPN working with me to pass oral meds).

Sometimes, it was difficult if either the LPN or the CNA had a student or orientee with them.

But it worked out really well. :)

ceecel.dee, MSN, RN · Oct 27, 2004

At our place team nursing looked like this (have changed to a modified primary nursing model now): 3 RN's per shift (2 at noc) with one as charge, one on meds and one who was available to float around or cover ICU/CCU (if it was open), L&D (if there was anyone laboring), or ER. 2 LPN's and 2 CNA's did patient care. One of the consistant complaints about the team nursing model is the fact that one nurse passing all the meds and having nothing to do with their assessments or cares does not allow for monitoring of med effectiveness. There is just no care continuity for the patients or the nurses. That is not to say that even a modified primary care model is flawless.

ceecel.dee, MSN, RN · Oct 27, 2004

At our place team nursing looked like this (have changed to a modified primary nursing model now): 3 RN's per shift (2 at noc) with one as charge, one on meds and one who was available to float around or cover ICU/CCU (if it was open), L&D (if there was anyone laboring), or ER. 2 LPN's and 2 CNA's did patient care. One of the consistant complaints about the team nursing model is the fact that one nurse passing all the meds and having nothing to do with their assessments or cares does not allow for monitoring of med effectiveness. There is just no care continuity for the patients or the nurses. That is not to say that even a modified primary care model is flawless.

TweetiePieRN · Oct 27, 2004

Our team nursing module is set up a little different that what you guys have going on. A team consists of 1 RN, 1 CNA, 5 patients. I work on the Oncology/Medical Floor and we do not use LVN/LPNs.

The RN is responsible for all the RN stuff (care planning, assessments, meds, etc). The CNA is responsible for all the personal care and is also a unit secretary. So the CNA is really busy, becuz she has orders to put into our computer system along with answering the phone lines, filing papers, etc. Of course, the RN will also do tasks the CNA does if the CNA is busy. It really is a team effort at my hospital. This system works really well for us and I have not heard any of the nurses or CNAs complain.

TweetiePieRN · Oct 27, 2004

Our team nursing module is set up a little different that what you guys have going on. A team consists of 1 RN, 1 CNA, 5 patients. I work on the Oncology/Medical Floor and we do not use LVN/LPNs.

The RN is responsible for all the RN stuff (care planning, assessments, meds, etc). The CNA is responsible for all the personal care and is also a unit secretary. So the CNA is really busy, becuz she has orders to put into our computer system along with answering the phone lines, filing papers, etc. Of course, the RN will also do tasks the CNA does if the CNA is busy. It really is a team effort at my hospital. This system works really well for us and I have not heard any of the nurses or CNAs complain.

URO-RN · Oct 28, 2004

Yes, as long as their is a team effort it works well.

We helped each other. I helped with ADL's, baths, etc..as much as I could. The LPN would help by passing oral meds as much as she could as well. We just had a good system and we made it work very well. We would keep in contact about any changes or new orders etc...

Of course, nothing is 100% super duper. :)

URO-RN · Oct 28, 2004

Yes, as long as their is a team effort it works well.

We helped each other. I helped with ADL's, baths, etc..as much as I could. The LPN would help by passing oral meds as much as she could as well. We just had a good system and we made it work very well. We would keep in contact about any changes or new orders etc...

Of course, nothing is 100% super duper. :)