Colleen............
You don't say whether or not the "team", consists of all RN's, or is mixed. Although I have never worked on a floor, (I'm a CC RN), I have had to float to a med-surg unit at times......We had an all RN staff, and they did "total patient care", VS, baths, linen changes, everything. While working on the floor, I couldn't help but feel that a lot of my time was wasted doing minimally skilled, labor intensive tasks which precluded my rounding with the physicians, following up on lab results, and having a sense of "control". Of course this is probably because that is the environment that generally exists in a critical care setting, and what I was used to....I also felt that this inhibited a more interdisciplinary approach to patient care because the MD's "rounded" separately and nurses often were not available to bring up issues for open dicussion, and then had to page them with problems AFTER they had already made rounds. If the "team" approach is stuctured well, then the RN is free from most of those tasks and is now available to report abnormal lab results more quickly, round with the MD's, talk, teach patients and their families, do a more thorough asssessment, plan for discharge......We have abandoned this "all RN" patient care model since in today's healthcare environment, it is not very cost-productive. We now use assistive personnel as part of the team. I personally feel that our model is stuctured poorly and could work much better, but am not in a position to effect any change. We use assistive personnel in the ICU, and when motivated and well-trained can be an invaluable member of the "team". So, to end this opus, team nursing is NOT a step backwards, but rather a reasonable accommodation to the reality of nursing practice today.....the challenge is to come up with more creative ways of making it work better!
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