team nursing

  1. recently started team nursing which means that both nurses on the team see all the patients on that team. rn is reponsible for 12-14 pts. how does this work in other facitlites. prior to this we would see the other patients sometime during the shift but now is must be done with initial assessments. this is time consuming when we are also still responsibe to stop and do iv pushes for pain, take phone calls, and stop for the docs. before while i was doing that the other nurse continue with her vs, assessments and could help catch us up if needed. any suggestions on how you do this would be helpful. we are all trying differant ways but so far still finding it difficult thanks much for your input
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  2. 3 Comments

  3. by   frann
    They did that on my floor. I just left. They have 3 "teams" on the floor. It can work if you are with the right people. or you can be stuck doing all the work. I didn't like it because I can't do assessments on 10-12 pts and then 4 hours later do them againa and remember how they sounded. Just give me my 6 pts.
    The hospital is just trying to cover there butts, because they say a lpn must be supervised by a rn.
  4. by   Charles S. Smith, RN, MS
    Originally posted by frann
    They did that on my floor. I just left. They have 3 "teams" on the floor. It can work if you are with the right people. or you can be stuck doing all the work. I didn't like it because I can't do assessments on 10-12 pts and then 4 hours later do them againa and remember how they sounded. Just give me my 6 pts.
    The hospital is just trying to cover there butts, because they say a lpn must be supervised by a rn.
    In reality, the facility might be helping to cover your butt.. The issue of supervision/delegation is fast becoming an important legal issue in litigation all over the country. Where there is an RN, there is responsibility for ALL the care that occurs on the unit, especially if care is rendered by LPNs, NAs, etc. Yes, the work may be arduous if you are working with a less than energetic co-worker, but that is an administrative issue that needs to be dealt with before the problem turns chronic.
    chas
  5. by   live4today
    This is team nursing as I use to work it and know it to be:

    Each team consisted of one RN, one LPN, and one CNA. The patient load was anywhere between 6 to 10 patients (depending on the shift). Each nurse got to plot out their own way of working their particular team with the RN totally in charge of that team.

    After report, I would take my LPN and my CNA on rounds with me to see and greet all of our assigned patients. That way, each of us got to visually see what tasks needed to be met in order of priority. The CNA would check I/Os, linen needs, bathroom needs, assist with meals and meal trays, refill water pitchers, check safety guards on the beds of the patients who needed them, and any other CNA task she/he needed to do. The LPN would work with me. After greeting all of our patients, I would begin the patient assesments while the LPN did vitals on all the patients, recording them as required in the patients bedside chart. She would hand me the list of vitals she took on a separate sheet of paper so I could compare them with my own assessment of each patient (I would only repeat a vital sign if it was way out of norm or a drastic change from the previous shift's notation). Each of our patients were told that we would return after making rounds on our assigned patients. I always introduced my team as the three that would be responsible for their care during that shift, so between the three of us, we would do our utmost best to attend to them as quickly as each situation would allow, and their patience was greatly appreciated.

    After greeting our patients and doing our patient assesments, the LPN and I would check our assigned patients medsheets. I, the RN agreed to give all the PRN meds, and the LPN agreed to do all the regularly scheduled meds. That way, I could chart my initial assessment on each patient before mid-shift, check any new doctor orders, treatment plans, sign off on the other "nonsense paperwork" every RN has to check off, look over the patient's care plan and update or check task completed if needed, call for missing labs, check last lab results, receive any new admits or transfers, etc, etc. For all the patients who required vital signs more than once per shift, I would do that and chart them. The LPN would do as many treatments, dressing changes, etc., as she/he could, and I would help once my mid-shift assessment was complete. Together, we would compare notes on each patient to make sure the important information was documented. Sometimes, we switched up on things that the RN wasn't necessarily required to do. We were a team, so we worked fairly as a team. That's the important thing when doing team nursing.

    When I worked in a military hospital, team nursing on a ward worked this way: Following our ten minute report (no kidding), all the RNs would do walking rounds as a group to the bedside of each patient. Then, we would take our place at the nurses station to gather information on each patient, document our findings in their chart, and pass meds if needed. Otherwise, the enlisted staff did EVERYTHING for the patients. The enlisted staff were what I called the "REAL NURSES". My hats off to every one of them. Excellent nurses!
    Last edit by live4today on Feb 8, '02

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team nursing