team leader model

[renerian, BSN, RN]

Good day everyone! I am curious how many agencies have a structure that includes a DON and clinical team leaders based on the specialty of each particular team?

Do you think it is a good structure? If so what do you think at your agency are the pros and cons?

renerian

[hoolahan, ASN, RN]

We used to have Team Leaders, but it wasn't based on specialty, it was based opn geographical territory. Now they changed it to be Acute and Chronic teams, so all the long-term foley changes, SPT and GT changes, are all on one team, while fresh post-ops are acute.

I don't think the acute/chronic is efficient, basically because you are sending two nurses to the same senior building for 2 patients, and it would have been more cost effective to sen one nurse. Now 2 nurses have higher mileage. Also, it discourages the nurses to manitain a braod range of skills, so when that one weekend comes up, and someone gets a fresh trach, they have no idea what to do for the patient.

I always get those trach patients, sometimes the second visit is a nightmare because the first nurse didn't realize that even though the pt was on room air, the trach needed humidity. His trach was almost completely occluded with a cement-like secretions. Do you know how hard it is to get md's to order these things and DME to get it out on a weekend?? What a disaster!!

Anyway, once you start specializing, you paint yourself into a corner when the nurses no longer feel comfortable doing this or that because they haven't done it in so long. If you have geographical teams, you can have one wound nurse, one cardiac nurse and a blend of skills evenly divided on each team, but that still keeps some out of practice.

I liked out team approach, but team leaders had lower productivity, 4 vs a day, so when staffing got crunched, that position was eliminated so they could take more pt's. Now a computer does scheduling, and it isn't one bit more efficient, in fact, I think it's worse. That was when I left case management, when the autonomy and control of scheduling my caseload left my hands and went to a computer!

[renerian, BSN, RN]

Thanks for your input. Our team leaders do not have a productivity quota. They are in the office unless someone cannot be staffed. They process paperwork, take calls, triage so to speak.

renerian

[renerian, BSN, RN]

Thanks for your input. Our team leaders do not have a productivity quota. They are in the office unless someone cannot be staffed. They process paperwork, take calls, triage so to speak.

renerian