Do you like team nursing?

team nursing does suck, but i don't think it's all that bad. maybe i'm just used to it. we don't tape report anymore but use kardex's. we also get the vitals and give them to the LPN and she gives all the meds and does dressings, etc. if a problem arises, she comes to you. maybe i'm just used to doing it. but i keep lots of notes on my patients

It's not a LVN vs. RN thing for me, but rather, one of autonomy. I just want to be free to do MY job.

The few times I've floated into a team nursing system, I normally strike a deal with the LVN that she take half of the patients, and I take half and we both work in a 'primary care' model. And yes, I know that requires some work to ensure that a proper 'delegation' model is met. But, THAT work is easier than working 12 hrs and always feeling like my patients aren't really MY patients.

Most times, the LVNs I've worked with jump at the chance to take a break from team nursing and work a 'primary care' shift.

That's officially frowned upon, of course. But, you can get away with it when you are just floating into it for a shift, and it's not your 'home unit' situation.

Team nursing is designed to solve staffing problems, not to empower nurses. As a rule, if a unit moves to team nursing, it is a hallmark sign that staffing is at issue and, more likely than not, THAT is a key evaluation of management.

Run, don't walk, to the exits. There's a REASON why there are 17 staff openings in such a model. It's an indication of much deeper problems.

~faith,
Timothy.

Eek - I worked at a hospital that went to Team Nursing. They went bananas on the day shift. On nights, we pretty much split up our team and the RN and LPN were "primary" to "their" patients.

Things I didn't like:
1: Having to do all the assessments - I felt I didn't have enough time to really, thoroughly go over my patients and know them well.

2: Sad but true, there ARE nurses out there that get by doing the least they have to - if one of those nurses is your "team mate" you either let it go, or (me) feel that I have to ride herd to make sure MY standard of care was met, since I was responsible. And then they get mad at you, no matter how diplomatically you try to couch your requests.

3: related to #2, I felt I had to check behind everything to see it was done, and done right. Sure, I had some LPNs I knew well and trusted, in those cases, I could relax a little in the knowledge that this nurse always did a good job.

Incidently, at this hospital (where I no longer work), team nursing lasted about a year - that was all.

Where I am now, there is one "zone" which is usually teamed - and the same, very same, problems crop up. HATE it - if my new hospital went completely to team nursing, I'd quit in a heart beat. Give me my OWN patients, that I can care for, know well and bond with, and I'm happy. Please don't make me have to check over others' stuff just cause it's on me if they don't do things that're supposed to be done.

Bah sorry - can you tell I had a rough time recently, related to a team-nursing situation?

In my hospital, med surg floors have 1 RN and 1 LPN for 5-6 pt team. RN does assessments and vitals and dressing changes, LPN does all meds, IVs and I & Os. It works out good on my floor, as long as you don't get stuck with a slacker. They stopped hiring CNAs, and are replacing them with LPNs. We have a capacity for 24 on each of the floors and usually not totally full, and there are usually 4 teams, unless census really drops.

There are a few floors at my hospital that do team nursing. I have never floated there but I think it is ridiculous. To have to float an LPN, RN or PCNA from our floor to their floor even though they have enough staff to run but they don't have 1rn to 1lpn to 1pcna is so stupid. I agree "I" want to care for "my" pts. Not rely on somebody else to maybe tell me something valuable that I need to know. If they forget to tell you then you're still held responsible.

I like the Nurse/CNA team, because that's two people taking care of the patients. We used to have that were we worked, but recently to save money the increased the CNA workload, so we now have to share the tech with other nurses. Still that's better than being totally on my own.

I haven't really worked with the RN/LPN/CNA team but when you start adding more people into the mix you run into the problem of not everyone pulling equal weight, and resentment breeds. Also you run into the LPN/RN dynamics when you have a new grad RN trying to run a team that includes an LPN whose been doing it for 30 years. I can see it working if there are specific roles (like stated above the RN assesses, etc.)............AND people work together for the good of the patient, rather than worrying about what the other one is doing.

Here, we just ignore the nurse practice act and let the LPNs on their own assignment without direct RN supervision, with an RN on paper beside their name.

That's a very excellent ratio. I think I could manage that.

that's a good ratio, with 10 patients though it's a different thing, and team is much harder than primary

Our hospital does mostly team nursing on all the floors except the critical care areas. I love it.

Our floor is one of the heaviest in the building and we have 8 patients with 1 RN and 1 LPN and the floor has a float LPN and float care aide. The RN and LPN work together to get care and assessments done. The RN usually does all the meds, but the LPN will jump in and help if the RN gets behind due to a sicker patient etc. We really work together as a team to get the work done and I have never worked with someone who didn't pull their weight.

Having never worked anywhere where there was primary nursing I have never understood how it worked. Where do you get help to turn or feed patients as you can not be in 4 places at once? Sometimes not safe to ambulate or even reposition the patient in bed with out a second person. Do you have float LPNs or aides to grab or do you have to pull someone from their 4 patients to help you?