Do you like team nursing?

Bleecckk!
I have a PRN job at a facility that does the RN/LPN/CNA bit. I despise it. My main job is great for the fact that I am the nurse that cares for the team. I have a CNA or Tech with me and we do what needs to be done. I do my assessments. rounds with Drs meds and ALL of it. Thus I know what is going on without having to get it second hand. Someone elses " IV patent and unremarkable" may be my "need to d/c due to increased inflammation and decreased blood flow to distal extremity. " This IV was in a pt foot. Toes were literally white, no cap refill, no pulse present and above the ankle, the leg was RED and HOT. Every other body part was fine and other leg was normal! I'm glad I do my own assessments, even though there the RN is who really does them. No other contact than the initial one and IVPs but they are responsible for all charting and rounds? Whatever! If I'm competent enought to take care of 7 pt on my own at one place, I shouldn't be just a med-tech at the other!

it depends on the area where you are working.with me, i work is psychiatric nursing and i believe team nursing works for us.when i worked in er, we did team nursing although sometimes if the cna's are very busy, we just do some of their work like vital signs,collecting specimen,etc. in telemetry, we used primary nursing and i believe it works better than team nursing.

I love team nursing. I'm an EEN (I think that's an LPN overseas) and I really enjoy working with an RN throughout my shift. There are no 'set' jobs that we each have to do - we plan our shift and help each other out with whatever is needed. It also means that if a particular patient requires monitoring (ie for chest pain etc), or if a patient needs to be taken to surgery, the other patient's aren't without a nurse.

My hospital just switched to team nursing, as much as i thought i would hate it I love it. The team leader (RN 1) assess and charts, RN 2- pass meds, admits, and d/c, CNA does her thing. We have a wound team to change all dressings. The ivs are started by whoever has time. Each team gets 13 patients

Team nursing is the only thing I've done but I like it. I have the suspicion that if our hospital went to primary nursing, they would routinely saddle us with 10 patients each. On average, an RN-LPN team has 15 pts. One team can have up to 17 though. If census is low, they will cut an LPN or move her ER. This leaves one LPN for 18-23 pts. The RNs split those. So if i have 20 patients, each RN has 10 of those. It's overwhelming to be responsible for all meds except IV, dressing, accuchecks, tube feedings, checking orders, checking the night work. Then sometimes you have to call the docs. The aides are usually busy turning so I have to interrupt my med pass to take people to the bathroom. Thankfully, the RNs do help or else I would quit ASAP. Usually the RN will ask what you need or she will say what she will do to help. I think a lot of times, they don't really understand why it is so overwhelming but at least they do try to lighten the load. I look forward to getting to sit and chart. Luckily we don't have that many pts too often. It's nice to have a partner to help each other out. The RNs are usually done with their med pass before the LPNs and free to start opening charts. We don't keep track of who does more charts because there are times when one person opens more than the other then it may be different the next time. We do what we can. We are all busy and just get it done instead of worrying who did what. As long as it gets done. There's not much than LPNs can't do at our hospital, so we can help out a pretty good bit as time allows.

Right now I work on a "modified team nursing" unit. Each nurse, both LVN and RN have 5-6 pts on day shift. We work primary care for those pts and the RN's are there as a "resource" for the LVN's. Care plans, hang blood etc. The only thing that LVN's can't do in the hospital is those things outside the BNE scope and admission assessments. So the "team nursing" concept works, just in a different way.

I'm an EN, on my way to EEN.
I'd give the thumbs up to team nursing any day.

Levin.

I couldn't agree more. The only hospital that uses team nursing in my area is the hospital that can't keep RN's. Their pay is the lowest, the patient care is poor, everything they do is to maximize profit for the owner at the expense of everything else. It's basically the worst place to work bar none. And, of course, hiring LVN's is cheaper for them than paying RN's better wages.

In California you either get five patients or 10 with an LVN. I have nothing against LVN's but ... if you can't choose the LVN you work with (which you can't in most cases) and get stuck with a slacker then ... I'd rather just have my five patients.

I have mixed feelings about team nursing. I've been working for 1.5 years on a med/surg/tele unit that has team nursing. On my unit we have three teams, with each team of one RN, one LPN, and one nursing assistant taking up to 11 patients. Here is how we do it: the RN and LPN split the patients into two groups, the RN takes half the patients, and the LPN takes the other half. Each RN and each LPN assesses his/her own patients, does all the meds, treatments, etc. The only exception is the LPN cannot push IV meds, can't hang blood, can't touch PICCs or TLCs or portacaths, can't hang TPN, and cannot do the initial assessment of a new patient admitted from the ER. So the RNs have to do all these extra things on the LPN's patients. Some of the time, the LPNs I work with (I'm an RN) are good about saying "well since you are doing the IV pushes on Mr. Smith for me, let me do the po meds for you on your pt. Ms. Jones. " At least on my 3-11 shift, I feel like the LPNs and RNs really do work well as a team, we pretty much get along fine with each other, and help each other out when it gets nutty. The nursing assistant does ADLs, VS, along with the nurses who also have time to help out with these. So really, I feel like it just depends on who you are working with, and how you all get along...hopefully people aren't taking advantage of others. That being said, it can still get very stressful on my unit if one of the 11 patients we have is getting critically ill,is having CP, if they have a lot of issues, etc...I feel like lately, every patient has so many meds, so many treatments constantly that it's beginning to feel like critical care on our med/surg unit! I suppose that is typical med-surg for you.

I am a new LVN (9 months now) work in med surg in team nursing, RN, LVN, Nurse Tech. I have 11 to 14 patients and it is scary and overwhelming. I may work with two or three RNs with that 11 - 14 patients, but they are so ill like someone else said it is hard to monitor that many even on team nursing. If all three of you truly work as a team it is easier, but you don't always have that. I just want to know when I am going to start feeling like I know what I'm doing!!! Help!!! I'm still scared to start IVs, do things I haven't done and make decisions. How long does it take to feel comfortable? I do not sleep the night before I go to work as I am so stressed out. I am also finishing my pre-reqs to go into the LVN to RN bridge program. Any advice would help. Thanks.