Do you like team nursing?

  1. i'm still a student (one semester to go), but there are hospitals in my area w/ & w/out team nursing. should i stay away from the ones w/ team nursing?...opinions?....the good & the bad?
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  2. 37 Comments

  3. by   jonear2
    what is team nursing?
  4. by   RN1263
    Quote from jonear2
    what is team nursing?
    to my understanding.... 1 cna, 1 rn, & 1 lpn have 12 pts. and the work is split up.
    example:
    cna- bed baths, bgm, vitals, ect.
    lpn- p.o. meds, dressing changes, ect.
    rn- assessments, iv's, nursing notes, ect.

    so, the pt. doesn't have a "primary" nurse......sounds messed up to me & that's why i wanted some opinions on how people do it and keep 12 pts. straight & so forth.
    i think it's unfair to the rn's who are ultimately responsible, since they have to sign off on procedures that they can't possibly know if they were done or not (by the lpn & cna)????
  5. by   ZASHAGALKA
    I detest team nursing. I would not work in a team nursing model.

    One of the greatest benefits of nursing is that my shift is MY shift. It is autonomy of professional action. Team nursing trades that for staffing solutions for the hospital. It's not about what benefits nursing, but what benefits staffing.

    I spend way too much time verifying what others in the 'team' are doing, both to ensure that it is done, and to prevent replication of effort.

    It's not a nursing friendly model. It's an administration friendly model. I give far too many concessions to administration already.

    When it comes to MY patients, LEAVE ME ALONE, and let me take care of them. If you don't trust me to do JUST THAT, then you hired the wrong person, in the first place.

    ~faith,
    Timothy.
    Last edit by ZASHAGALKA on Oct 5, '06
  6. by   RN1263
    timothy,
    thanks for your reply.....
    i don't see how anyone could like it???? but, several hospitals in my area are doing this now....
    guess i'll be trying to get a job at the few that don't have it, because i don't think i'd like it. not that i'm not a team player, but for the reason you stated about having to "verify" what others have or have not done. seems like it would be VERY frustrating!
  7. by   jonear2
    Oooh, no I dont think I would like that. Sucha large group of patients to be responsible for. Timothy is right, thats all administration. But it would be interesting to hear from anyone who likes it, if there IS such a person.
  8. by   Daytonite
    You need to find out how each place defines "team nursing". When I was in nursing school in 1973 team nursing was more of a thing where functions were delegated out to team members. We had a charge nurse who's job was to be at the nurses station, take and note orders off the charts and communicate them to the RN team leaders and make rounds with the doctors. The RN team leaders had a group of patients over which they were in charge and were making sure the overall plans of care were being carried out, perform initial patient assessments and to take care of IVs and IV medications. To help accomplish that, (s)he had an LVN to pass medications and a number of LVNs or nursing assistants to do direct patient care. LVNs could also carry out some of the treatments.

    I'm not sure what "team nursing" means today. I've worked in some places where it meant nothing more than we all worked together, but we each had our own patients to take care of and do everything for. Usually, that meant that the RN took the most critically ill or unstable patients, the LPNs were given patients less ill and nursing assistants got stable, easier patients to care for.

    Lately, I've seen nursing assistants being assigned groups of patients on which they were to do all the vital signs, baths and linen changes with the licensed staff assigned a group of patients on which they were to do IVs, meds and assessments.

    Ask.
  9. by   RN1263
    daytonite,
    thanks for your input, the team nursing i'm referring to is where the lpn's & rn's do not have a clear cut "this is your pt. & this is mine" out of 12 pts.
    when i did ask someone briefly they just said the tasks are split up between the cna, lpn, & rn, but no one has there "own" pt, so i "thought" that was what "team nursing" ment in general? i guess there are differents models of "team nursing".

    thanks
  10. by   littleroxy79
    we have team nursing at my hospital. for the most part, i work on a floor that is strictly RN. but sometimes we get pulled to another floor. the ideal is an RN, an LPN and a CNA. it depends on the census as far as the ratio goes. it could be anywhere from 8-14 patients. it does suck because you don't know half of what's going on with all of your patients. i don't like it because when you have to call a doc, you have to find the LPN and look at their meds. you do all of the assessments and charting as the RN, and some IV push meds. sometimes it's not so bad if you have a good team that works together. i have worked with a good team and a not so good. it's always a catch and miss. but for the most part, i like primary.
  11. by   CHATSDALE
    this was tried at a hospital i worked at..i was to take v/s when i gave meds
    this was a cardiac floor so many meds and v/s were tied so this was not unusual, the number were, i had 16 patients instead of the usual 7 or 8 i was ripped to pieces that morning....the other nurse was to check behind the ward clerk and do the charting
    the ward clerk was very experienced so the other nurse acted like she had the day off..by 2p i had finished the absolutely horrid day and she sat down to chart..i gave her some notes that i had made throughout the day and i went to conference room taped my report and counted narcs she was almost crying...I NEED HELP WITH THIS CHARTING to the head nurse

    head nurse was there all day and she knew what went on.the team nursing didn't last, gone in less than a week...tptb c/o that the nurses didn't give it a chance, i heard that the other floors had worse results
  12. by   RN1263
    yeh, one of the hospitals i was talking about has 17 rn job openings all for the same medical foor posted on their website ....17!!!! so, somethings not working right, it's not that large of a hospital to have that many openings on the same floor???......
  13. by   littleroxy79
    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
  14. by   ZASHAGALKA
    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.

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