Originally posted by Rapheal
I will give you my opinion as an RN. If you want this to work and do not want to have alot or errors you will need to supply an adaquate amount of aides and have the floor well stocked with supplies. Is the RN also responsible for all the next days med sheets? Do you have an IV team or is the RN responsible for starting all IV's? Does lab do the blood draws? Many times an RN will come in and be faced with IV's that are no longer patent, new admits, and panic labs. To do the job effectively the RN will need all the support that is available. Does the LPN look at the care plan and treatments? Will they have to be told who needs PAS stockings and whose stools need to be hemmocculted?
How is the leadership of the unit? Does the RN and LPN know their responsibilites? Does the RN get support when delegating responsibilities ?. Team nursing is ineffective on my unit. Many errors are made because of the lack of support staff and ineffective leadership. Also there were and are financial problems. Many nurses left, many bullies stayed. There is also an abuse of informational power.
Another hard question is how does your hospital guage success? If it is on patient satisfaction and lack of errors then you will know in a short time if team nursing for your unit is successful. If the success is measured in dollars saved then the results will be very subjective. Good luck on this approach. I hope it works for your unit.
In my hospital, we do not have any aids--it is a dream that we all wish was in the budget, we alas, its reality. We find that 4-5 pts each between RN and RPN is adequate. We are always fully supplied. The night shift nurses are responsible for next days med re-orders and safety checks, however, the day and evening shift nurses are to make sure to send empty med bottles and narcotics to pharmacy for the next day. The RN is responsible for starting and maintaining all IV's, however, lab draws and sends all blood for tests. The RPN does look at the care plan--at our hospital, the RN and RPN take report together side by side, and the RPN does all treatments for her own patients that are within his/her scope of practice--that includes dressings, TED stockings, and hemmocculted stools, Midstreams, etc.
There is one "group leader" who stays at the nurses station and keeps track of all the Dr's visits, new orders, and outpatient appointments.
We have a discharge nurse who plans and sets up home care, prepares teaching for follow-up appointments, and gets in touch with the admitting and family Dr re: new meds for at home. They also set up possible placements in long term care facilities.
We guage success on patient satisfaction, and how quickly (or long) the patients hospital stay is. Our patients are well cared for, and are treated prompty, and with care.
Team nursing is the best way to go. It is efficient, time saving, and all tasks between RN and RPN are equal with the only exceptions being IV's, telemetry, Central lines, etc. The RN and RPN work together
as a team
to accomplish optimal patient care. We share the care plan, and discuss each patients care together. This, I still believe, is the BEST way to nurse.
if you want the rainbow, you have to put up with the rain