Team Nursing

Nurses Safety

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I am the Educational Coordinator for a 44 bed Orthopedic-Neurological unit that has been primary nursing for several years. All of our med-surg. units are changing our focus of care to team nursing. Several of our nurses have expressed concerns with this new approach. Since we have a blend of 12 & 8 hour personel, our team will consist of a 12 hour RN who will be doing majority of the assessments and the 2nd RN or LPN (an 8 hour worker) will be assisting with meds, treatments, assessments and assisting the nursing assistant with baths. Althought all on the team will be assisting each other with all aspects of care. Some of the 8 hour nurses who will tend to be that 2nd Nurse on the team, have expressed some concerns that now they will be the runner and gopher. I am developing a bullentin board to help encourage team work, and would love to post some comments from other nurses who have had the expereince with team nursing. Does anyone have anyone have any comments-pro or con?

:balloons: Thank you!!!

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Specializes in ER.

I work ER so my experience may not be relevant to what you are talking about, but here goes....I have been a nurse a long time, and in the ER you are the primary nurse, who is responsible for everything regardless of who does the care. With that in mind....I would love the opportunity to be a "procedure nurse", if there were such a thing. I would love to start all the IV's, put in the foley's and NG tubes, flush the central lines and feeding tubes, do the wound care, etc..in exchange for not having to take responsibility for the chart and the patient as a whole. What freedom that would be!! So, if I were the "2nd nurse on the team", I think it would be great! Just send me to do something, I will do it with a smile on my face. I don't need to have a "territory", just let me do my thing and go home!!

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Specializes in Critical Care,Recovery, ED.

All told I think this is a lousy idea. You are creating two levels of responsibilities and not based on competency and licsense but rather on who can work the longer shift, 8 vs 12. It is not "team nursing" in the historic sense but rather giving one RN all the resonsibilities and professional stature and another to a lower level.

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Being the second nurse on the team sounds good to me too! I would have no problem being a runner and gopher!

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Consider alternating the teamleader role between the 8 hr nurse and the 12 hr nurse, OR ask for volunteers ie who wishes to be the lead vs the assisting or adjunct RN. If you have a RN working 'under' the other, this perception may be irksome.

I worked in true team nursing for years and there was a RN, 1 or 2 LPN's and a CNA for each team of 13-16 patients.(back in the 70's) We had as policy standard responsibilities and job descriptions for all roles and this helped tremendously. We also had policies for contingency plans when census dropped, if we had more CNA's than LPN's or vice versa, etc...and how we split things up on the unit when that happened. This helped prevent bickering; we had a plan and we were expected to use it.

You are just starting so there will be resistance...but if you can form a committee to study the best ways to define the roles and policies this will help.

The recipe for successful team nursing begins like all good recipes...with the right ingredients. Good people who will work together will get the job done. A nurse manager in my last facility tried to integrate a team/functional model to the unit, the staff refused to 'buy into' it, and it failed miserably, unfortunately. I thought that was sad because it CAN work well.

Good luck to you. :)

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