Team Nursing, Does it work??? - page 4

My hospital wants to go to outcome based nursing called Bold Steps. You see the abbreviation? It is based on a Racine, WI. hospital and it is essentially team nursing with an aide or an Lpn with 6... Read More

  1. by   missmercy
    Yaddadoit,
    Thanks for your candid input! I am really steamed about how you were treated. :angryfire That is just WRONG!!!!! That is what I am afraid of in our situation -- if administration tries to "force the issue" won't that set the table for some resentment and feuds?! I think so. However, since the management is so determined to do this, I am going to be sure that I try to establish clear guidelines for our LPNs and Aides. (and the RNs for that matter) I am studying the OH nurse practice act for guidelines. Hope that will help to eliminate some of that nitpicky, nastiness!!!
  2. by   yaddadoit
    It sounds like your team is already off to a great start!

    The unit that I had my bad experience on was one of the last to incorporate the team philosophy... obviously kicking and screaming the whole way. Wish I would have known beforehand and I never would have accepted that position!! However, within the same hospital, there are several units which are utilizing team nursing and the teams are thriving. I had the opportunity to float and loved it! All of the team members seem to be enjoying it. One of the nice things this hospital has done on the units where team nursing is working is adjust the team/patient ratio accordingly. Originally, when primary nursing was being done, the RN might be responsible for 5 to 6 patients, however, when the team with 3 members are given assignments, the team might be assigned 7 to 9 patients. With 3 teammembers 9 patients is not so overwhelming, however, with one primary nurse, 6 patients certainly can be. I also observed that depending on the teams, sometimes the RN's chose to continue with primary care for specific patients while assigning their LPNs to provide primary care for other patients with the CNA's helping where needed. Other teams did tend to become task oriented, ie, LPNs doing med passes and treatments, CNA's doing bed baths, etc. One of the RN's I worked with told me that she varies the team assignment based on the skills and knowledge level of her team members as well as the individual needs of the patients. I did find that the expectations were clear and that there was mutual respect between the team members-- I think those are two of the biggest factors to being successful with team nursing.

    I wish you luck and success with your teams.
  3. by   JWaldron
    Quote from 3rdShiftGuy
    We tried it. The main problem we had was the team didn't buy into it. There was massive uncooperative and closedmindedness by the staff.

    The other problem was the RNs were so green compared to the LPNs. Taking a new grad from nursing school and putting him/her in charge of a team was very intimidating to the new grad, and frustrating for the LPN who had to carry a bigger load (with some resenstment).

    We are not doing it anymore, as we seem to like the single nurse-single assignment, with CNAs on the floor way of doing things.

    Good luck. Keep an open mind. It only works with a spirit of team work.
    When I finished nursing school, I got a job as a float (tough way to develop your clinical skills, but what experience!) mostly to units were staffed, 1 RN, 1 LPN and maybe 1 NA, for 16 pts. One floor, the RN and the LPN each 'took' 8 pts, but of course the RN has to assess the LPN's pt's, do the pushes, central lines, certain IVs (at our facility at least). NAs do not do FS, caths, or anything like that. No IV teams, no transporters. On another unit *same hospital) the LPN was the med nurse, did dressings, etc, RN did all the paperwork, assessments, and of course the pushes, centrals, hung blood, and so on. Unit I'm on now, I have 8-9 pts, and usually a CNA. I feel like this is a vacation compared to before. I can do more pt. teaching, listen more, be present for pts in general more. Much better. But this is not really primary nursing either, because I may be on a different hall of the unit after every day off, or because the Charge needs to take the assignemtn I had the day before because it is nearer the main desk, or is lighter, so she can also carry out other responsibilites.

    Savvy

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