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 patients or whatever they decide.
That will allow the Rn to have more time to teach and chart and assess. I am very concerned as it seems the old team nursing with a new name. Anyone currently practicing this way and how is it going?
Mar 8, '04
What I should have said was that we "teamed" in the purist sense for the first year that I worked there, 6 patients, one RN, one LPN and one aide because we had the staff to do so. The day shift still uses this approach. Unfortunately on nights, we just don't have the staff right now. We're running short constantly with 2 RNs gone, 1 RN out on Maternity leave and 2 LPNS gone. I'm on a med/surg unit with no tele. Our floor is split into "mods". 2 Mods have 6 patients and 2 have 7. Typically on nights I work we have 3 RNs, me and two aides. Two RN's will split covering me, 3 patients each. They do my IV med pushes, but we have very few on our floor. LPNs can hang IV bags. I do a complete assessment on each of my patients and all documentation. They come in a do a quick assessment of each patient and rely on me to tell them if any problems arise. I always go to them for help if it's something I'm unfamiliar with or unqualified to handle. I understand that I'm risking their license as well as mine because they're covering me and I'm very very careful. I can understand how this can be a tough spot for an RN to be in if they don't fully trust the LPN they are working with. I can see myself feeling the same way soon. All I know is it works for us on our night shift and none of the RNs have complained so far. We would love to have more staff, ofcourse, but we all do work very well together during crunch time. Maybe it's because the other LPN that works nights has 15+ years experience and they "trained me the way they want me" according to them. I consider myself extremely fortunate to work with such great, experienced RNs willing to "teach" me what they know.
I should add that of the two RNs we lost, one retired, one husband was transferred, and the LPN's; one moved across the country to be with his kids and the other is out on long term disability. We don't have many that leave because they aren't happy with conditions.
Last edit by theblondeone on Mar 8, '04