changing to team nursing

lisa122 · Oct 12, 2004

Anyone have any helpful hints for team nursing. Our hospital is now changing to team nursing and we are having a difficult time adjusting. How many patients has anyone had on one team as well as how many nurses. We have tried two nurses for 10-11 patients and it is hard for both nurses to chart on the same chart without having to make late enties, etc. Any help is appreciated!!

Farkinott, RN · Oct 13, 2004

Team nursing is an outdated practice form the 1950's. the left hand doesn't know that the right hand is doing! Protest!

BBFRN, BSN, PhD · Oct 13, 2004

Uggghhhh...I hated team nursing when I did it. I totally agree with Farkinott- it doesn't work very well, and most places have figured that out by now.

Quickbeam, BSN, RN · Oct 13, 2004

Everything old is new again. I can't believe team nursing is making a come back. My opinion? It really fragmented care.

allnurses Guide · Oct 13, 2004

Everything old is new again. I can't believe team nursing is making a come back. My opinion? It really fragmented care.

Yep, bad idea. Fragmented is the right word.

Just say no.

steph

EwwThat'sNasty · Oct 13, 2004

I thought all nurses on a shift were a team? Ohhh, I am such a babe in the woods...

What a nice concept though: "We really are a team..."

Seems to me though that it might work with some documentation modification. A computerized entry system will adjust vital signs, fitting in a late value, found hiding on a piece of tape... And properly graph it, fitting the value in neatly. Pain or nausea med follow up would be pretty easy if the system gave a verbal reminder, then the team, utilizing headset communication could deal with the "who's gonna get that." Oh, I forget...those aren't due out for five or so years...hmmm.

I wonder, is this a "save money" thing, or truly a "make it better quality thing?"

ERteleRN · Oct 13, 2004

The hospital I work in utilizes team nursing. We are supposed to run our floor with 3 RN's, 3 LPN's, and 3 aides. Each team has 10 patients (Many x's we have 2, 2, and 2 with 15 patients on each team). The RN's are responsible for assessing patients, charting, and certain IV medications. The LPN's are responsible for medications, and charting meds given. The aides are responsible for vitals, baths, etc. Ultimately the RN is responsible for EVERYTHING that is done, and is why you hope that you have a good LPN and aide on your team.

On the floors, we chart on computers and do not have problems with more than one nurse trying to chart at the same time. When we look at our charts to verify orders, I usually start at one end, and the LPN starts at another. The LPN is looking for medications, and the RN checks it all. That's how we do things, and it seems to work out fairly well.

Sadie04 · Oct 13, 2004

I agree with most posts, team nursing doesn't work. I just spent 2 years on a unit that used this staffing model and it was very difficult to stay organized.

NYCRN16 · Oct 13, 2004

We do team nursing in my ER, but we do it somewhat differently from what I am reading here. It breaks down like this:

There are 2 teams: 3 nurses start at 7 am, another comes in at 11 am. At 7 pm, 3 nurses relieve the 7 am nurses, and at 11 pm that nurse divides up her patients to the 3 7pm nurses. Each nurse on the teams has her own assignment of patients, and the only thing that really makes it a "team" as far as nursing is concerned, is that we are responsible for covering for our teammate while we are on break, or we are supposed to help each other out when one gets busy. Not all teammates are created equally as you might imagine, and you not always get the help you need from your teammates. We divide our patients up at the beginning of the shift in order to even out the # we each have, but after that you can wind up having like 12 patients and your teammates can have like 4 :angryfire

ERteleRN · Oct 13, 2004

We do team nursing in my ER, but we do it somewhat differently from what I am reading here. It breaks down like this:
There are 2 teams: 3 nurses start at 7 am, another comes in at 11 am. At 7 pm, 3 nurses relieve the 7 am nurses, and at 11 pm that nurse divides up her patients to the 3 7pm nurses. Each nurse on the teams has her own assignment of patients, and the only thing that really makes it a "team" as far as nursing is concerned, is that we are responsible for covering for our teammate while we are on break, or we are supposed to help each other out when one gets busy. Not all teammates are created equally as you might imagine, and you not always get the help you need from your teammates. We divide our patients up at the beginning of the shift in order to even out the # we each have, but after that you can wind up having like 12 patients and your teammates can have like 4 :angryfire

I don't see how you can have 'team nursing' in the ER. We start out with about 3 nurses at 7A, then we have a couple of 9A/11A/1P (12 hour shifts). At 7p we have 4-5 nurses that come in to relieve the 7A nurses for the rest of the night. We all take orders as the doctor writes them (it doesn't matter who triaged or assessed the patient first). Sometimes the nurse that initially took care of the patient never lays eye on that patient again. We try to keep things moving. And that way, no one really has "more" patients than anyone else. We are "all" taking care of that patient. (Although every place you go you will have one or two that like to 'socialize' instead of work)

lisa122 · Oct 13, 2004

Thanks for all your thoughts, sounds like computer charting might help, i doubt the hospital will spring for that any time soon. It is very frustrating right now while we are going through the change, hopefully it all works out in the end for the patients' sake, as many of us are feeling like we have not been able to give the best care in a team nursing setting and have stayed over trying to complete charting on 11 or 12 patients. We'll see how it goes!