changing to team nursing

skay · Oct 14, 2004

our medical unit recently went to team nursing from primary nursing. the unit has mostly rn staff. staffing for the day shift is usually 4 rn, 1 lpn, 2 aides. but some days may have 3 rn 2lpn 2 aides or 4 rn 1 lpn 2 aides or 5 rn 1 aide or 2rn 2 lpn 2 aides etc. need suggestions how to make team nursing work with this blend of staff. the lpn nor rn feel they should function as aide. the rn feels she is doing too many assessments, most of the rns have problems delegating,they prefer to do it themselves. the unit is a very busy unit. teams with 2 liscence and aide have had 13 patients with discharges and admissions. any suggestions to make this work better? any suggestions re. assigning patients with the combination of staff as suggested above ?

skay · Oct 14, 2004

Lisa122 Is There Always A Rn, Lpn, Aide On The Teams? What Kind Of Unit Do You Work On? Before Team Nursing How Were You Providing Patient Care? Why Did Your Facility Change To Team Nursing

ERteleRN · Oct 14, 2004

skay,

On our unit, we occasionally have a bridge nurse that does our admissions and discharges during the day shift. Also, before the shift starts, we assign the position of RN (assessments, charting, etc) and med nurse (whether it is an LPN or RN). We have a very busy, 30 bed, acute, cardiac/med-surg unit and this seems to work well and organized most of the time (just wish we had a bridge nurse for 7P-7A shift as well).

skay · Oct 14, 2004

ERteleRN what are your staffing ratios? do you have aides? thanks for responding.

Hairstylingnurse · Oct 14, 2004

Hi guy's, I just wanted to say that I had an absolutely wonderful experience with team nursing on a very busy surgical med surg floor at a hopital in Nashville, Tn. Our set up is very similar to erteleRN (hope I spelled that right). We did have computer charting in every pts. room. It was soooooo awesome. We definantly didn't have much if any free time. But that was one of my best experiences as a nurse. This hospital must have been exceptional after hearing what team nursing is like for most nurses. We didn't always have an aide on our team so in that situation the team with the aide or cna would get 1-3 more pts. than the team without an aide. I live in another state or I'd proably still be there.:) But let me say it was still very rushed and stressful. I haven't found much yet (in nursing) that isn't that stressful, but I love it. I can tell you that our 12 hr. shift (7a-7p or vice versa). flew by everyday.

explorer · Oct 14, 2004

Hi guy's, I just wanted to say that I had an absolutely wonderful experience with team nursing on a very busy surgical med surg floor at a hopital in Nashville, Tn. Our set up is very similar to erteleRN (hope I spelled that right). We did have computer charting in every pts. room. It was soooooo awesome. We definantly didn't have much if any free time. But that was one of my best experiences as a nurse. This hospital must have been exceptional after hearing what team nursing is like for most nurses. We didn't always have an aide on our team so in that situation the team with the aide or cna would get 1-3 more pts. than the team without an aide. I live in another state or I'd proably still be there.:) But let me say it was still very rushed and stressful. I haven't found much yet (in nursing) that isn't that stressful, but I love it. I can tell you that our 12 hr. shift (7a-7p or vice versa). flew by everyday.

One of the ways that this can be accomplised is by using the computer. You can use it for your charting, medications, order and look up labs, order medications(when a medication is ordered it automatically shows up in the pharmacy and then your medication program after the pharmacy has finished with the order.) The possibilities are only limited by the imagination of your mind.

Town & Country · Oct 14, 2004

Personally I prefer Team Nursing.

When they say "Primary" nursing or "Modified Primary", what that means (around here), is that they are too cheap to pay for LPNs to do PO meds, and happily turn it over to the RN, thus adding even more work to her ever-burgeoning roster.

Give me team nursing anyday..........

ERteleRN · Oct 14, 2004

ERteleRN what are your staffing ratios? do you have aides? thanks for responding.

On our 30 bed unit, we usually had 3 teams. 3 RN's, 3 LPN's, and 3 aides. We would take 10 patients each. However, on 7P-7A, it was not uncommon to have 2 RN's, 2 LPN's, and 2 aides and end up with 15 patients on each team.

I think that we all work well as a team on our unit. When I'm caught up, or see one of my peers drowning, I do what I can to assist. I pass meds, answer call lights, give baths, etc. When the other team is caught up in a code situation or something like that, then my team helps take care of their patients as well. One thing that we don't say on our floor is "That's not my patient," and be unwilling to help. The 30 patients are all of our patients theoretically, and we are all there to help them.

Hairstylingnurse · Oct 14, 2004

One of the ways that this can be accomplised is by using the computer. You can use it for your charting, medications, order and look up labs, order medications(when a medication is ordered it automatically shows up in the pharmacy and then your medication program after the pharmacy has finished with the order.) The possibilities are only limited by the imagination of your mind.

Hi again, I just wanred to say that yes the computers are absolutely heavenly but we didn'thave such a good system that it dealt with medications and pharmacy. Our system was older called medi-tech and it was 3 years ago. But your right it was a wonderful thing to have. And you can look up labs(like u said) and document on the pt. right there as you were doing procedures and assessements on them. I really do miss it.

ERteleRN · Oct 14, 2004

Hi again, I just wanred to say that yes the computers are absolutely heavenly but we didn'thave such a good system that it dealt with medications and pharmacy. Our system was older called medi-tech and it was 3 years ago. But your right it was a wonderful thing to have. And you can look up labs(like u said) and document on the pt. right there as you were doing procedures and assessements on them. I really do miss it.

Our computerized system is wonderful as well. Being able to sit in front of the screen and seeing the whole story behind the patient, i.e. labs, medications, orders, procedures, x-rays, medical transcriptions from this admission and for some patients...the numerous other admissions and complaints at those times. The only question I would pose is how do others feel about 'charting by exception'?? All of our floor units utilize this, but in the ER, we still write every single bit of info on our RADD sheets (boy, talk about hand cramps!).

jannecdote · Oct 14, 2004

Team nursing sucks if the people on your team are lazy and you have to pick up the slack.

I did it once 10 years ago. The RN was unit coordinator and stayed at the desk, made us aware of new orders, made rounds with the docs. Usually had 10 or 11 patients. Even though I'm an LPN, I was usually team leader, other LPN passed meds, and a CNA. I assessed the patients and the RN would come behind and sign after me.

I worked my tail end off. The LPN would pass meds and nothing else. I would be starting foleys, IV's, address changes in patient's status, assist patient's on the bedpan when the CNA was busy elsewhere, etc. Responsible for all the charting and signing off new orders, making sure they were all carried out. Busy med/surg floor.

It was a horrible experience and I wouldn't wish it on anybody. As far as co-workers go, it's like a box of chocolates. You never know who you're gonna get.

renerian, BSN, RN · Oct 14, 2004

Yes it is amazing isn't it how things come around and around.

renerian :rotfl: