Decentralized Nursing Units

[Celo]

My new unit is now has decentralized nursing stations, which means we have about 4 different desk areas around the unit outside of our patient rooms. We think this is great for direct patient care but it does have it's draw backs. For instance, if you need help with a patient you are less likely to find someone in the hall to help you. There also less chances to sit with your co-workers and bounce ideas around. The point of this post is to gather information about what people feel are the benefits and drawbacks of decentralized nursing units AND what have you or your units done to address those issues. I would really appreciate any feedback. Thanks so much!

[Mike A. Fungin RN]

I don't know. Our ICU is going to be switching from a centralized to a decentralized floorplan next year when we move to a new building. My thoughts run parallel to yours. I think it'll be great for patient care (particularly in providing more isolation/quiet for our brain injured patients) but worry there will be less teamwork. I'm interested to say what others who have already experienced this have to say.

[ChristineN, BSN, RN]

My floor just went to decentralized nursing unit a few months ago. While it's nice to be closer the the pt's and keep a closer eye on them, there are times where it does seem harder to find another nurse. I feel they do try to address this problem by having us all carry portable phones.

[Up2nogood RN, RN]

We are decentralized and the pts love the quietness of our unit. We depend and use voceras A LOT. I think our teamwork is better than the centralized units with definitely less pt falls. We still have the main desk where the charge sits and we congregate there during down time, not necessarily at the same time though.

[onetiredmomma]

Quite frankly, I really like decentralized stations. The further away fromthe chaos at the main desk the better!! We use cell phones to call each other for help. The draw back is having to go to the main desk for charts to check new orders, to access the tube system, etc.

[HouTx, BSN, MSN, EdD]

Decentralized seems to be much better received by patients & their families. They like having the nurse closer & not having to pentrate the 'hive' of a central station to get attention or help. Are they delivering supplies to each 'hub' or do you still have to do the same amount of hunting & gathering?

Did your unit practices change at all to accomodate this shift without impacting communication? For instance - having regularly scheduled 'huddles' a couple of times each shift designed to bring everyone together & see if anyone needs additional help.

[Penelope_Pitstop, BSN, RN]

I think it's six of one, half a dozen of the other.

My old floor was centralized, and we did all work together. Also, I felt like I could go sit at the desk and have some space...rather than family members breathing down my neck at all times. But...you know, if a patient falls and there's a centralized nursing station, most likely no one is going to hear it.

What I like about the decentralized stations is that I do have my own work space. This is MY desk, MY computer, MY phone. Of course, since no one else needs to use my stuff, I may get forgotten about by other nurses. And it's harder on the techs because they have to be several places at once.