Do you like team nursing?

sweetielin · Dec 16, 2006

team nursing is the only thing i've done but i like it. i have the suspicion that if our hospital went to primary nursing, they would routinely saddle us with 10 patients each. on average, an rn-lpn team has 15 pts. one team can have up to 17 though. if census is low, they will cut an lpn or move her er. this leaves one lpn for 18-23 pts. the rns split those. so if i have 20 patients, each rn has 10 of those. it's overwhelming to be responsible for all meds except iv, dressing, accuchecks, tube feedings, checking orders, checking the night work. then sometimes you have to call the docs. the aides are usually busy turning so i have to interrupt my med pass to take people to the bathroom. thankfully, the rns do help or else i would quit asap. usually the rn will ask what you need or she will say what she will do to help. i think a lot of times, they don't really understand why it is so overwhelming but at least they do try to lighten the load. i look forward to getting to sit and chart. luckily we don't have that many pts too often. it's nice to have a partner to help each other out. the rns are usually done with their med pass before the lpns and free to start opening charts. we don't keep track of who does more charts because there are times when one person opens more than the other then it may be different the next time. we do what we can. we are all busy and just get it done instead of worrying who did what. as long as it gets done. there's not much than lpns can't do at our hospital, so we can help out a pretty good bit as time allows.

wmsclan · Dec 29, 2006

right now i work on a "modified team nursing" unit. each nurse, both lvn and rn have 5-6 pts on day shift. we work primary care for those pts and the rn's are there as a "resource" for the lvn's. care plans, hang blood etc. the only thing that lvn's can't do in the hospital is those things outside the bne scope and admission assessments. so the "team nursing" concept works, just in a different way.

Levin · Jan 1, 2007

I'm an EN, on my way to EEN.

I'd give the thumbs up to team nursing any day.

Levin.

Sheri257 · Jan 1, 2007

Team nursing is designed to solve staffing problems, not to empower nurses. As a rule, if a unit moves to team nursing, it is a hallmark sign that staffing is at issue and, more likely than not, THAT is a key evaluation of management.
Run, don't walk, to the exits. There's a REASON why there are 17 staff openings in such a model. It's an indication of much deeper problems.
~faith,
Timothy.

I couldn't agree more. The only hospital that uses team nursing in my area is the hospital that can't keep RN's. Their pay is the lowest, the patient care is poor, everything they do is to maximize profit for the owner at the expense of everything else. It's basically the worst place to work bar none. And, of course, hiring LVN's is cheaper for them than paying RN's better wages.

In California you either get five patients or 10 with an LVN. I have nothing against LVN's but ... if you can't choose the LVN you work with (which you can't in most cases) and get stuck with a slacker then ... I'd rather just have my five patients.

:typing

christvs, DNP, RN, NP · Jan 3, 2007

I have mixed feelings about team nursing. I've been working for 1.5 years on a med/surg/tele unit that has team nursing. On my unit we have three teams, with each team of one RN, one LPN, and one nursing assistant taking up to 11 patients. Here is how we do it: the RN and LPN split the patients into two groups, the RN takes half the patients, and the LPN takes the other half. Each RN and each LPN assesses his/her own patients, does all the meds, treatments, etc. The only exception is the LPN cannot push IV meds, can't hang blood, can't touch PICCs or TLCs or portacaths, can't hang TPN, and cannot do the initial assessment of a new patient admitted from the ER. So the RNs have to do all these extra things on the LPN's patients. Some of the time, the LPNs I work with (I'm an RN) are good about saying "well since you are doing the IV pushes on Mr. Smith for me, let me do the po meds for you on your pt. Ms. Jones. " At least on my 3-11 shift, I feel like the LPNs and RNs really do work well as a team, we pretty much get along fine with each other, and help each other out when it gets nutty. The nursing assistant does ADLs, VS, along with the nurses who also have time to help out with these. So really, I feel like it just depends on who you are working with, and how you all get along...hopefully people aren't taking advantage of others. That being said, it can still get very stressful on my unit if one of the 11 patients we have is getting critically ill,is having CP, if they have a lot of issues, etc...I feel like lately, every patient has so many meds, so many treatments constantly that it's beginning to feel like critical care on our med/surg unit! I suppose that is typical med-surg for you. :)

MimismomRN · Jan 19, 2007

I am a new LVN (9 months now) work in med surg in team nursing, RN, LVN, Nurse Tech. I have 11 to 14 patients and it is scary and overwhelming. I may work with two or three RNs with that 11 - 14 patients, but they are so ill like someone else said it is hard to monitor that many even on team nursing. If all three of you truly work as a team it is easier, but you don't always have that. I just want to know when I am going to start feeling like I know what I'm doing!!! Help!!! I'm still scared to start IVs, do things I haven't done and make decisions. How long does it take to feel comfortable? I do not sleep the night before I go to work as I am so stressed out. I am also finishing my pre-reqs to go into the LVN to RN bridge program. Any advice would help. Thanks.

U12beme · Jan 26, 2007

Im also a Student Looking into a Med/surg Position @ a large hospital in My area. They too have Team nursing, One RN, One LPN, One CNA. It sounds pretty cool to me.

Rn - assessments, charting, IVs, Pain Meds.

LPN - PO meds, Dressings, etc

CNA - Walks, turning, baths, Vitals

I have worked in a hp as an extern where there is primary care. I noticed the Nurses are more stressed. And often (very often) they may not have time to give the pt a good bath. Unlike were CNA can be there to do that. More med errors buy the RN, b/c of patient Distractions (running to get drinks, getting them up to the bathroom) Then you have the LPN that are primary nurses. So the RN has to pass her Pain meds plus hers. So Buy the end of the shift. RN has been running constently.

As though Team nursing, I feel it would be a lot better to plan time. Do your assessments, meds, check on the pts, Check on your team members. I just feel it's more benefical to the Pt. Makes them feel as thou ppl care for them, instead of just one person, who may come in the room 2 times...

AtlantaRN, RN · Feb 16, 2007

I don't like it...they have micromanaged my facility to the point, each nurse has 6 patients, one tech has a whole hall, up to 18 patients....they have just implemented a "bath team" consisting of 3 techs, they are supposed to have all the linens changed, and bed baths done by 12:30pm (shift starts at 7am)...but they are found to be in the clean linen room chatting instead of doing bedbaths... frankly we have too many folks with clipboards checking the computer charting and telling the nurses how to do their jobs, rather than helping!!! I NEVER call out and after today, I told the OHS "I don't care what you put down as the reason, but I WON;t be here tomorrow..."

One nurse had finally gotten off the floor to go get some food for lunch, her beeper went off....now she hadn't even OPENED her chick fil a lunch, didn't have the straw in her soda...BUT she set her food down IN the med room/nurses station...NO WHERE NEAR MEDS OR COMPUTERS...she was repremanded because "jCAHO is coming soon and we have to break bad habits." now she could have just let the patient WAIT for her pain meds, but she is a consciencious nurse, a damn good nurse---yet she is repremanded.

also, she got hurt on a 600 lb patient today also. lady on a bariatric bed, they ordered one of those KCL overlays for her, we used a hoyer lift, and there were 4 nurses in there, but lady wouldn't even help move her upper body...I noticed the nurse was walking asymetrically, limping...had her write it up just in case.

patients barking, management barking...today was just way too much.

thanks for listening...rant mode off.

linda

Wheaties · Mar 13, 2007

I couldn't agree more. The only hospital that uses team nursing in my area is the hospital that can't keep RN's. Their pay is the lowest, the patient care is poor, everything they do is to maximize profit for the owner at the expense of everything else. It's basically the worst place to work bar none. And, of course, hiring LVN's is cheaper for them than paying RN's better wages.
In California you either get five patients or 10 with an LVN. I have nothing against LVN's but ... if you can't choose the LVN you work with (which you can't in most cases) and get stuck with a slacker then ... I'd rather just have my five patients.
:typing

I totally agree.

In my area Team nursing is defined as RN with 5-6 patients, LVNs with 5-6 patients, and CNA. The RN and LVn assesses their own 5-6 patients. So as an RN I only have to assess my 5-6, but really the RN is responsible and ahs to know what's going on with the LVNs 5-6 patient ans well.

RN- IVs , initial assessments for new patients, and making sure everything is done, and all the responsibilities bestowed on the RN, which is the fact that they are responsible for everything.

LVN- PO, dressings, fingersticks, foleys, etc.

CNA- basic care of patients, turning, vitals, suctioning, emptying drains/foleys.

I dont like team nursing because in team nursing u get more patients, more responsiblities, more things to oversee that the LVN get their work done and yeah basically more patients that the RN is really responsible for.

sofaraway04 · Mar 22, 2007

I work in the Uk and on our ward we have 3 RN's and 3 HCA's (which are same as CNA's i belive), we work in pairs,

the RN does all meds, dressings, liasing with doctors, observations, discharge planning, evaluations and handover.after morning meds starts bedbathing

the HCA's serve meals, feed pateints and do bedbaths and toileting,

i like working like this because a lot of patients on my ward are "doubles" they require 2 nurse to transfer/mobilise and to bedbath. so working alone would be problamatic.

sometimes we have a different staff mix e.g. 4 RN's and 2 HCA's, on the occasions i have been paired with another RN we have split our patient load between us, otherwise it's hard to know who is responsible for which patients and who is going to do what tasks.

nurseitu · Oct 16, 2008

Yes I do. I started in UK on an acute Medical unit where I worked with a HCA (AIN in australia) and we knew each others scope of practice. This meant that I could have the time to cover my jobs that needed an RN and the HCA covered the basic health care needs within their scope of practice. We had a healthy respect of each others contribution to the care of our patient. After a while you come to realise that good care giving is done by everyone and not just the RN. There is NO I in the word Team and the patient is entitled to total care and that cannot be done by 1 person alone. Respect for each other is promoted by good team nursing. People and time managment is also gained by all who work as a team.

sweetspirit · Oct 18, 2008

I HATE TEAM NURSING! My floor does not currently do this - Thank Heavens! But there are some floors in our hospital that do and I have floated there occasionally - I think I have way to much of an "A" personality for this to work for me! I was constantly checking to see if the work was done and offending others when I tried to help! GRRRR! :banghead: