Our facility is planning on converting to a team nursing approach in the ED. It would consist of approx. 3 nurses, tech, MD, unit clerk, for 8 pts. The majority of nurses don't want this, especially since we don't have a plan for taking trauma's, i.e(another team, or taking nurses away from existing team, etc.) Can anybody give me some advice on if this will work, how was the transition, so on. Any help would be appreciated.
May 25, '03
I work in an ER that switched top team nursing. We didn't do anything as structured as what your facillity is planning . We have two nurses and a tech per eight patients and share the secretaries, the doc's take patients as they come in, I actually asked if we could assign the doc's so we aouldn't have to go searching for them when we had a question. The teams are split into two assignments of four and the overload gets distributed on the basis ofwho can handle more. If a trauma or medical mess arrives all bets are of and everyone tries to help until the patient is stablized. The benefit of the team is you know who covers for you when you need to take a break or go to lunch, and who to ask for help when you need to do a procedure or check things.
May 28, '03
We worked with team nursing in my old ER. The ER (20 beds) was divided into A side and B side with 2 RN's, an ERT, and an ACC (unit clerk), Fast Track had an RN, an ERT and 2 PA-C's. We also had a Clinical Coordinator (No pt assignment), a triage nurse and a float nurse. IMHO it worked great.
Then we built a "Newer, Bigger and Better" ER. It is not conducive to team nursing due to the lay-out. We have been in it for a year and continue to have many problems and well as higher staff dissatisfaction and turnover. Our nurse patient ratio remains 5-1 (with 30 beds ) with 2 ERT's (float), 3 ACC's (centralized)and occasionally a float nurse. Fast tract has gone from 6 to 8 beds still with 1 RN, 1 ERT and 2 PA-C's. There is also a triage nurse and Charge nurse (who doubles as triage after 2300).
I'd love to have "the old days back" when we worked together as a team rather than individually.