In your facility, which to you use?
Team Nursing - an RN leader with other nurses working under her, but the leader is ultimately responsible for outcomes.
functional nursing - patient care is divided into tasks, med nurse, iv nurse, and ADL assistants.
primary care (case load management) nursing - One nurse is assigned to a patient for the entire period, even when they are not onsite, and all interventions are reported to the patient's primary nurse.
Do you find your organizational structure is effective?
Nov 1, '01
We do semi-primary nursing. Hard to near impossible to be primary caregiver when you are working 3-12 hour shifts and avg LOS is 7 days.
We have co-primary nurses, one on days, one on eves/nights usually. That way, the patient has consistent caregivers and we are up to date on what is going on with the patient but we also get to leave work at work and know that our co-primary partner is taking care of our shared workload.
Nov 1, '01
things are a changin at my place. we had primary care-rns and lpns. now they are changing. after 11 yrs. the rns are to do all the paperwork/assessments and the lpn and cna have most the pts. there is not much paperwork that only rns can do so the work load is unfair at the moment. we are still in the change process though. hope it gets better..
Nov 2, '01
Teams: 1 RN + 1 RN or LPN + 1 Tech to a pod of 10 patients.
3 pods on the unit.
LOS was between 12hrs and 4-7 days usually.
12 hour shifts...stay with same pod until day off then rotate to another pod when you returned.
Nov 2, '01
Each unit has a head nurse or charge nurse each shift. This person is responsible for making nursing patient assignments. This is supposed to be done using acuity not just "numbers".
Each nurse is responsible for the care of her patients but the charge nurse is responsible to see that all patients rec. appropriate care.
We have very few aids/assistants (tonight we had one aid on one unit on 3-11 shift). When we are lucky, most units have one aid.
This may be over-simplified but basically that is it. Our nurses do their own meds, IV's, treatments, etc. If there is not an "official" charge nurse on duty, the nurse with the most experience (on that unit) is the person "in charge".
Must Read Topics