Team Nursing Approach?

[jfpruitt]

I'm finally in my LAST semester and graduating in May. After numerous clinicals and rotations, I learned something new this week that I wanted to get input on. I attend a small, rural RN program and our clinicals are limited to 2 hospitals. This semester we started learning about management styles and nursing. They have told us that many hospitals use a "team" approach. Where the RN may be responsible for a whole wing of patients and they delegate out to maybe 4-5LPNs and 4-5CNAs. The RNs work as the "managers" and handle the complicated procedures and IVs while the LPNs and CNAs do the bedside care/meds. In the 2 hospitals I have been, both of them did NOT use this approach. Each RN had 5-8 patients and you did all the bedside care. There were no LPNs and the RNs shared the CNAs. Is this team approach the standard now? I really like the idea of delegating to LPNs and CNAs but wonder if this is something that happens in other hospitals or just a few? Never heard of this before and I'm intrigued. Just thought I'd ask. Thanks...

[Hellllllo Nurse, BSN, RN]

When I worked med/surg (2 years ago) Each nurse did all meds, assessments, tx, etc. for her own pts. (5-13 per nurse). We had both RNs and LVNs. The RNs were not over the LVNs. Each had their own pts. There were 2 CNAs for the whole unit. They were to do V/S and such on all pts.

LVNs did their own IV fluids. If a pt was on TPN or something only an RN could administer, that pt was assigned to an RN.

If an LVN's pt got an order during the shift that an RN had to give, the LVN would ask one of the RNs for help.

[jfpruitt]

That is pretty much the same at the 2 hospitals I've been exposed. That's why I was so intrigued by this team approach.

[mayberry]

Have worked in places that did "team" nursing or some variation thereof and have never been a fan of it. I find that there is always some tid-bit that doesn't get passed on or is lost in the translation. It also puts a lot more pressure on the RN whose "in charge" . Havn't had a great experience with it.

[lenawa]

care delivery models can be a very touchy subject. the very busy med. unit i just came from worked using a team approach, one RN and one LPN for 6-8 pt's. everything SEEMED to be working fine, however, when you look at the big picture it really isn't best practice. although i loved the girls i worked with and we all worked well together, it's impossible for the RN to provide holistic care to every patient when he/she only has time to do the "RN-only duties" (LPN's aren't allowed to give meds on acute units at my hopsital) also, as has been mentioned, there can always be that one thing that doesn't get passed from one nurse to another. i know a lot of people may disagree with me on this (especially the excellent LPN's who have practiced this way very effectively for many years), but team nursing really does seem outdated. Sorry for the long post

Lena

[P_RN, ADN, RN]

I love team nursing. Always backup, always cover for lunch, always that extra pair of hands.....

[Daisy]

I wish we would change to some type of team nursing. I work on a med/surg unit that has a " mother may I?" charge nurse and a useless assistant. The RNs are filling water pitchers and not involved in patient decisions. All the communication is with the charge nurse. If we had teams we would really be the coordinators of patient care, not high paid technicians. The team concept creates a real together effort by the players to get the job done. If the team leader is a real veteran of nursing this is a good place to include new RNs or new grads to teach or groom them into making competent decisions. Our new grads are just floundering out there and the old timers are managing two assignments. We might as well work as a team. Its no use to try to change this at my hospital . I have brought it up with administration several times and they were not interested.