How to fix bedside nursing

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We all know that bedside nursing is brutal. I truly believe that this is an of area of nursing which needs a major overhaul. As it stands now, there will always be rapid staff turnover and a shortage of nurses who want to stay in this type job, yet it is crucial that patients in the hospital get good care. Improving ratios can help, but the way the job is structured is a major cause of burnout and dissatisfaction. We are expected to be in more than one place at the same time and do everything for patients and their families and that is just not possible. Let's try to start from scratch and redesign how to provide care to patients at the bedside. It's just fantasy for now, but maybe some great ideas will emerge. What are your ideas?

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All of my suggestions circle back to increased staffing. Lower PCT and nurse staffing ratios. Easier/quicker charting systems.

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Specializes in Critical Care, Education.

I know this is going to be unpopular. . .

If we want more bodies at the bedside, we need to take a step back & look at alternative models of nursing care. Payment for health care overall is decreasing & this is not going to be fixed any time soon. The only way to increase staff in this environment is to move into a team nursing model with RNs leading an appropriate team. Depending on the patient population and their needs, the team may include techs, CNAs, LPNs, etc. Unfortunately, most nursing programs stopped teaching team nursing skills in the mid '80s, so we'd have to invest in some significant training to get there.

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Specializes in Medical-Surgical/Float Pool/Stepdown.
I know this is going to be unpopular. . .

If we want more bodies at the bedside, we need to take a step back & look at alternative models of nursing care. Payment for health care overall is decreasing & this is not going to be fixed any time soon. The only way to increase staff in this environment is to move into a team nursing model with RNs leading an appropriate team. Depending on the patient population and their needs, the team may include techs, CNAs, LPNs, etc. Unfortunately, most nursing programs stopped teaching team nursing skills in the mid '80s, so we'd have to invest in some significant training to get there.

We just trialed this at my hospital on one of the floors last year and it did not work out. Not saying that expectations were clear for all team members especially about charting, etc but the LPN role was so restricted on the floor, coupled with high patient acuity, that everything still fell to the RN which essentially doubled their patient load. Too many IVP meds, etc...it may have been way more successful had expectations been clearly laid out from the get go but the other issue was hiring even enough qualified LPN's.

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Does anyone work under a team nursing model (that has been successful) who could share how it breaks down and what makes it work ?

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