Team nursing

Specialties Med-Surg

Published

Our hospital has been using a modified primary nursing model for the past 20 years. We are now going to try team nursing. I need lots of good comments about it to convince our nursing staff to give it a try. Any suggestions?

Thanks,

Betsy

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Team nursing. I have worked in many places that team nurse including my current job. It does work really well but the essential element has to be a good, approachable team leader who can encourage and motivate the team as a whole. I have always found it easier to nurse as a team. In my jobs where team nursing has been practiced we have managed to

. write our own off duty to cover our team

. give better more consistent care to our patient for example getting to know there relatives, problems other than their medical ones

. we also managed to support each other more by agreeing on the way in which care will be delivered etc

. our unit at the moment is also implementing teaching so every team now has a month of teaching to do and each member does something be it a formal teaching session or journal/article review or discussing problems with particular patients

.ps the team composition is also important ie a good skill mix not all junior or senior nurses

We also managed to get weekly meetings with physios and social woerkers etc to discuss patients care discharge plans

The doctors only the juniors though actually turned up to give their point of view. it works really well but you have to be committed to giving it a go.

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Our hospital recently went to "team nursing" it took alot of convincing because we have alot of green nurses who have never used this model. The positive side of this is that the overtime has been decreased greatly on our unit, and the pressure is also greatly decreased. There are still some nurses who believe that primary nursing works better because you get to know "all" of your patient, but I feel team nursing is the best way to go these days when due to "the numbers" we arent able to have as many nurses per patient as we would like.

Good luck!!!!!!!

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Please describe how modified team nursing works.

Thanks!

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We are currently exploring TEAM NURSING as well. We probably do more functional nursing right now because we have a spinal cord injury unit that is physically split. Soon our new SCI center will be ready for move in and we need to think about our delivery care model with looong hallways as every patient room will be private. Any insight as to TEAM nursing is most appreciated.

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Specializes in ER / ICU.

I don't know if my unit does team nursing the way it's designed, but I can't stand it. I have a maximum of 12 patients on any given night. My LPN passes all meds, and if we're lucky we have an aid, but that's not always a given. With so many patients it is almost impossible to keep on top of everything. Physicians will ask me about certain meds a patient is on and it's really embarrassing because I don't have a clue. I have to track down my LPN or shuffle through the chart and MARs. Patient's will ask the LPN something about their plan of care or a schedule procedure or what have you, and it's embarrassing for her because she won't know the answer so she has to come ask me. We communicate the best we can and try to keep things organized but it becomes near impossible. I think team nursing is one of those things that looks good on paper but is not at all practical once applied.

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Thanks for the response.

Here is what are staff consist of - we have two units with 19 patients each (all spinal cord injury). One unit has ventilator patients (up to 3 at one time). Currently across the board (on day shift) we have 1 charge RN (overseeing 19 patients) and other RNs/LPNs/NAs usually have 3 patients each (mixture of quads and paras). An RN or LPN is assigned meds and also treatmetns. If anyone looked at our current assignments one would not know if the staff person is an RN/LPN or NA, other than the charge RN. SOON we will be moving into our new center ($32 million dollar building) which will still have 38 beds BUT long hallways. The nice part is each room will have a computer right outside the room and we will have nurse servers to hold supplies (this will decrease the walk).

No matter what the delivery model is there are always issues especially if staff do not play nice

in the sandbox :).

This is what I need feedback on - based on what I am envisioning....

I'm thinking we would have 2 teams on each side (4 when the new building arrives) that would include 3-4 LPNs and 2-3 NAs each. The RN would be responsible for delegating duties, assessing patients, central line meds/IV push meds, teaching, documenting, admissions/discharges. The LPNs would be assigned treatments, meds, ADL cares, trach suctioning, tube feedings. The NAs would be assigned to complete ADLs, turning/repositioning, getting patients unpacked/packed, item inventory, other chores as assigned. This is not all of it but gives an idea of my thoughts.

Thoughts?

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"Thoughts?"

I am an RN, and prefer primary nursing. For team, it depends on how

good the team communicates with each other. From a personal experience I have had 2 family members with major issues inpatient where important information and changes post op were not passed on to the MD on a team

approach.

If the team is not communicating and cohesive, it can be potential

disaster for some patients..

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