I have to agree with tweety here. A Med-Surg floor, 1 RN, 1 LPN, 1 CNA with 12 patients just doesn't seem to be that big a deal. I've certainly covered far more patients with the same staffing on Med Surg floors. I'd find that a problem in an ICU, to be certain, but not a Med Surg floor.
I find it odd that in "team nursing" they each took x number of patients and provided total care to those patients. That kind of negates the idea of team nursing. In true team nursing they would have worked on all of the patients as a team. I don't think that in a true team nursing environment, this incident would have as great a chance of happening as it did in a total care environment. Regardless, the LPN in question accepted assignment for a certain number patients to provide total patient care to those patients. That makes her responsible for those patients, end of discussion. She was sloppy, she failed to check on the patient for 3-4 hours and the patient died because of her failure to do her job. She is, or was, a licensed nurse and fully responsible for her own duties and deserved to be fired. The RN, who certainly has questionable supervisory skills, got reprimanded probably in her permanent record and perhaps even had the incident report to the BON. She deserved the reprimand she got but does not deserve to get fired over the screw up of another licensed nurse. One could easily put two RNs into this story, with one of them being the Charge Nurse. The punishments in that case should be the same as in the stated case. The supervisor does not receive the same punishment as the person who screwed up, PROVIDED that the assignements were made properly. It seems that, given what few facts we have, the assignments were probably correct. The GI bleed patient in question does not appear to be beyond the capabilites or scope of practice of a LPN to handle. Of course, we don't have the facts in this case, so conjecture is going to fill in the gaps.