team leading

Hi,

I worked for a hospital here in Michigan(now closed) that did team leading. We were a med/surg unit and it was busy with admissions and discharges.

I felt the same way that you do, with the RN having to cover the LPNs, and sign off on all the admissions.

Maybe you need a charge nurse for all the shifts that you have. They could do the assessments and help out and free up some of the nursing staff. Easy in thought, hard in practice.

Let me know how it goes.

anyone working or have worked on a med-surg unit doing team leading? my facility is attempting to change from primary care to team leading. many of the nurses are unsure how team leading will work. the Rn,s are esp. concern re. the patient load. the unit involved is basically a med. unit. with a total of 26 patients. it is a busy unit with an average of 5-6 discharges and as many admissions on a daily basis. generally we are staffed with 3 RN's, 2 LPN'S, and 2 Nurses aides. right now if the unit is full the LPN would have 5 and 6 pt. with the RN each with 5 and two of the RN,S would resource the LPN'S , one each. the nurses aides would split the patient evenly either working togerther or alone. each nurse is responsible for total care for her pt. the rn calls dr. for lpn and also does any IVP meds. in team leading the RN and lpn would tke half the patients along with one of the aids. the rn would do the assessments the lpn would do the meds and assist the aide with the bedside care and assessments. the rn would note all charts and assisst as needed with pt. care. the rn is saying they feel that this concept gives them to many patients and more staff will be required to do this. the night shift is very much against this. they are usually staffed with 2 rn and 2 lpn with a nurses aid. same amt. of patients. would appreciate any feedback. thank you.

this is why we are going to an all-RN facility. Have not hired LVN in years. The few remaining ones have a job, but when they leave, the position will be filled by an RN. The RN's end up doing all the assessments, IV pushes, blood transfusions, calling MD, etc. for their own 5-6 patients as well as the LVN's. And RN's HATE it when they have a responsibility for a patient, but no time to see them adequately and have to rely on the LVN to mention something going awry, etc. A real PIA. Duties have to be clearly delineated. Even then it is a chore.

None of us like team nursing here, but we are forced to do it this way. It is too disjointed. At the end of the day, we find a lot of things didn't get done because we thought the other one was doing it. Things you don't even think about at the beginning of the shift. As the RN, I feel like I am having to rely too much on someone else to see my pts firsthand. I am stuck doing all the assessments, admissions, calling docs when a pt is in trouble, and the rest of the pts may not be seen by me for hours.

And it seems there is never a cut-off on how many pts your team can accrue in a shift. You might start off with 10, but with discharges and admits, you may have 15 to chart on by the end of the day. Very hard!