Team Nursing advice please

Nurses General Nursing


Hi there,

This question is both directed at LPNs/VN's and RN's alike.Anyone who can give good advice please respond. My unit is Tele/Stepdown and are begiining to re-introduce the team nursing concept with RN+LVN+PCA's. Generally we will have 2 or three LVN's on the floor,which means that at times each RN will be teamed w/a LVN and a PCA. Other times, two RN's will (please excuse the expression...came from management) "share" a LVN. Ii believe that we will have one RN to 8-10 patients. My question is, what is the most efficient and fair way of organizing the work. Even though LVN's are absolutely capable and great at assessing patients and data, according to our facility (they say they quote the BRN guidelines), the RN is responsible for the patient assessments,Careplanning, and IV push/IVPB's. How do others with this setup like it, and how do you do it there?

Appreciate any feedback.



317 Posts

Good luck!!


6,011 Posts


here's how we did it. decide how many teams of how many patients. we had 3 teams of 10 for 30 patients.

we had a charge nurse: makes rounds with docs, pulls labs, calls reports to doc, checks order entry after unit secretary, makes assignment for next shift. (we did 12h shifts)

team i 1 rn 1 lpn or rn 1 pca

team ii same same same

team iii same same same

so that makes at least 4 rns. chg + tl

sometimes, particularly on nights or weekends, we might have 2 tls that shared the 3 lpn/rn and or pca. so each rn had 15 assessments, charting, iv push meds etc. lpn/rn assistant member had meds, starting iv's, helping chart, carrying out orders etc. with the tl

team i rn a lpn/rn pca (rooms 1-10

1/2 of team ii rna lpn/rn pca (rooms 15-21)

1/2 of team ii rnb

team iii rnb lpn/rn pca (rooms 22-28, 11-14)

the architect who numbered our rooms should have been strung up. no rhyme or reason to them.

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