Team Nursing.....anyone

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Specializes in Med/Surg, Ortho, Rehab, ACU-Telemetry.

I am on my first travel assignment (since 2000). There is only one unit where I am at, that does team nursing. I'm not sure why or how this particular unit can get by with doing this type of nursing, since it's the only unit in the hospital that does it (500+beds). The reason (I was told) that this unit does team nursing, is because the nurses are afraid of change. There are a couple of nurses that have been there for many years. Anyway, here is my experience:

The first night I worked on this unit, I was told that I would function as a PSA (or whatever they call CNA's here in Texas). I looked at the charge nurse and said "You do know that I'm a RN". She said that she did...so report started, and I'm sitting there because for the past sixteen years of being a RN, I have listened to report. The charge nurse turned off the recorder and told me that I didn't have to listen to report, that I would get my report from someone else. I left the room, and literally (and several times that shift) had to bite my tongue from saying or doing anything stupid. The person that gave me report was a LVN (in Ohio, we call them LPN's). I asked her right out, if she minded not being able to work as a LPN. She looked at me like I was crazy...so I proceeded to do my VS for 11 patients. It was VERY difficult to go into a patients room and function solely as a CNA. I found myself asking questions that nurses normally ask a patient during an assessment, etc.,., NOW, DON'T GET ME WRONG..........I'm not above doing VS, emptying trash, doing I&O's etc...but when you haven't done it since BEFORE you became a RN, it was very difficult. I have floated to this floor twice so far. The second time was last week. It seemed like I was 'dumped' on by the other RN I was with. Nothing was explained or discused up front between me and this nurse, as to what our (or I should say MY) role was in taking care of these patients for the night.

Anyway, anyone have any thoughts on this topic, please share.

Kathy

:redpinkhe:innerconf

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Specializes in MedSurg Tele.

I haven't heard of "team nursing." However I had a similar experience. I worked on a unit as a CNA 3 or 4 times because there were no available spots for an RN. I had about 12 patients with brief report. If I needed assistance with turning, changing, bathing, I asked another PCA or RN. Took VS's, I'Os, documented them. Did bloods. Dressings needed to be changed so I'd change them with the RN. When I worked as RN, I'd assist where needed. At least they didn't send me home just because I was an extra. I guess as a traveler I just learn to adapt :redpinkhe:up:

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Specializes in Med/Surg, Ortho, Rehab, ACU-Telemetry.
I haven't heard of "team nursing." However I had a similar experience. I worked on a unit as a CNA 3 or 4 times because there were no available spots for an RN. I had about 12 patients with brief report. If I needed assistance with turning, changing, bathing, I asked another PCA or RN. Took VS's, I'Os, documented them. Did bloods. Dressings needed to be changed so I'd change them with the RN. When I worked as RN, I'd assist where needed. At least they didn't send me home just because I was an extra. I guess as a traveler I just learn to adapt :redpinkhe:up:

Team nursing has been around for ages. Your assignment is usually more than you have if you did primary care. You usually have a RN, LPN (LVN in some states), and possibly a CNA. I'm not saying that as a traveler, I 'haven't adapted"............I'm just saying that team nursing is not the NORM in how nurses practice nursing. Primary nursing is the way nurses practice. And as I mentioned in my post, there is only ONE unit in this large hospital that is getting away with it, because there are a couple of nurses that are afraid of CHANGE. It's not BENEATH me to function as a "CNA", but my license is on the line. I will do as I'm instructed when I have to float to this floor,,,,in your words,,,I WILL ADAPT........

Kathy

:redpinkhe:innerconf

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Specializes in MedSurg Tele.

Team nursing is definitely not the norm. I guess what this unit did with me is similar to team nursing. I don't see how my license would be at risk as a patient care tech. However, I had worked on a unit that I did everything: All duties as cna and all duties of RN.. patient ratio 1:3, there was an IV team and a discharge nurse. It was very busy with even a 1:3 ratio. Anyway, I agree with you, you're an RN and that's what the unit needs to recognize -- primary care. :)

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Team nursing has been around for ages. Your assignment is usually more than you have if you did primary care. You usually have a RN, LPN (LVN in some states), and possibly a CNA. I'm not saying that as a traveler, I 'haven't adapted"............I'm just saying that team nursing is not the NORM in how nurses practice nursing. Primary nursing is the way nurses practice. And as I mentioned in my post, there is only ONE unit in this large hospital that is getting away with it, because there are a couple of nurses that are afraid of CHANGE. It's not BENEATH me to function as a "CNA", but my license is on the line. I will do as I'm instructed when I have to float to this floor,,,,in your words,,,I WILL ADAPT........

Kathy

:redpinkhe:innerconf

I don't think your assignment had anything to do with "adapting". That assignment was just odd. I've had days when we were short a CNA so the patients were divided up between the RN's as usual and we did our own vitals. Very strange they had you working as a CNA. I've worked in one hosital that did team nursing and it was horrible.

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Specializes in ED, ICU, PACU.

Doesn't your contract say that you are being employed as an RN? To ask you to do CNA work seems to violate your job description; and, as an RN, you are responsible for your patients in the role as an RN. Seriously, the next time they try that with you, say that it is out of your scope of practice to function a CERTIFIED Nursing Assistant (and, you are not certified as one). Print up a Safe Harbor form off the Texas BON site and tell them that you will file it if you have to take a patient load that high again.

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Specializes in Med/Surg, Ortho, Rehab, ACU-Telemetry.
Doesn't your contract say that you are being employed as an RN? To ask you to do CNA work seems to violate your job description; and, as an RN, you are responsible for your patients in the role as an RN. Seriously, the next time they try that with you, say that it is out of your scope of practice to function a CERTIFIED Nursing Assistant (and, you are not certified as one). Print up a Safe Harbor form off the Texas BON site and tell them that you will file it if you have to take a patient load that high again.

Thanks for the reply, but I'm only there until March 15. They have a new director who started January 8, so maybe she will make sure that all of the units function the same. I know that another traveler refused to do team nursing on that unit. Guess I don't have the balls, YET!!:icon_roll

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I am a med/surg RN. On a rare occasion I have worked as a CNA when we were short on CNAs. I was under the impression that the scope of practice of an RN includes the scope of practice of a CNA....does each state Board of Nursing vary on this??

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I just quit a job (not a travel job) where team nursing was used.

I was told I was hired as night charge nurse, but functioned pretty much as a CNA/LPN and RN. This facility is a LTC/rehab facility within a hospital.

It's weird- On my hall, I did incontinance rounds and care, I&Os. VS, water pitchers, stocked supplies, and did morning med pass. Yet, I also lead report, made staff assignments, did the charge nurse reports. etc. for the entire unit.

Yesterday morning, there was a pile up on the freeway due to black ice. I was told I may be mandated to stay over, and be involved in triaging the accident victims (they were taken to another hospital, so I was not mandated).

This is one of the reasons I quit- I felt I really was not being utilized as an RN.

Switching back and forth between CNA duties and RN duties just does not work for me. I have to either be charge nurse and stay within that mind set to function effectively, or not be charge and focus soley on my own pts and duties. The constant switching of focus was not working for me.

Since your assignment is a travel assignment, it will be over soon enough.

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Specializes in Med/Surg, Ortho, Rehab, ACU-Telemetry.

I agree with Valerie. When I was working as a CNA, I found myself asking the patient 'typical' RN questions, while doing their VS. I felt stripped of my 'nursehood' if you will...............when I was 'assigned' with another RN, I felt 'priviledged' to be able to give one of 'his' patient's medication.

There's a reason why RN's have more education. And it's not to function as a CNA just because one floor refuses to change with the times. Team nursing does NOT, at least in my opinion.

Kathy:redpinkhe:bugeyes::innerconf

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Specializes in L & D; Postpartum.

I personally loved team nursing way back in the 70's and 80's. As an RN I had time to actually do assessments and treatments (sometimes we had a med nurse who did all meds) and didn't have to spend my time doing waste baskets, mopping floors, clearing meal trays out of the room. Now as a "primary care" RN we do it all: wash the beds, the floors, trash, trays, AND all the actuall RN work. Rarely do we have CNA's to help.

And I would think that you're certainly qualified to do CNA duties, and if they want to pay you the big bucks to do that, I'd go for it.

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Specializes in Corrections, neurology, dialysis.
I personally loved team nursing way back in the 70's and 80's. As an RN I had time to actually do assessments and treatments (sometimes we had a med nurse who did all meds) and didn't have to spend my time doing waste baskets, mopping floors, clearing meal trays out of the room. Now as a "primary care" RN we do it all: wash the beds, the floors, trash, trays, AND all the actuall RN work. Rarely do we have CNA's to help.

And I would think that you're certainly qualified to do CNA duties, and if they want to pay you the big bucks to do that, I'd go for it.

I was thinking the same thing. If they want to pay me an RN salary to do CNA work, I'm okay with that.

At the job I have now I work mostly as a PCT with an LVN salary. My job duties didn't change at all but my pay did. I think it's a pretty sweet deal.

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