Team Nursing Approach in ED

wanttobeacrna · Jul 19, 2007

I worked in ER for 8 years..if you don't have a team in the Er...It just doesn't work. Forget primary nursing..your team will save your butt someday. Be glad they have this approach when you have your first critical chest pain or your first mass casuality.

Maverick80 · Jul 19, 2007

How effective or non-effective do you consider team nursing to be in the ED? I'm working for the first time under the team nursing model. It's very different from the primary care I'm used to doing.
Any thoughts or experiences of your own about team nursing?

I am a tech in an ED which has team nursing. Although i'm not a nurse just yet, i think this works very well, and actually i think it would work better then just having 4 rooms all by yourself.

In my ED we have A, B, and C, team which covers a 39 bed ED. All are different sections of the ED and all get different types of patents, but with somewhat the same acuity some with higher then other of course. We have a to be seen rack for the DR. and they see the patients write orders give to the unit clerks (secretaries) and they put in the orders and the nurses pick up the charts and give meds line and lab the patients on their team. Having a team is great because sometimes a person's 4 rooms of charts all come up at the same time, and one person can not complete orders on on all 4 patients in a timely manner. Sometimes a nurse has to spend longer in some rooms then others like when they are giving rounds of nitro, when you have to watch BP and pain and give them every 5 minutes. This is when a team is wonderful. They can help out because there rooms are not busy!!

i can't say the team thing is perfect sometimes you end up with someone who is really slow, and not easy to work with, but you will find that everywhere. It's so nice to have this system in the ED, and everyone i work with seems to really like it!!

meandragonbrett · Jul 19, 2007

Team nursing reminds me of the joke about the office where four people called Everybody, Nobody, Somebody and Anybody worked - Everybody thought that Somebody would do it ; Anybody could have done it but in the end Nobody did it.

Each job and patient needs one nurse who IS responsible for them not four who might be.

Just my .02 cents.

Team work is vital in the ED, but NOT Team Nursing

S.T.A.C.E.Y, LPN · Jul 19, 2007

Each job and patient needs one nurse who IS responsible for them not four who might be.

We have one section of our ED that has Team Nursing, and while it works ok most of the time, occasionally I have found a patient sitting there for an hour or more without having been assessed because everyone in the team thought someone else was going to do it, was doing it, or did it. When it comes back to "why wasn't it done", well, everyone else was busy and nobody noticed.

NYCRN16 · Jul 19, 2007

Team nursing reminds me of the joke about the office where four people called Everybody, Nobody, Somebody and Anybody worked - Everybody thought that Somebody would do it ; Anybody could have done it but in the end Nobody did it.
Each job and patient needs one nurse who IS responsible for them not four who might be.
Just my .02 cents.
Team work is vital in the ED, but NOT Team Nursing

I see what you are saying, and I can see how the patient could suffer if the team approach works likes this. In my ER we have 2 teams with 3-4 nurses on it, but each nurse individually is assigned his/her own patients. If the nurse becomes overwhelmed or gets stuck with a sick patient, we do help our teammates out. So the problem mentioned above does not happen because there is a primary nurse responsible for the patient.

RunnerRN, BSN, RN · Jul 19, 2007

We have a "zone nursing" format. We have 4 areas to our ED - Acute I, Acute II, Fast Track, and Peds. At peak, we have 5-6 RNs, 1 tech, and 2 docs assigned to each Acute area. We still sign up for patients as they come back, but some people aren't as, shall we say, eager to accept new patients.

Which reminds me.....with the whole Anybody/Somebody/Everybody thing (in the end Nobody did it.) Why do I always end up being "Nobody?"

bill4745, RN · Jul 19, 2007

We each have 4 rooms, but we are always willing to help anywhere we are needed if we are not busy. Somewhat of a team approach, but still with one nurse responsible for each pt. Works well for us.

abundantjoy07, RN · Jul 19, 2007

For those who have had this experience do the teams consist of the same 3-4 nurses or do the teams vary?

Besides the newness of this experience, I do find it frustrating to work with different nurses whenever I go to work. Our teams are not fixed. That is something I will have to adjust to as well.

Thanks for all of the responses...it's food for thought!