Team Nursing, Does it work???

Nurses Safety

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My hospital wants to go to outcome based nursing called Bold Steps. You see the abbreviation? It is based on a Racine, WI. hospital and it is essentially team nursing with an aide or an Lpn with 6 patients or whatever they decide.:uhoh3: That will allow the Rn to have more time to teach and chart and assess. I am very concerned as it seems the old team nursing with a new name. Anyone currently practicing this way and how is it going?

If you don't have the right staff mix I don't know why you are even discussing it.

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fergus51 said:
If you don't have the right staff mix I don't know why you are even discussing it.

The upper mucky-muck are assuring us that the right people are "out there" to fill the gaps and provide the needed mix. My opinion, frankly, is that as long as they're "out there" we can't implement the change "in here"! I am not about to sell the idea if there aren't people in place to make it work! I had a meeting with the "big boss" this morning and told her that we could revisit the issue after I had names of the folks who were going to fill the holes on my orientation roster.... she laughed. We'll see -- jut another chapter in the continuing saga of non-nursing personel trying to make care decisions without getting input from the rest of us!

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EXACTLY!!! There are a lot of things "out there", but if you don't have access to them in the hospital there is no way it's going to work.

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I think one of my favorite (sarcasm dripping from the word) phrases our administration has handed out lately is "There are all sorts of resources available" while they are rubberstamping "DENIED" on our check request forms to purchase much needed equiptment. Unless they have some idea of what "life in the trenches" is like -- they live in a different world. I guess my job is to help them see what it's like "in here" where resources are scarce, staffing is short and hours are LONG!!

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Ick. I don't envy you a bit. I think management is just stupid to try to implement a change the staff is not behind and not provide the resources needed to do it. I can understand management pulling rank and saying "this is what we're going to do", but I can't understand them doing that and not giving you what you need to do it.

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They are really pushing the issue too -- we are facing a merger and they are looking for ways to trim costs everywhere! I am just greatfull that I am not high enough on the food chain to be disposed of at this point. It seems like they are just trying things -- anything -- without really giving it serious thought, researching or planning. It will come back and bite them in the rear -- always does. Just would love to have them hear me out.

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we have been doing "team nursing" for about 7 months now. Basically on our Med/Surg and Pediatric floor. There is a RN who does all the admissions, discharges, assessments, documenting, calling the doctors and making rounds, drawing blood, putting down NGT's, small bore feeding tubes, assisting the physcians with treatments, deep suctioning and so on. The LPN, does all the medications and dressing changes or treatments that they are allowed to do. The CNA does the baths, and vital signs, and things like that. We have 12 patients to a team. If we get rid of 4-6 patients and the other team still has their 12, we will get the next 4-6 admissions.

I do not know of anyone who likes this type of team. It seems as if no one really knows the patients at all where as in primary care nursing, we knew basciallly just about everything going on with the patient. It is ALOT of charting and paperwork for the RN who always has to stay over to get it done, and heaven help if you have to actually work 12 hours, give report and take a different assignment at three when you haven't even charted on everyone yet.

Basically, in my opinion, if it was just 8 or 10 patients, it would be alright but 12?? Good grief ! It is very dangerous and threatening to the nurse as well as the patient. Wish governmnet would hurry up and pass a safe nurse patient ratio in Virginia, I can't take many more days like this. I like to sleep at night, but it's hard when you go home knowing the patients didn't get the care that they deserved.

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Specializes in ER, ICU, L&D, OR.

Now in the old days Team Nursing worked even with up to 20 and 24 pts on your team but then again things were diff charting was much less Never even heard of care plans back then none of the puter stuff to slow you down

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I work in a hospital that does primary care. My experience with team nursing came about 7 years ago as a family member; it was not good. My mom was in the hospitial after surgery for a brain tumor, having medical power of attorney I tried to find out what was going on with her care and no one could tell me any thing !!!! The responses I would get would be I'm only the IV Nurse or I'm only the treatment nurse or I'm the assessment nurse ........... you get the picture. How can any one really know what is going on or recognize any changes when you don't take care of the whole person ?? I personally do not like team nursing. And as a nurse I want to know what is going on with my patient at all levels and all areas of thier care. Thanks for letting me spout off a little !!!!

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Specializes in ER, ICU, L&D, OR.
dlmickley said:
I work in a hospital that does primary care. My experience with team nursing came about 7 years ago as a family member; it was not good. My mom was in the hospitial after surgery for a brain tumor, having medical power of attorney I tried to find out what was going on with her care and no one could tell me any thing !! The responses I would get would be I'm only the IV Nurse or I'm only the treatment nurse or I'm the assessment nurse ........... you get the picture. How can any one really know what is going on or recognize any changes when you don't take care of the whole person ?? I personally do not like team nursing. And as a nurse I want to know what is going on with my patient at all levels and all areas of thier care. Thanks for letting me spout off a little !!

Thats cool

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dlmickley said:
I work in a hospital that does primary care. My experience with team nursing came about 7 years ago as a family member; it was not good. My mom was in the hospitial after surgery for a brain tumor, having medical power of attorney I tried to find out what was going on with her care and no one could tell me any thing !! The responses I would get would be I'm only the IV Nurse or I'm only the treatment nurse or I'm the assessment nurse ........... you get the picture. How can any one really know what is going on or recognize any changes when you don't take care of the whole person ?? I personally do not like team nursing. And as a nurse I want to know what is going on with my patient at all levels and all areas of thier care. Thanks for letting me spout off a little !!

This is not true team nursing, it's actually functional nursing. In true team nursing, EVERYONE on the team is responsible for their group of patients, and works together to get the job done.

What you're describing is not team nursing as I knew it..just some crazy invention of someone who wants to CALL it team nursing.

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If your admin. is pushing for team nursing, suggest a pilot program. Choose or ask for volunteers to pilot 2 teams for each shift consisting of RN, LPN, CNA. Define the roles of each team member, and the expectations. Communication among the team members is essential for this type of approach to nursing care.

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