Team nursing in the ED

Yes, we do team nursing, we have different pods and 2-3 nurses in each. I like it this way, check ins are a breeze with 2 nurses, and it makes breaks easy to arrange :)

We don't have an organized "team" but we always jump in to help each other. (although there are always a few who never seem to go the extra mile). We are constantly asking each other "do you need anything?" And I've come to welcome the help and I'm always extra appreciative to the nurses who do so. Unless we are all swamped. We don't "share" patient assignments but we do have a strong bond.

I worked in an small 7 bed ER where we did team nursing, and now I work in a 12 bed ER where we do primary nursing. I think there are pros and cons to each, and I don't really have a preference. Both ERs had/have good teamwork, so we were always helping each other out. The thing I like most about primary nursing is that I am with the patient from beginning to end, whereas with team nursing, if you get caught up in something, a patient can be discharged by another nurse without ever knowing if treatments worked, or what the end result was for that patient. With team nursing, things get done faster sometimes because the nurses are grabbing whatever needs to be done next. I also always had an idea of what was going on with every patient in the dept with team nursing, and with primary nursing I don't always know what is going on with other's patients (unless I am charge nurse).

Primary nursing is the direction most of the country will probably be going because patient satisfaction is so important. Patient's give better scores if they have the same nurse and are not passed around to whoever has time in that moment. I agree that team nursing is more efficient but we need to think about courtesy as well as efficiency more and more in the ED. We used to think we were doing a good job by saving lives or getting you through the department fast but it has been shown over and over that patients actually want to have some of the touchy feely care that ED's have been extremely unsuccessful in providing. "I'm here to save your ass, not kiss it" needs to retire...

I agree with the posters who prefer primary nursing. I think it's better for the patient as well as the nurse. I like to know what's going on with my patient's so I can fully care for them. If someone else is jumping in, they are less familiar with the patient's case. Plus it allows for a better nurse-patient relationship.

Even when I'm helping a busy co-worker, I don't feel as well equipped to keep the patient informed. For instance, if I'm discharging someone else's patient, I don't fully have all the information they could potentially need. For example, if the patient asks, "Should I still take my medication tonight?" I'm not familiar with their case and it'll have to find out the answer to better educate them. As a patient, I wouldn't feel comfortable with a nurse that doesn't know me...if suddenly someone else is discharging me, it may look like my nurse "doesn't care" or they're just trying to get me out of there.

I like to follow my patient from the time they first come in to the time they leave the ED. Maybe team nursing has it's role, but I like to form a relationship with the people I'm taking care of!

The main reason I prefer primary nursing is that with primary nursing, the physician knows who they need to communicate with. It drives me nuts when the physician thinks they can just talk to the closest nurse about any patient, when I might not have even been in the room or know anything about said patient. While I don't like the "that's not my patient" mentality and I always offer to help out ("No, I don't have that patient, Joe has been taking care of him, but I'm happy to help, what is it you need?"), when it gets busy, clear communication is so important in preventing errors or delays in patient care that I think primary nursing is really superior to team nursing.

We practice primary pod nursing... 3-5 nurses per 12-bed pod depending on acuities.

Things go great when we have a float but that's not typical. We usually do good job helping each other out with the sick arrivals and traumas.