Team Nursing

Nursing.capps, RN · Aug 27, 2006

Hi, I just got hired on a med-surg floor and start sept 11. In my interview they told me that they utilize team nursing. It will be me (I'm a rn) one lpn and a cna. we will have typicaly 8 patients together but on a bad day we could have up to 14 per team. I know I will do all iv's, assessments, emergency's, and the lpn will do all po meds and assist me with admits and discharges. the cna will do hands on care and vital signs. that is how it was explained to me. I have yet to work so I am anxious to see how it works. What scares me is the bad days when we have up to 14 per team. that sounds way too many to me. I have not ever worked an acute care med surg floor. I have always worked long term care. In long term care we did a form of team nursing. I would be charge for 35-60 pts depending on what shift. I would have some one to pass po meds. Then we had cna's that did all adl's for the residents. It would be very busy for that many but it worked. however, in ltc they are usually considered stable. I do have my worries about team nursing in med-surg. So I to would appreciate any other posters with this type of experience to shed some light and ease my anxiety. thanks.

Ruby Vee, BSN · Aug 28, 2006

team nursing is a great way to get lots of work done in a short staffing situation; unfortunately it's not nearly as satisfying for the nurse as primary nursing. i did it for years . . . your team is as good as your weakest member. taking up the slack falls on the rn. i worked with 15 patients and a nursing assistant . . . it got hectic, to say the least. but it was doable.

NurseBeefcake · Aug 28, 2006

I'm an LVN who works registry and there is one hospital that I go to that uses team nursing. It has its pros and cons. As the LVN cons are passing meds for eight patients instead of four. However the pros are that the LVN and the RN get report on the same patients so that the situation never occurs where i have to report something to the RN hours into the shift on a patient that she has never seen and 2 there is some one always on the floor who actually knows your patients because report is never as complete when one goes to lunch. Also you can share a lot of the paperwork.

MU/WVUGRADRN · Aug 28, 2006

I'm an "old" (experienced) nurse and we did team nursing a long time ago. I loved it.

Creamsoda, ASN, RN · Aug 28, 2006

Absolutely hated it. I dont think what they called "team nursing" was really team nursing, but it is my only experience when I was in the float pool. They only did team nursing on the evening shift. There were usually 2 RN's and 1 LPN to each side for about 18 patients to each side. So basically what they would do is all three of them would all go together in a group, with the ice chips, blood pressure machine, and they would each all go to each bedside together and do the assesment together. One would put the cuff on the arm for the BP, the other would give ice chips and record vitals, and the other would lift up the gown and look at the incision. If they asked for pain medication, someone would go get it for them. No one had a specific job. After the initial round was done, everyone would volunteer for a job, like a saline soak dressing that had to be done, or whoever needed a glucose or stuff like that. There was usually 1 other nurse that did meds for both sides.

Man what a complete and total waste of time. Like I said, I dont think this is true team nursing. But thats what they called it. I am pretty sure the nurses raved and said it worked so well was because they got to talk to eachother and gossip while they did rounds. Often no one would know who did what, you had to track ppl down to find out what was done, or needed to be done. Charting was split up evenly, but if you happened to step out of the room while thye did the assesment to grab a analgesic, you had to ask them what the incision looked like, bowel sounds ect, so basically you were depending on someone elses juegement and signing your name to it. Most of the nurses were trustworty, but you never know if they forgot to tell you something. They were always their late past shift change because everything took 3 times longer. Would have been easier to just split up the patients and have 6 to your own, and im positive things would have gotten done sooner.

The only time team nursing was beneficial was when I floated to ortho which was ALWAYS shortstaffed. If they were, then they would switch from primary care to team nursing just to get the most important tasks done. Usually there were 3 nurses to each side for 16 pt's on each side, but sometimes there were only 4 in total, so 2 would do one side and 2 would do the other. Between the 2 nurses they wouldgo into the same room, but each did their own assesments on whoever was in the room but would just carry on to the next patient untill they were all assessed one after the other if that makes sense. As long as you communicated with eachother, things got done.

Team nursing can work in some places, but there have to be clear roles, and everyone needs to know what they are to do, and clear communication is important.

I always hated relying on someone elses assesment. Now I work ICU and would never go back to the floor. I just found it so chaotic in a bad way and I hated not being able to do as much as I wanted with my patients.

So just beware, it may take some adjustment, but they may have a good routine going.

Cher