Published Oct 20, 2000
I am a little disgrunted with the label of team nursing. It doesn't exist at my hospital, despite the fact that management says it does. In my opinion, a "team" consists of an RN, LVN(if used on your unit) and a CNA. On my unit, there aren't enough CNA's to make teams, and fellow RN's barely have time to take care of their own pts, let alone "team up" with another nurse. I was wondering what others had experienced regarding this.
I experienced the same at my former hospital skilled unit-where we had LTC regulations and staffing, which really meant less staff and increasing acuity. I usually didn't take notice of the team approach until I let an LPN know that a family member was leaving her dad and did he need put in bed for safety reasons? I had had him a previous week and was familiar with his history but uncertain of any changes needed in his care. The shift had just started and the LPN would have been inconvenienced by taking care of the situation and not very nicely growled at me (loudly) to get the CNA to take care of it. I asked the CNA to look into the situation and she made some excuse. I told her to get with her nurse and take care of it. (I said this in a nice way, but my face must have shown impatience,) any way the CNA went to the DON and I got into trouble for my tone!!! She said I should have gotten all three of us together for a plan of care. This would have taken up alot of crucial time; the LPN and CNA should have taken care of their assignment. We get authority, but only on paper. This was my first nursing job and I hated it. Team nursing there was just an excuse to blame the RN, possibly in a really adverse situation, where the hospital can prove themselves innocent of any wrongdoing. I left that position asap. I will never go back. (For many reasons-the 15-1 pt rn ratio for one)
Our hospital uses the team approach. We have one RN, one LVN, and one CNA for 8-12 patients. It works pretty well when we're properly staffed, but like goldilocksrn pointed out, we often times don't have the full team due to staffing problems. This creates much extra work for existing team members.
When the full team is staffed, work flow is evenly distributed and things go smoothly (usually!). When the LVN or CNA is missing, it makes for a very slammed shift.
At my hospital, we don't do team nursing any longer. We call it Modular Nursing. For example, if you work on a 38 bed unit, then depending on your staffing, the module can be individed into three or four. So, for purposes of explaining this, will say, 3 RN's for the day. You are assigned to module I. You are the primary nurse for that group of patients. You are responsible for their care, administering their medications,
picking up and transcribing orders, treatments, etc. Usually, on my unit, we try to keep the same nurse with the same group of patients for the number of days she may be working. It is to provide for continuity of care.
Has its advantages and disadvantages in comparison to team nursing. I recall team nursing before I became an RN.
Usually, each module has a nursing assistant, again depends how staffing is for the day.
Originally posted by goldilocksrn: I am a little disgrunted with the label of team nursing. It doesn't exist at my hospital, despite the fact that management says it does. In my opinion, a "team" consists of an RN, LVN(if used on your unit) and a CNA. On my unit, there aren't enough CNA's to make teams, and fellow RN's barely have time to take care of their own pts, let alone "team up" with another nurse. I was wondering what others had experienced regarding this.
I did do "team nursing" in the Emergency room as a nurse tech. In this instance it worked well. Partly because the techs knew their responsibilities: we would round on all the pts on our "team" (One side of the ED, about 15 beds) DO necessary vitals, help with the exams, run and get the juice, water etc that the pt has to have (or they will code, ). Escort non ICU pts to the floors, take EKGs, put in orders, run pts to xray/VQscan etc...and alert the RN to nursing needs (ie pain meds, "my chest pain is back!!, )and the warm blanket rounds. I really did feel Part of the team, and worked well with the nurses in that role. We really relied on each other- I don't see that too much on the floor and I don't know why.
I agree Cargal- a plan of care just to get a man into bed? Geez, I would have done it in a hearbeat- sure beats all the paperwork and guilt when the guy is found IV out, bleeding on the floor waving his foley cath around like a lasso...)
I think team nursing is a good idea in theory- I wonder why it doesn't usually work out? Too many patients/responsibilities?
It is hard to have a so called team approach in LTC without team players.Always being short staffed makes for short tempers. Our faclity could use some real leadership.
Worked in a "team" environment on a neuro floor. Patients were often in comas and vented, team approach worked nicely. But our teams were that of 2.... either an RN and Lpn or 2 RNs... very very rarely a CNA. It was 2 nurses for 14-16 patients. It really did work.
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