Team nursing?

[lnle3618]

I'm a baby nurse of only 6 months, when I took the job we had our own patient load 6-8 pts. As of a month ago, they are trying to go to team nursing. Hiring more lpns, aids...does anyone have ecperience with team nursing? Having a pt load of 10. With an RN to assess, lpn to medicate, and both help the aid. I'm so afraid if we have a weak link in this, it will make it more difficult for the others in the team. I have spoken to more experienced nurses about this and they say if it's done correctly it is a great thing. I've only done it a couple of days here and there as it is not going in full force yet. The whole time I was worried if the lpn was getting everything done in a timely manner. I'm so punctual about med passes. I am my worst enemy when it comes to worrying. . So just seeing if you all have some advice. Thanks!

[Been there,done that, ASN, RN]

This is a former nursing model known as team leading. It requires confidence in your team memers, which could take awhile to develop.

Worst case scenario is a team member not pulling their weight.

Make sure you know exactly what your role expectations entail.

As far a punctual med passes... get over it. It's a long standing joke that nobody can deliver all those meds in the "ideal" ivory tower expectations.

[NicuGal, MSN, RN]

I did team nursing on a busy surgical floor. We would have up to 16 patients on each team. Your team consisted of you, an LPN and an aide. And God help you if one of them was having an off day! If you had a good team you had a good day and things flowed well. At least now you wouldn't have as many patients, but you also don't have the ancillary staff we had. Make sure you set priorities straight off!

[Bringonthenight]

Agree with the above posters.

Team nursing can be great but your only as strong as your weakest member! I've worked in areas where it was fantastic and everyone worked hard and helped each other out, and I've worked in areas where someone in the team is lazy or just generally not good at their job and the whole team suffers.

It can also be stressful on you if someone in your team calls out and is replaced by an agency or float nurse- you'll be carrying that team all shift!

How are the other nurses on your floor? Are they team players? Have they helped you when you've been drowning? Have they taught you tips and tricks to make your shift run smooth? Or Is it a floor where the mentality is "that's not MY job" "that's YOUR patient that's calling".

That could give you an indication of what team nursing will be like on your floor.

[SoldierNurse22, BSN, RN]

Had experience with team nursing, hated it. No one ever seemed to know what was going on. As a Type A personality and a nurse who wants to keep her license, I have never had enough confidence in other people to trust them with my license.

[Sapphy, BSN, RN]

I worked in a rehab facility where they did team nursing. What I found, having gone there as a new grad BSN was that I was supposed to be the team leader with an LPN who had more experience in her little finger than I had in my whole brain, and one possibly two aids who usually had been in the healthcare field longer than me as well. There were days that everything ran smoothly. LPN passed the meds, I did the assessments and the treatments and dealt with the docs. But with 20 patients, it became that the LPN was just the med passer and I was just the treatment nurse. We were lucky if we even got a second to touch base during the day. So we would see this.... I am wrapping a patient's legs from toe to knee with ace wraps and the LPN is giving the patient their Lasix... those are two pieces of a puzzle that you want to know both of... but if we didn't even get a second to talk... see where I am going with this?

Also, on occasion there would be some resentment on both of our parts. I was ultimately responsible... but this LPN who had been in practice for 30 years has to answer to me who has been out of school six months? This poor nurse felt undervalued and underappreciated and I don't blame her. While I felt overwhelmed and terrified that I was going to make the incorrect, uninformed decision.

Now, as an educator in an LPN program, what I have learned from the whole thing is that LPN's as a general rule ARE undervalued. My students leave our program more prepared to practice clinically than I ever was coming out of a BSN program? Why? Because while I was toiling away in underwater basket weaving to get some silly elective credits, these amazing people are taking care of patients! My students start clinical 3 weeks into the program and are hands on from then on out.

So I have now totally gone off topic to say give LPN's the respect they deserve lol... but what I was trying to get at is that team nursing can work very well if you have the right team and the right support from administration. What I experience was administration trying to pit the RN's against the PN's and it just opened up an ugly can of worms.