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Team nursing?

Posted

I am wondering if anyone has any experience (positive or negative) with team nursing. I am on a transitional care unit that takes care of post-CABG, critical drips, general cardiac patients, and ICU stepdown. We currently run 4-5:1, with 1-3 CNAs to 33 pts. With 4 days notice and no training, management is about to roll out team nursing consisting of 2 RNs and 1 CNA to 11 patients. This just seems very unsafe to me, but trying to get feedback before I start stressing too much.

Thanks!

Team nursing has been around for decades and decades. Just like anything else it has its pluses and minuses. If executed as intended it isn't any more dangerous than any other model. I will admit that the ratios you are describing seem a little optimistic however you and your teammates will likely find a rhythm that works for you.

What is the goal and/or the purported benefit--from management's perspective? Why do they want to do this?

I have remote experience with team nursing, but not with 2 RNs on the team. I'm not sure how that would work, since it seems like it would be a little uncomfortable to function as an RN who is only doing part of the RN role...so it seems that naturally people would just say "I'll take these 6, you take those 5..." What else are you gonna do? You can't be just the med nurse or just the assessment nurse very easily...those things go together and our role is to bring the various elements together and have them all in consideration.

Interested to hear how people actually do this 2 RN team thing.

56 minutes ago, JKL33 said:

What is the goal and/or the purported benefit--from management's perspective? Why do they want to do this?

I have remote experience with team nursing, but not with 2 RNs on the team. I'm not sure how that would work, since it seems like it would be a little uncomfortable to function as an RN who is only doing part of the RN role...so it seems that naturally people would just say "I'll take these 6, you take those 5..." What else are you gonna do? You can't be just the med nurse or just the assessment nurse very easily...those things go together and our role is to bring the various elements together and have them all in consideration.

Interested to hear how people actually do this 2 RN team thing.

From what I've been told, their goal is to try to make things more efficient and smooth since we have massive staffing shortages right now. It's a hard unit and we have a ridiculously high turnover rate. I havent seen any documentation of a 2 RN team, just RN/LPN so I'm not sure how it will go. We have had zero education or notice of this so nobody has a clue. I'm guessing it will be 1 person has 5 the other has 6 and we will just buddy for tasks, but the only way this is different from the primary nursing we are doing is increasing our patient ratio.

So really they are looking to reduce the RNs and increase ratios?

It doesn’t sound like there is clearly defined roles. I think one is supposed to be assessments/tasks and another is like meds/some other tasks.

Zone nursing never works in my experience in the ED which is the closest I can think of

3 hours ago, emergencynurse2011 said:

but the only way this is different from the primary nursing we are doing is increasing our patient ratio.

That was certainly my thought when reading your post. But 🤷🏻‍♀️

Sour Lemon

Has 11 years experience.

4 hours ago, emergencynurse2011 said:

I am wondering if anyone has any experience (positive or negative) with team nursing. I am on a transitional care unit that takes care of post-CABG, critical drips, general cardiac patients, and ICU stepdown. We currently run 4-5:1, with 1-3 CNAs to 33 pts. With 4 days notice and no training, management is about to roll out team nursing consisting of 2 RNs and 1 CNA to 11 patients. This just seems very unsafe to me, but trying to get feedback before I start stressing too much.

Thanks!

My first nursing job had "team nursing" that consisted of one RN, one LVN, and maybe half of a CNA for 16 acute care patients. The RN was required to get report on all 16 patients (bedside report, as if). When the slightest thing went wrong, the "supervising RN" was hunted with a torch and a sharp stick.

It was NOT a good experience.

We did usually divide the patients in half and work more independently than as a team. It's just not possible to keep close, ongoing tabs on 16 acute care patients. It's not even possible to do with eight.

Edited by Sour Lemon

LibraNurse27, BSN, RN

Specializes in Community Health, Med/Surg, ICU Stepdown. Has 8 years experience.

OMG. 5 or 6 sick step-down patients?? How do you do it?

DavidFR, BSN, MSN, RN

Specializes in Oncology, ID, Hepatology, Occy Health. Has 35 years experience.

Sounds like just an excuse to up your ratios. Resist, resist, resist.

Are you unionised?

I wish we were unionized! The CNO managed to chase the reps off, unfortunately. Yeah I'm not sure how they think this will help, I'm starting to lose faith that my management has my back (they honestly used to, the new CNO has changed things) and am thinking about jumping ship. Very discouraged right now.

Also, they are zoning the unit, so your assignment is based on your zone. Not by acuity. We get such a variety from immunocompromised, to CABG, to medical with cdiff and VRE. This isn't a safe way to make assignments

3 hours ago, emergencynurse2011 said:

Also, they are zoning the unit, so your assignment is based on your zone. Not by acuity. We get such a variety from immunocompromised, to CABG, to medical with cdiff and VRE. This isn't a safe way to make assignments

I’m sure CT will love the cdiff patients next to their cabg patients.