Difficult problems require creative solutions. None of us are strangers to the nursing shortage affecting nurses and patients everyday in the US. Since this problem doesn’t look like it’s going away anytime soon, as nurse innovators, it’s time we put our thinking caps on. A novel solution to staffing demands may be new formations of an old practice, something called the Team Nursing Model. You may remember learning about Team Nursing in nursing school and probably practice it every shift without even realizing it.
The concept dates back to WWII when nurses were pulled away from the bedside. Forced to come up with a way to still care for patients, the use of nurse aides increased drastically. Hospitals found that they could quickly train nurse aides to decrease the workload of hard-pressed nurses by allowing the them to focus only on tasks that their specialized training and education prepared them to do.
What this typically looks like today is a charge nurse (RN), primary nurse (RN), and ancillary personnel (often a CNA or similar nursing aid) working together as team members to care for a group of patients. Though this is the most common format for Team Nursing today, variations of this concept are endless and may prove to help combat the nursing shortage. Staffing strategies can vary from facility to facility as we work to be open to ways in which we can best work together to provide the highest quality of care for our patients.
Another take on team nursing utilizes LPNs. For example, one orthopedic unit I came across utilizes one RN, one LPN, and one CNA to work as a team to care for a group of 9-12 patients. The RN is responsible for assessments, the LPN is responsible for medication administration, and the CNA helps patients as needed. This model is a great way to utilize the skills of each team member to the highest potential and is nothing new.
Using this model is actually more traditional to the way in which LPNs have worked in hospital settings. However, some hospitals are recently finding it to be especially beneficial when they do not have enough RNs to cover the patient care load.
More ample-staffed units will assign RNs an additional RN to act as a partner that works closely with them to cover lunches, pass out late medications, and provide support and second opinions on cases that may require more experience or expertise than one of them has alone. In this case, the nurses will give/get handoff together on all their collective patients so they are aware of the background for each patient.
In this partnered form of nursing, patient ratios will likely stay the same as before the partnering since the partner is only meant to act as a resource to the primary RN. Anecdotes have shown that partnering nurses together can be helpful in units with a high number of novice nursing staff and new hires (looking at you, new grad nurses). Giving a novice nurse or new hire a more seasoned or senior nurse as a partner can build relationships and take pressure off a charge nurse to act as the only resource.
With fewer RNs available and more patients, it’s time to get creative and build a team of competent caregivers to provide the best experience for patients.
This general concept can be applied in various care settings and situations. The key is to keep in mind the unique problems that the unit staffing has, and then cater this concept to those specific issues.
The flexibility of the Team Nursing model is what allows it to shine in so many different scenarios. What unique applications of Team Nursing have you participated in or heard of? What ideas do you have for innovating hospital staffing? As Modern Nurses, now is our chance to make those ideas a reality!
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