Have you ever seen real team nursing in practice? It is poetry in motion! Let me tell you how we worked together when we were all stationed at the Army Medical Center (AMC).
The orderlies were enlisted soldiers whose job it was to work as nurse’s aids. In wartime, they would serve as field medics. And they took their jobs seriously. To all of us, “serving well” meant promoting as much patient/soldier independence as possible – with a cheerful attitude.
LVN’s would either pass the non-injectable meds or perform all of the wound care and treatments. When doing wound care, they were careful to get the RN in charge to look at the wound before redressing it.
BSN RN’s would either act as charge nurse or pass the injectable meds and start IV’s as ordered. Generally, the RN with seniority would charge, but all the RN’s had to learn this function.
The charge nurse was responsible for performing assessment on each patient and documenting such, calling and talking to doctors about any problems concerning the patients, take off orders and tell them to the appropriate nurse, answer phones, direct traffic, and pretty much know everything that was going on in the ward at all times.
We worked hard for eight hours per day. We worked as a real team – just like the name “team nursing” implies. We knew our jobs, and we did them to the best of our ability. We each made sure we were all finished on time. And we played hard too. We actually liked each other. We got together for picnics, or some activity, with our families. We bonded.
When I again became a civilian, hospitals all used primary nursing. And that can make you feel like you are working all alone sometimes. The CNA’s are overworked, the boss is always demanding more from the nurses, the patients are waited on hand and foot. In civilian hospitals, nurses are expected to kiss patients on the place that their mothers used to spank!
Policies and new regulations in civilian hospitals far outweigh the rules at our AMC. With team nursing, we also had team spirit. We were a team of Army soldiers who were proud to have jobs in healthcare. But our identity was not in nursing. It was in being part of an awesome team of people we would take a bullet for.
If team nursing was to ever become popular in civilian hospitals again, there would have to be a lot of adjustments. With the MSN becoming the new RN entry level, the MSN would charge or pass injectables. The BSN would do the wound care and treatments or pass non-injectables. CNA’s would have to become CNT’s. All staff would have to perform their duties with excellence and HELP EACH OTHER. Patients would have to start participating in their own recovery and stop acting like they are at the spa. (You know the ones I’m talking about!)
Wow! What would that look like? Sounds like a revolution!
Anyway, maybe something to ponder. We loved it!