Team nursing
Team nursing is a collaborative care model in which a team of nurses and other healthcare professionals provide care for a group of patients, typically in critical care or inpatient settings. Developed in response to nursing shortages and the need for consistent patient care during the mid-twentieth century, this approach assigns responsibilities based on patient needs and team members' skills. A typical team is led by a charge nurse who coordinates care, assigns tasks, and ensures that all team members, including aides and technicians, contribute effectively. The model aims to deliver individualized patient care while enhancing communication and support among team members.
One of the primary advantages of team nursing is the improved quality of care, as patients benefit from the collective expertise of the healthcare team. However, the model can present management challenges, particularly in ensuring that team members' skills align with patient needs. Despite these challenges, studies indicate that team nursing can lead to greater job satisfaction and higher retention rates among nursing staff, as it fosters mentorship and collaboration between experienced and novice nurses. This approach ultimately seeks to create a more efficient and supportive environment for both patients and healthcare providers.
On this Page
Subject Terms
Team nursing
Team nursing is a model in which nurses and other health care professionals care for a group of patients in critical care or inpatient settings. The team nursing model developed as a response to a shortage of nurses during the mid-twentieth century and concerns that patient care under existing models could be inconsistent.
A team usually includes a team leader, such as a charge nurse, as well as nurses and nurses' aides, or patient care technicians. A team is usually responsible for about five or six patients at a time. The team leader must understand the patients' needs and plans of care. The leader also assigns patients to members of the team. The nurses delegate some duties for patient care to the aides or technicians.
Background
US hospitals have experienced nursing shortages periodically. For much of the early twentieth century, nursing was regarded as an occupation for women. During World War II (1939–1945), many women were eager to serve their countries and went off to war as nurses. The US government helped meet the resulting nursing shortage in the country by funding education programs for nursing students. Another tactic used by hospitals was to boost the numbers of licensed practical nurses (LPNs), a profession that originated during the 1930s. LPNs worked under the supervision of registered nurses (RNs). LPN education programs were usually about a year, while RN programs required about three years of education and on-the-job training. Many hospitals relied on nursing students for a large percentage of patient care. Hospitals also hired more nurses' aides, who might be employees or volunteers. Nurses' aides received little or no education in medical care. Training often consisted of several hours or a few days of instruction.
When the war ended, health care leaders expected many nurses to return home and resume their professions. This did not happen. Nurses worked long hours under difficult conditions for low pay. Many nurses simply chose not to return to the field. The demand for hospital care began an upward trend during the 1930s and escalated considerably during the 1940s. New hospitals were built to meet the demand, but nurse staffing lagged. The low wages deterred many people from attending nursing school. The profession was changing with the development of new medical advances, and hospitals needed nurses who could meet the technical needs of patients.
Hospitals again turned to LPNs and nurses' aides to fill the need. RNs took on a greater supervisory role and provided less of the hands-on care they had traditionally been involved in. By 1951, less than half of patient care was provided by RNs, according to the University of Pennsylvania.
For some time, many hospitals had used a system called functional nursing. This system assigned tasks to different nurses—for example, one nurse bathed patients, while another administered medication. With so many people with varied levels of training caring for patients, the level and quality of care that patients received varied widely. Many in the health care industry saw the need for a patient care system to address these concerns. Eleanor Lambertsen at Teachers College of Columbia University in New York City developed the concept of team nursing, or modular nursing. She first proposed the idea in her doctoral dissertation for her doctoral degree in education, which she received in 1957. Lambertsen envisioned a team led by doctors and experienced nurses, who coordinated patient care with physical and occupational therapists and social workers.
Teachers College Press published Lambertsen's team nursing dissertation. As a result, a pilot program putting her ideas into practice was developed and demonstrated at a cancer hospital in Manhattan. The nurses held daily meetings to review patient care plans and assign duties to LPNs and other staff. Many hospital administrators visited to see how the system worked.
Overview
Team nursing seeks to meet the needs of a group of patients through the assignment of professional and nonprofessional personnel. Care involves identifying needs, planning patient care, implementing care, and evaluating the care. Staff members are assigned to duties based on patient needs and workers' skills. A patient group might consist of a unit, such as a critical care unit, or a wing of a hospital.
Team nursing has benefits and drawbacks. The benefits are primarily seen in improved patient care, while the drawbacks are related to team duties and structure.
A main benefit is that patients receive individualized care. Team members are able to perform tasks that are in line with their skills, which provides the best patient care. Each member of the team can have input in making decisions that are in the best interests of patients. With many duties delegated to other members of the team, the leader is able to focus on documenting patient care. Under other patient care models, patients were assigned to individual nurses. Experts found that many nurses were not likely to help a patient that was not assigned to their care if that patient's nurse was busy elsewhere. Using the team approach puts multiple nurses in charge of a group of patients, and other team members are available to help when needed.
Despite the benefits, team nursing can be difficult to manage. The team leader is ultimately responsible for the patients' care, though other members of the team are performing many of the actual duties. Staff skills must match the needs of the patients, which may make work scheduling difficult. The outcome of a team's efforts relies on all members contributing to patient care.
Studies have found that hospital staff members report greater job satisfaction after a team nursing system has been established. Hospitals have also found that the retention rate among nurses is higher. This is attributed to the team concept, which pairs expert nurses with less-experienced nurses. New nurses report they have found greater opportunities for mentoring in teams as well.
Bibliography
Cioffi, Jane, and Lorraine Ferguson. "Team Nursing in Acute Care Settings: Nurses' Experiences." Contemporary Nurse, vol. 33, 2009, pp. 2–12.
"Collaborative Health Care: How Nurses Work." American Nurses Association, Jan. 2016, nursingworld.org/Content/Resources/Collaborative-Health-Care-How-Nurses-Work-in-Team-Based-Settings.html. Accessed 30 Nov. 2017.
"Eleanor C. Lambertsen, EdD, RN, DSc (Hon.), 2012 Inductee." American Nurses Association, 2012, www.nursingworld.org/EleanorCLambertsen. Accessed 30 Nov. 2017.
Ray, Linda. "The Advantages of Teamwork in Today's Health Care Organizations." Houston Chronicle, work.chron.com/advantages-teamwork-todays-health-care-organizations-5143.html. Accessed 30 Nov. 2017.
Saxon, Wolfgang. "Eleanor C. Lambertsen, 82; Introduced Use of Nurse Teams." New York Times, 10 Apr. 1998, www.nytimes.com/1998/04/10/nyregion/eleanor-c-lambertsen-82-introduced-use-of-nurse-teams.html. Accessed 30 Nov. 2017.
"Team Nursing Benefits Both Staff and Patients." Modern Medicine, 1 Dec. 2005, www.modernmedicine.com/modern-medicine/content/team-nursing-benefits-both-staff-and-patients. Accessed 30 Nov. 2017.
Weydt, A. "Developing Delegation Skills." OJIN: The Online Journal of Issues in Nursing, vol. 15, no. 2, manuscript 1, 2010.
Whelan, Jean C. "Where Did All the Nurses Go?" University of Pennsylvania School of Nursing, www.nursing.upenn.edu/nhhc/workforce-issues/where-did-all-the-nurses-go/. Accessed 30 Nov. 2017.