Let’s Look Back, at TEAM Nursing!
Submitted by Elaine Puricelli, RN, BSN
Writing this work after retiring from nursing. In 1988, I joined the field of nursing as a new grad. I had worked in another field for 10 years prior to graduating nursing school and I wanted to get a professional degree. Nursing fit the bill!
Working as a new nurse was wonderful and an affirmation that I made the right call, the right career choice. At that time, my employer engaged in a team nursing concept. As the registered nurse I was the team leader of my patients: That is, the patients assigned to me on a shift. The team consisted of a registered nurse, an LPN who was in a dedicated role as medication nurse, and a nursing assistant.
This was an AMAZING way to enter the field of nursing! I’m sure I will hear complaints from LPN’s reading this essay, stating that their role as the dedicated medication nurse was not the best use of nursing skills. However, the RN still had to administer I.V. medications and start I.V. drips; the medication nurse could hang antibiotics (I.V.) as I recall.
My takeaway point with this essay is that team nursing in this scenario, meant 3 sets of eyes on our patient load. The RN was required to start I.V.’s, take off doctors’ orders and administer I.V. push medication, but the RN was ENGAGED directly in patient care under this style of nursing! The nursing assistant and the RN worked side-by-side to provide outstanding care to the patient without the RN (myself, in this example), feeling chained to the medication cart and having the feeling that taking time out for patient care would make me late for a medication pass. Perhaps other nurses in my era didn’t appreciate this style of nursing care, but in more recent days, primary nursing is the paradigm.
I have NO IDEA how primary nursing model of nursing care took hold and became the norm. Perhaps LPN’s complained en masse that acting as the medication nurse, daily, was disengaged from the patient. But TEAM nursing, once again, meant 3 sets of eyes on the patients to whom we were assigned and many more opportunities for the patient to SEE a caregiver in the room, providing care for him or her.
In my opinion, primary nursing models are NOT progressive nor a thoughtful role for the caregiver. One set of eyes versus three sets! All three members of the team completely engaged in their roles. Perhaps with a small nurse-to-patient ratio primary nursing makes sense, but back in the day, taking on our many patients with a team approach was efficient and more gratifying to me as a nurse. I could assess my patients as per my role. I could perform personal care and wound care. Finally, I could team lead AS the team leader. An outstanding model of nursing care and a role which I relished as team leader and participant in my patients’ care, and a role for which my academic degree as a professional nurse made practical and professional sense.