Healthcare team nursing is a staffing model that utilizes a head nurse and several team members to provide health care to a group of patients. It was first introduced in 1957 by Eleanor Lambersen.1 The goal at that time was to improve total patient care, maximize efficiency, and increase communication between staff members.
The team nursing practice fell out of popularity by the late 1970s with the introduction of other approaches to direct patient care. However, team nursing has seen a resurgence in popularity due to nationwide nursing shortages and the COVID-19 pandemic.
Why is Teamwork Important in Nursing?
Providing the best quality nursing care delivery should be the top priority of all healthcare facilities, and nurses are critical to overall patient outcomes.
However, all different types of nurses work long hours and many healthcare facilities are short-staffed. Without effective teamwork, nurses have a more difficult time performing their role efficiently, and the quality of patient care delivery suffers.
Prioritizing teamwork is important in nursing because it:
- Helps make up for staffing shortages
- Increases staff satisfaction and patient satisfaction 2
- Capitalizes on strengths of the care team members
- Maximizes available resources
- Grants new nurses to learn from more experienced co-workers
How Does Team Nursing Work?
Team nursing involves the delegation of duties for patient care delivery among several staff members. There is always a team leader or a nurse manager who is in charge of assignments. The nurse leader delegates responsibilities to other team members based on the type of care that is needed. This nursing practice allows for a better total patient care experience because each team member performs the skills in which they excel.
Communication is a critical factor for team nursing to be a success. The health care team lead needs to coordinate communication between team members to facilitate nursing care and any needed changes. When done correctly, team nursing can benefit both patients and staff.
What Does a Nursing Team Include?
The size of a nursing team will vary depending on the facility, staffing availability, and patient needs. Most nursing teams include a team leader, primary nurse practitioner, and unlicensed assistive personnel. Some teams are expanded to involve interprofessional collaboration that includes specialized nurses, therapists, dieticians, and other healthcare professionals.3
The roles of each team member typically go as follows:
- Team leader – The team leader, which can be the charge nurse, is the person in charge of coordinating all aspects of the team. The lead is typically an experienced RN with excellent coordination, communication, problem-solving, and organizational skills.
They need to be able to prioritize responsibilities and shift the tasks of staff as patient needs change. There is considerable pressure on the nurse leader because they’re responsible for planning patient care, assigning each team member tasks, providing care when needed, and maintaining a cooperative environment among all team members.
The team leader also needs to make sure that communication between team members is clear and consistent.
- Primary nurse – The primary nurse often acts as an assistant to the team leader. They can administer medications, help make decisions, and provide support for the team lead. Primary nurses also perform assessments and reassessments of patients.
Many hospitals pair a less experienced primary nurse with a veteran team leader or charge nurse. This is mutually beneficial as a newer registered nurse can learn from the more experienced one, while also removing some of the pressure off the team leader.4
- Unlicensed assistive personnel – This group can include CNAs, nursing students, patient care technicians, and assistants. Depending on the care the patient needs and the scope of the assistive personnel team member’s abilities, duties can include positioning patients, collecting data, bathing, feeding, and other tasks.
- Pediatric nurses – If your nursing team includes pediatric nurses, they will handle duties related to the care of child patients. Often pediatric nurses assist with family communication in a team nursing environment as they’re trained to work with children and families.
- Perioperative nurses – If your nursing team is caring for patients who are scheduled to have surgery, your team will include perioperative nurses. These nurses specialize in preparing patients for surgery, assisting during surgery, and post-surgery care.
- Pharmacists – The nursing team leader can communicate directly with the health care pharmacist to plan and obtain needed medications for the patient.
- Physical therapists – If a patient requires physical therapy while in the hospital, the nursing team will coordinate transportation to and from the physical therapy session. The team will also communicate with the physical therapists about changes in the patient’s condition.
- Respiratory therapists – When a patient needs respiratory care, the nursing team includes respiratory therapists in the treatment and care plan. This adds a layer of planning and communication for the team leader.
- Dieticians – The lead registered nurse has access to all of a patient’s up-to-date information and can communicate any changing needs in nutrition, variations in appetite, and other dietary-related concerns with the staff dietician. This allows for the best possible meal planning and nutrition care for the patient during their stay.
What Is The Difference Between Team Nursing and Primary Nursing?
Team nursing was very popular until the late 1970s when primary nursing began to take over as the most commonly used approach. However, the recent shortages in nursing staff and the COVID-19 pandemic have led to a resurgence in team-based nursing care models.
The main difference between the two is that primary nursing eliminates the team leader as a go-between for communication with physicians and the nurse providing the patient’s care. Instead, the primary care nurse communicates directly with the patient’s doctor. The primary care nurse then develops the care plan for the patient themselves.
In primary care nursing, some tasks are still delegated to CNAs, LPNs, and other patient care techs. Many experienced nurses and their patients agree that there are benefits and drawbacks to both approaches.
Pros and Cons of Team Nursing
Some benefits to using a team nursing model include:
- Better distribution of human resources
- All team members’ strengths are used
- Individualized patient care is prioritized
- Team members work together to make decisions
- Creating a learning environment for less experienced team members
There are also some drawbacks to the team nursing approach such as:
- Heavy reliance on effective communication between multiple members
- All activities are coordinated through one person who does not perform the tasks
- It creates a very high-pressure situation for the team lead
Pros and Cons of Primary Nursing
Primary care nursing supplanted team nursing in the late 1970s due to the benefits it offered at that time, including:
- Allowing RNs to be responsible for patients by making decisions about their care
- Creating stronger nurse to patient relationships
- Providing patients with more individualized care
However, many critics of primary care nursing argue that there are more drawbacks, including:5
- Giving newer RNs too much responsibility for patient care
- Being less cost-efficient
- Creating staffing issues when the primary care nurse is absent
- Not accounting for needed changes in the level of patient care
- Not establishing a centralized protocol for communication among staff
- Causing higher stress levels for primary nurses as they are solely responsible for the care plan
The Future of Team Nursing
The switch in approach from primary care nursing back to team nursing may have arisen from the COVID-19 pandemic, but it will likely stick around long after the pandemic has ended. With many hospitals facing staffing shortages and dwindling resources, the team approach is often a more cost-effective way to ensure all of a patient’s needs are being met.
The benefits to nurses are also difficult to deny.
By sharing responsibilities and creating a protocol for communication among all staff, nurses are better able to focus on patient care. Team nursing also provides opportunities for novice nurses to work directly with and learn from more experienced coworkers.
Finally, the future of nursing likely includes an increase in mobility. The popularity of travel nursing has grown and is expected to continue to do so. Nursing shortages create a demand which leads to better opportunities for experienced nurses who are willing to move around for their work. The team nursing approach works well when staff members are changing regularly.
Team Nursing and Host Healthcare
The return of the team nursing model is a positive change for many in the healthcare industry. Patients benefit from the team approach, as do staff members, especially when there is a shortage of nurses. Team nursing allows a hospital to better utilize its resources and provide opportunities for all staff to work with their areas of strength.
All of these features of team nursing have benefited nurses interested in travel. Travel nursing has become increasingly popular. When the nursing staff is regularly changing, a team approach assures that patients’ needs are being met.
There has never been a better time to be a travel nurse. If you’ve dreamed of a life of traveling and adventure, you should consider applying to be a travel nurse with Host Healthcare. Not only can you expect a great salary, an opportunity to see the country, and outstanding perks, but you can also benefit from learning from other
functional nursing teams across the nation.
- American Nursing History. Historical Review Nursing Care Models. https://www.americannursinghistory.org/models-nursing-care
- BMC Health Services Research. Introduction of a Team-Based Care Model in a General Medical Unit. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4940946/
- Lippincott Nursing Center. Team Nursing Model – What it is and How to Make it Work. https://www.nursingcenter.com/ncblog/december-2020/team-nursing-model
- Trusted Health. What is Team Nursing? https://www.trustedhealth.com/blog/what-is-team-nursing