I’ve often joked that we should hold onto things that have gone out of style. What goes around comes around and, before we know it, we’ll again be wearing bell bottoms and sporting a shag haircut. Until the COVID-19 pandemic, though, I would never have imagined that team nursing would be one of those things to come back into style.
I briefly experienced team nursing as a new RN in the late 1970s. After that, primary nursing became the preferred patient care delivery model. Since then I haven’t given team nursing much thought, nor did I appreciate the history. I’ve recently learned that team nursing began during World War II. The military faced a shortage of nurses and trained ancillary healthcare staff and medics to work with nurses in a team-based model. This model was later adopted by the Veterans Administration Health System and eventually spread to other hospitals.
Now, because of the COVID-19 pandemic, critical care units in some areas are pushed beyond their critical care staff’s capacity. Surges in critically ill patients means that hospitals are unable to maintain a primary nursing care model and must find ways to leverage existing critical care expertise to serve larger numbers of patients. Forward-thinking organizations have reached into the past and rejuvenated the team-based model to combat the COVID-19 crisis.
The move to a team style of patient care allows for the redeployment of staff from other areas to assist in the care of critically ill patients with COVID-19. In fact, the Society of Critical Care Medicine’s “United States Resource Availability for COVID-19” provides a team-staffing framework. This tiered, team model is similar to the traditional team model. It assigns non-critical care staff and providers to perform specific elements of care for critically ill patients, while staff with critical care experience focus on elements that require their expertise.
However, questions and challenges arise when models of care shift. Team nursing requires the designation of a team leader who is responsible for coordinating care for a pod of patients. Team leaders wonder about the impact this may have on their liability and license. They also must determine how to designate and distribute the workload while ensuring the alignment of core competencies with patient and family needs.
In this video presentation “Team Nursing Revisited During COVID-19,” Rose O. Sherman, EdD, RN, NEA-BC, CNL, FAAN, well-known nurse leader and an expert in team nursing, describes strategies to support a successful transition to team nursing. She also discusses concerns related to team nursing. AACN thanks Dr. Sherman for generously sharing her content. To learn more, see her blog, “Revisiting Team Nursing During COVID-19.”
Additional AACN Resources
AACN resources to meet the learning needs of non-critical care staff include:
- AACN blog: “How Do We Staff During the COVID-19 Pandemic?”
- A free course: “COVID-19 Pulmonary, ARDS and Ventilator Resources”
- COVID-19 resources that can be downloaded at no cost from our procedure manual
- Sample checklists for professional development nurses providing education to non-critical care staff
Comment below about the benefits of team nursing during a patient surge from COVID-19.