Disadvantages of functional nursing include:
● Uneven continuity ● Lack of holistic understanding of the patient ● Problems with follow-up
Because of these problems, functional nursing care is used infrequently in acute care facilities and only occasionally in long-term care facilities.
Team Nursing Team nursing (Figure 3-2) evolved from functional nursing and has remained popular since the middle to late 1940s. Under this system, a team of nursing personnel provides total patient care to a group of patients. In some instances, a team may be assigned a certain number of patients; in others, the assigned patients may be grouped by diagnoses or provider services.
The size of the team varies according to physical layout of the unit, patient acuity, and nurs- ing skill mix. The team is led by an RN and may include other RNs, LPNs, and UAPs. Team members provide patient care under the direction of the team leader. The team, acting as a uni- fied whole, has a holistic perspective of the needs of each patient. The team speaks for each patient through the team leader.
Typically, the team leader’s time is spent in indirect patient care activities, such as:
● Developing or updating nursing care plans ● Resolving problems encountered by team members ● Conducting nursing care conferences ● Communicating with physicians and other health care personnel
With team nursing, the unit nurse manager consults with team leaders, supervises patient care teams, and may make rounds with all physicians. To be effective, team nursing requires that all team members have good communication skills. A key aspect of team nursing is the nursing care conference, where the team leader reviews with all team members each patient’s plan of care and progress.
Charge nurse
UAP responsible for transportation
UAP responsible for vital signs
UAP with bath duty
Treatment nurse
Medication nurse
Patients