Vol. I, No. 4
August, 1954
Durham, N. C.
Too Many Chiefs and Not Enough Indians?
By Mary Whiting Thomas
Team Nursing at Duke doesn’t
have that problem!
Wliat’s Team Nursing? Something
new? How does it work and W'hy is
it better?
The concept of team nursing isn’t
new and what the members of the
team do isn’t any newer. The pur
pose of nursing is the same as it has
been from the beginning . . . the com
fort, the cleanliness and the healing of
the patient. It’s just a new term for
personalized, interested, GOOD nurs
ing care.
The war brought into sharp focus
the volunteer aide, the licensed prac
tical nurse and other auxiliary per
sonnel and the part each plays in
relieving the registered nurse of cer
tain duties. This, added to the assist
ance of the many antibiotics discov
ered during this period, caused the
nursing staffs of hospitals to stop,
look around and listen for a new look
in nursing care. We think team nurs
ing is the answer.
It. combines these otlier groups of
Morkers, the aides, the practical
nurses, the student nurses, into a
compact nursing unit. Delegating to
each the job suited to her si)ecific
ability and skill and based on the
patient’s needs, it gives high returns
in job satisfaction.
Well-Planned
Tlie team nursing plan is not a
sudden experiment at Duke. The com
mittee to study this plan has been
working on the details of such a pro
gram for about two years. It is not
installed arbitrarily on a ward. It is
explained and demonstrated and then
left up to the head nurse to request
it. Two series of lectures of eight
hours each have been given for head
nurses by Miss Helen Plyler and Mrs.
Elizabeth Gilbert both of whom at
tended the three-w’eek conference on
team nursing at Teachers College, Co
lumbia University. They head the
Duke team to demonstrate the new
concept.
Since January three wards, Cush
ing, Drake and Nott, have installed
the system and a fourth has just re
quested permission to change over.
The nursing office says it would take
approximately eighteen months to in
stall it throughout all the wards.
Under the old system the head
nurse on a ward containing, say 36
beds, was responsible for some indi
vidual patient service, or supervising
the service of an assistant, for each of
36 patients if the ward was full.
These duties were in addition to or
dering supplies, making rounds,
teaching student nurses, and checking
maids and orderlies in their regular
work. This usually meant a minimum
of nine people reporting to her about
everything and anything. Since all
j)atients obviously are not suffering
tlie same degree of illness this meant
more responsibility for some i)ersons
than others. All in all, it was more
than a full-time operation.
Now, under the team plan, the ideal
setup on tliis same ward would be
36 patients broken down into three
groups of 12 each. To each grou])
NURSE
r«ki«nts
would be assigned a team as follows:
a graduate nurse (team leader), a
practical nurse, and a student nurse.
Let’s make it clear right here,
though, that we emphasize “ideal”
setup. We have not yet reached this
nursing Utopia! Although there are
actually more graduate nurses on
duty now than since before the war,
there aren’t nearly enough to ’flu
every post in hospitals. Industrial
clinics, public health agencies, doc
tors’ offices, private duty and the
many other jobs which ro(iuire their
professional training and skill have
caused a shortage of prof(‘ssional
nurses.
There are many days when the
sum total of nurses on the ward might
be the head nurse and one team
leader, as the class schedules of the
students cut in on all sliifts, but with
work systematically delegated accord
ing to hel]) available and the tnnnber
of patients on the ward the job is
easier. The team, or fraction thereof,
confines itself to its assigned ))atients
exclusively and there is recognition of
labor, witli the emphasis on jobs to
be done for the patient. Tliese jobs
are grouped in the interests of econ
omy of time and expediency of serv
ice. There is time to know tlie patient
and his problems and sometimes this
(Continued on Pa(je 1)
TMm
Lttdtr
MEAD
NURSE
The Old Way
Patitnts
A New Day!