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Hospital to ditch ‘team nursing’

Community: Newhall Memorial leaders will increase 1-on-1 interaction

Posted: April 22, 2011 1:55 a.m.
Updated: April 22, 2011 1:55 a.m.

Henry Mayo Newhall Memorial Hospital administrators are abandoning their “team nursing” program and introducing a more intimate model that allows nurses more time with fewer patients, hospital officials announced Thursday.

After a rocky reception to the hospital’s team nursing pilot project initiated last year, hospital managers decided to reinstate a staffing program that promises a higher ratio of registered nurses assigned to patients.

Thursday’s announcement means about 100 licensed vocational nurse positions at Newhall Memorial will be phased out, through attrition, over the next couple of years.

A patient at Newhall Memorial would experience a more enhanced one-on-one interaction with the registered nurse assigned to him or her under the new “primary registered nurse” model, according to a memo sent out to nursing staff Thursday from Larry Kidd, the hospital’s vice-president and chief nursing officer.

“Based on many factors, including assessment of patient care needs, input from the Staff Nurse Advisory Group, anticipated changes in health care delivery, ... the hospital has decided to transition to a primary RN model,” the memo states.

Team nursing
Hospital president and CEO Roger E. Seaver said the nursing model at Newhall Memorial has “always been evaluated for appropriateness of skills, needs of our patients and the availability of skilled nurses by license category.”

Under team nursing, a registered nurse is teamed with a licensed vocational nurse, or LVN. Together, the team handles more patients than an RN would handle by themselves.

The LVNs were brought into the hospital as a “substantial workforce” during California’s nursing shortage, Seaver said.
The latest figures, from February, show there are 364,214 RNs in the state, up from 285,734 in December 2003, according to California Board of Registered Nursing data.

“The general economy has had, and will likely have, a continuing impact on the hospital’s approach to care delivery,” Seaver said.

Two nurse titles

A registered nurse with 25 years of experience is paid $50.74 an hour, according to the California Nurses Association. An LVN is paid $14 to $24 an hour. An RN holds a college degree while an LVN completes a one-year study with extensive in-hospital training.

No LVNs are being fired or laid off, said spokeswoman Andie Bogdan.

“If an LVN graduates to become a registered nurse, for example, or if she leaves, her position won’t be filled by another LVN,” she said.

Two hospital units described as “less medically complex” will retain the team-nursing model: the acute rehabilitation unit and the behavioral health unit, according to Kidd.

By Sept. 30, 2013, the hospital is expected to have completed its transition from team nursing — a system set up after World War II, when nurses were scarce — to a primary-care model widely embraced by hospitals since the ’70s.

The hospital switched to a “primary RN model” of nursing, in part, so that it could remain competitive with other hospitals, said Bogdan.

“Other hospitals are going in that direction, and so we need to stay competitive,” she said Thursday.

Welcomed change
Gerry Daley, labor representative for the California Nurses Association, said: “We are glad the hospital has seen the light.”
California is the only state in the country that mandates a ratio of patients to licensed nurses. The ratio varies according to the level of care required.

Since about a year ago when team nursing went into effect, Newhall Memorial administrators have maintained the program meets the ratio of patients to licensed nurses demanded by the state.

Registered nurses, however, represented by an elected team of eight, have maintained throughout the year that team nursing compromises patient safety.

Opposition to the program intensified in the last few weeks with at least 154 registered nurses signing their names to a petition calling on administrators to “shut down the team-nursing program and restore ... primary care.”

A candlelight vigil planned for next week has been called off, Daley said.


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