When comparing the Functional model against the team nursing model, several pros and cons can be determined with each. The functional model has less staffing involved but each staff member is designated to a specific task. Each person becomes efficient at specific tasks, and much work can be done in a short time (Yoder-Wise, 2019). But when you have a unit of 30 patients, one person performing a specific task/intervention can become time consuming depending of the needs of the patient. For patients, it does not allow for personalized care, which dehumanizes them, leading to poor quality care and major flaws in patient safety when compared to other methods (Parreira et al., 2021). Some advantages of the team method, particularly compare with the functional approach, are improved patient satisfaction, organizational decision making occurring at lower levels, and cost effectiveness for the agency (Yoder-Wise, 2019). When you have a team nursing in place, you cut the patient load in half, which can be more beneficial to patient and the staff itself. One study reported decreased medication errors and fewer emergency codes outside the ICU after implementing a modified team nursing model (Beckett et al., 2021). From experience with only team nursing myself, the team must be open with communication with one another. One negative advantage to team nursing that happened in the eight bed ED, with only two RNs and a tech at the time, was that there as a lack of communication in regard to collecting a specimen on a patient. I, at tech at the time, was unaware of needing to collect said specimen and ended up throwing it away. Now, as an RN, I make sure my coworker knows what interventions I have done or that I am waiting to do. Both models require communication between each staff member but until I experience functional nursing, team nursing will, in my opinion, require the most. When communicating with the staff utilizing the functional nursing model, you can have interventions “pile up” on each staff member due to the specific tasks the staff is allowed to do or not do. Does it really make sense to have one staff member perform all of one specific task? I understand the staff can be cross trained with task under the scope of practice depending on the credentials, but at the end of the shift, it is the Charge Nurse/RN license at risk.
When calculating hourly rates, the gross income for one month with the functional model staff, is approximately $17,280, and for the gross income for one month of the team nursing model staff, is approximately $27,360. Functional nursing is obviously the most cost effective when staffing a unit but are you really saving money if patient safety/satisfaction could become compromised or infections rates are increased due to the lack of staffing?
References
Beckett, C. D., Zadvinskis, I. M., Dean, J., Iseler, J., Powell, J. M., & Buck-Maxwell, B. (2021). An integrative review of Team Nursing and delegation: Implications for nurse staffing during covid-19. Worldviews on evidence-based nursing. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8450812/Links to an external site.
Parreira, P., Santos-Costa, P., Neri, M., Marques, A., Queirós, P., & Salgueiro-Oliveira, A. (2021). Work methods for nursing care delivery. International journal of environmental research and public health. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7924841/Links to an external site.
Yoder-Wise, P.S. (2019). Leading and managing in nursing (7th ed.). Elsevier.