Team-based model can help address critical nursing shortage hospitals across Canada currently facing

I’m a proud nurse, and now, as well, a hospital CEO.

I’m distressed about the criticism of team-based nursing, which has been slandered in the news recently.

I want to provide a different perspective, as someone who began their nursing career as part of a team-based model and now as a hospital administrator facing a critical nursing shortage. I also want to be clear that I am not arguing that we need fewer nurses. We definitely need more nurses.

Critics of team-based models argue that they are merely a cost-saving measure in response to the nursing shortage crisis, and that it leads to poorer care for patients.

That argument is a flawed and unfortunate distortion of a valuable way to provide health care. Team-based care is good for hospitals and patients, and it is good for nurses. This is how it works.

Currently, nurses are asked to look after every aspect of care for a patient — sometimes called primary nursing or total patient care. The intention is right; everyone agrees that we want to have one nurse with overall responsibility for the patient. However, the flaw in the thinking is that the nurse must do everything and if others help, it leads to “fragmented care.” I think this is nonsense. Team-based care encourages each team member to function to the full extent of their education, certification, and experience.

Teams can be made up of nurses, personal support workers, nurse practitioners and all manner of allied health professionals as well as non-clinical support staff. For nurses, having the support of other team members to assist with feeding, bathing and other physical and support needs of patients frees them up, as highly skilled professionals, to exercise their training. I know this.

My career began as a neurosurgical nurse, caring for very ill patients. I worked in a team-based model alongside orderlies, nursing assistants, rehabilitation nurses, lab technicians and others. This team helped me enormously to care for my patients, regularly checking in on them, particularly those who were unstable and needing close attention.

Many times, it was the orderly or a nurses’ aide who alerted me to urgent issues about a patient’s condition. I remember how challenging it became when the model of care changed, and those supporting roles were removed. With no team, I had to do everything myself and had to work far harder to track patient progress.

Teams are not unique to nursing. They are a feature of many professions and services. Dental offices share the work of the hygienist and the dentist. Both are important, but no one would argue that the dentist should perform the hygienist’s work. That would not make best use of the dentist’s training or time.

Any transition to a team-based model cannot be rushed, and team-based health care can only work when there is mutual trust, clear roles and shared measurable goals. And there will be variation depending on the clinical area involved — surgical wards do not resemble emergency departments

The evidence is clear that nurses make a positive impact on the health of patients and clients in every setting in which they work. My belief is that team-based care can be a tool to retain and recruit nurses, through elevating the profession and giving nurses the supports they need to focus on delivering exceptional patient care.

COVID-19 has exacerbated this country’s nursing shortage: it’s the most pressing challenge for every hospital in Canada.

I encourage other health-care leaders to dismiss the unfounded criticisms of team-based health care and embrace it as part of the solution to that labour shortage.

Jo-anne Marr is president and CEO of Oak Valley Health.