Finally, the exams were over and we got our work schedules; I was assigned to work the afternoon shift (4 – 12) on a Medical Surgical unit. I had spent several weeks on that unit throughout my first year so was familiar with the area. Medical patients on this ward were those with non-surgical diagnoses such as heart attacks, other heart conditions, pneumonia, complications of diabetes, abdominal or back pain, and strokes. Surgical patients were those recovering from surgeries. Both types were admitted to this ward but medical and surgical patients were not usually in the same room together. In the 1960s, hospital stays were typically longer than they are today so most patients were fully recovered by discharge day. A range of acutely ill, recovering, and fully recovered/ready for discharge patients filled the unit, allowing for assignment of a balanced nursing workload.
Reporting there for my first tour of duty, I discovered my role as a fully functioning team member was delightfully different from what I’d experienced over the last year as a Student Nurse. Team Nursing is the term used to identify the way nursing care in hospitals was organized at that time. The nursing unit was divided into two teams, with the central nursing station marking the half way point of the ward. All the patients at the A end of the floor were cared for by Team A staff members and similarly, Team B nurses were responsible for patients on the other end of the hall. I was assigned to Team A, and had primary responsibility for five patients, the same workload as the permanent staff members carried. It was gratifying to feel that I was pulling an equal weight as the other caregivers. It was further explained to me that my team mates and I would assist each other in caring for the entire group of fourteen patients on Team A.
One of my patients, Mrs. Jones, had had her appendix removed the previous week and was being discharged the next morning. Mr. Keen and his roommate, Mr. Adams, both had diabetes that neither was adequately controlling. They’d been admitted the day before for tests, and for medication and dietary adjustments to improve the management of their conditions. Mr. Cox had had a heart attack and was going home the next day while Mr. Mack, who had also had a heart attack, was only partially rehabilitated. His hospital stay would be extended by several more days.
Each team had a Team Leader who was in charge of her end of the hall, and who also usually carried a small patient assignment. A second RN, identified as the Medication Nurse, was responsible for administering medications to all the patients on our team. Only RNs gave medications in 1968, Personal Support Workers (PSWs) didn’t yet exist as a category of care providers, and Registered Practical Nurses – known then as Registered Nursing Assistants – were not permitted to give medications. One of the benefits of Team Nursing was that while the assigned nurse knew her patients very well, every Team member had a general knowledge about every patient. Therefore, those nurses who left the unit for their lunch and coffee breaks could do so without worry: the other team members would keep watch over their patients.