Ask the expert: Task load division for nursing care

Nurse Leader Insider, May 16, 2011

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This week, Gary. L. Sculli, RN, MSN, ATP, discusses how the nursing unit can apply task load division used in crew resource management to strengthen attention distribution.

Q: How does crew resource management use task load division to ensure attention distribution, and how can I apply it to my nursing unit?

A: Crew resource management (CRM) is about managing resources effectively, so it makes complete sense that when task load is high, as it is on most patient care units, the work should be strategically divided among the team. Dividing up the workload ensures two things: 1) Individuals are not placed at greater risk for low SA due to task saturation and depletion of the attention resource, and 2) everyone on the team is not focused on the same thing (attention narrowing). This is the premise from which I strongly advocate a team approach to nursing care. By this I specifically mean that more than one staff member is assigned to the care of a patient, and each staff member is responsible for different tasks. This, in my view, is preferable to primary nursing which, for the sake of this discussion, means a model of care where on licensed nurse carries out all aspects of the patient’s care on the unit: custodial care, medications, care planning, treatments, assessments, and communicating with physician providers. Primary care has its merits and is appropriate in certain conditions, but one must consider the fact that on many medical-surgical units, nurse-patient ratios are simply not conducive to sustaining this type of model.

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