Nursing Care Models

Nursing Care Models Name
Institution
Date
Quality nursing care is undeniably every patient`s expectation upon admission in any hospital. Nevertheless, this is not always the case especially in developing countries due to either unqualified nursing practitioners or shortage of competent nurses. A well-structured curriculum should be instituted in colleges to ensure that before their graduation, nurses are equipped with both theoretical and first-hand practical skills.
In the hospitals, nurses are expected to employ evidence-based practices, such as nursing care models, as a guide. According to Finkelman (2016), nursing models provide a framework that governs the nursing profession to guarantee better treatment outcome, improved nurse-patient relationship, patient satisfaction, job satisfaction for the nurse, and reduced financial burden.
Nursing models like team nursing have been in existence for decades. However, due to the progressive change in the nurses’ role, the complexity of diseases, and technology, newer models have been developed. Finkelman, (2016) mentioned that newer models such as inter-professional care are patient-oriented while the older models like team nursing, are task-oriented.
The nursing care model at American Fork Hospital
Dad was diagnosed with diabetes approximately ten years. With a strong desire to live long, he entirely adhered to the prescribed regimen. Two days ago, he was diagnosed with diabetic foot and admitted to the American Fork Hospital.

Today was my turn to keep him company in Ward 3, bay 2. At 7 a.m. the primary nurse came in to check on him. She was jovial and smiled often. I introduced myself, and she said: “I am your dad’s nurse”.
She did the routine sugar test before giving dad the scheduled medication; breakfast had been served at 6:30 a.m. She inspected dad’s foot, did some wound cleaning and dressed it. She finally changed the bedding, the patient’s clothes and indicated something in the treatment sheet before moving on to her next patient in bay 3.
The same nurse came along at lunch hour and in the evening to attend to dad, but in the evening, she was accompanied by another nurse and explained to her what to do during the night shift. The following morning, the primary nurse was among the medical team that came to assess dad. She took the responsibility of explaining the patient’s progress to the rest of the team since she understood the patient better. The nursing care model at the hospital was primary care model since a specific nurse was assigned to one patient during the day, the primary nurse gave orders to the night-time nurse.
Primary care model
Primary nursing care is a fundamental tool that can be relied upon for efficient and effective delivery of nursing services to both the patient and accompanying friends and relatives (Mattila et al., 2014). The effects of the nursing model to both the patients and the nurses were analyzed by Mattila et al. (2014). The authors observed that patients were more satisfied with individualization of nursing care. Participants reported an improved patient-nurse relationship which enhanced psychosocial support and continuity of quality care leading to improved treatment outcome.
The authors also confirmed that the nurses who practised primary care experienced job autonomy and the complexity of their regular duties decreased. In addition to that, one of the studies reviewed by Mattila et al. (2014) showed that the turnover among the nurses under primary care model was lower than in team nursing. Even though the primary care model led to patient satisfaction, the authors confidently ascertained that the model did not bring job satisfaction for the nurses.
From the systemic review, the author discovered that the primary care model is more economical than the team nursing. One of the studies examined specified that primary care model is 6.5% less expensive than team nursing (Mattila et al., 2014).
Mattila et al. (2014) concluded that the primary care model is reliable as it culminates in patient satisfaction, improved psychosocial support, enhanced information flow, reduced job complexity for nurses, it is less costly and produces better treatment outcome. The author also ascertained that the primary care model might not lead to nurses` job satisfaction.
Johansson et al. (2015) analyzed the impact of primary nursing in haemodialysis care. In the introductory remarks, the author claimed that the model was introduced to minimize the fragmentation of patient care and that the model was the best option for chronically ill patients. The participating nurses revealed that patients in the haemodialysis unit require total attention, understanding, and psychosocial support: a patient-oriented model was the best choice.
The authors proved that the nurses in the study were in control of their duties and could make decisions in consultation with other health providers. Feeling in control produced professional contentment and job satisfaction. Patients reported satisfaction with the nursing care. However, the nurses complained about the extended care of a single patient since some patients are never satisfied, they are so demanding.
Johansson et al. (2015) concluded by acknowledging that the study focused on chronically ill patients and the findings may apply to nursing of other chronic diseases such as cancer. All the same, the author illustrated that primary care model implementation requires thorough assessment and consultation with all stakeholders including the nurses.
Team nursing
Cioffi and Ferguson (2009) assessed the effect of team nursing on the nurses. Team nursing entails a group of nurses, working under the supervision of a registered nurse, attending to a group of patients. The author, in particular, pointed out that team nursing is the model of choice in cases where there are more enrolled nurses but very few registered nurses. Unlike primary nursing where the effectiveness of patient care relies on the primary nurse, efficient patient care under team nursing depend on the leadership of the team in addition to the commitment of each nurse in that group.
Cioffi and Ferguson (2009) illustrated numerous benefits of the team nursing. The model is task-oriented, and it encourages collaboration among the members to ensure continuity of care. The model provides a better opportunity to consult and learn new skills from the experienced nurses in the team. In the study, some nurses indicated that team nursing led to an improved working relationship with other nurses.
Despite the benefits, nurses involved in the study mentioned various shortcomings of team nursing. The workload was increased if some members of the team were on a sick leaf or when the hospital was not financially stable to employ enough nurses. Moreover, the nurses identified poor information flow among the team members as a cause of medical errors and poor treatment outcome. The author concluded by advising hospitals to evaluate their available resources before implementing team nursing; team nursing is not feasible where there is a shortage of nurses.
Ferguson et al. (2011) asserted that team nursing came about due to nursing skill mix. Nurses with various skills work together under the leadership of an experienced registered nurse. The author states that when nurses work as a team, medical errors are reduced, the nurses are more productive and exhibit job satisfaction. Patients also enjoy the continuity of care, satisfaction, and better and safer medical care. The nursing students also benefit most from this model since they learn a lot from the team unlike in primary nursing where they are trained by only one nurse.
On the other hand, Ferguson et al. (2011) affirmed that team nursing leads to overburdening of some team members. Poor team leadership cause poor working relationship, unfair work allocation, poor information flow, and decreased productivity of the team. Ferguson et al. (2011) concurred with Cioffi and Ferguson (2009) on the importance of effective communication in team nursing. Poor communication resulted in potential risks that would harm both the patient and the nurses. Shift communication sheets, face to face communication, and walk-around reports were identified as the primary communication channels. In their conclusion, Cioffi and Ferguson (2009) emphasized the importance of managers involving nurses in making decisions on the nursing model to be used. Besides, availability of enough resources should also be considered when selecting a nursing model.
Primary care model implementation
A validated approach is essential in the execution of any nursing model. The initial step is collecting relevant facts about the resources required, both financial and human resource (Légaré et al., 2011). The resources should be estimated based on the hospital inpatient capacity. After collection of the information, various stakeholders: hospital management, the physicians, and all the nurses come together to make an all-inclusive decision. Everybody’s contribution should be given due consideration before a conclusive decision is made.
The second step of implementation is trial of the model on a small scale. A few patients in each ward are allocated nurses over a specified timeframe. All the challenges encountered during this period is documented by the nurses. The problems are analyzed, and solutions sort out before the model is rolled out in the entire hospital. Subsequently, the long-term and short-term impacts of the model on the nurses, the hospital management, the patient, and the relatives are determined (Légaré et al., 2011)
My choice model.
An appropriate nursing model should be economically viable, lead to patient satisfaction, and job satisfaction for the nurse (Finkelman, 2016). The model should also take into account the availability of registered nurses. Because of the complex demands of the patient, nursing of the patient should not be left to only nurses, all the medical practitioner in the hospital must be involved in the care of the patient. Consequently, I will prefer interprofessional practice model. As reported by Finkelman (2016), this nursing model combines interprofessional competency of both physicians, nutritionists, psychologists, nurses, clinicians and pharmacists to ensure all the patient`s needs are catered for.
Conclusion
Nursing models are evidence-based tools that guide nurses in their operations (Finkelman, 2016). Old models like functional nursing were task-oriented whereas newer models such as interprofessional practice model are patient-focused. Unlike task-oriented models, patient-oriented ones lead to better treatment outcome and patient contentedness. Some factors guide the selection and subsequent implementation of a nursing model. To begin with, the implementers must check whether they have enough finances to acquire enough nurses required for enrolment of the nursing model. Additionally, the implications of the model on the nurses, other health providers, and patients should be examined.
Although nursing is believed to be an absolute role of nurses, some models such as interprofessional model insist in collaboration with all the healthcare providers in patient care (Finkelman, 2016). Physicians, psychologists, nurses, pharmacists and nutritionists must work together to attain desirable treatment outcome and patient satisfaction.
References
Cioffi, J., & Ferguson Am (2009). Team nursing in acute care settings: nurses’ experiences. Contemporary Nurse, 33(1), 2-12.
Ferguson Am, Lyon, & Cioffi, J. (2011). Team nursing: experiences of nurse managers in acute care settings. Australian Journal of Advanced Nursing, 28(4), 5-11.
Finkelman, A. (2016). Leadership and management for nurses: Core competencies for
Quality care. Pearson.
Johansson, P., Lundström, K., & Heiwe, S. (2015). The primary nursing care delivery system within a hemodialysis context–experiences of hemodialysis primary nurses in Sweden. Clinical Nursing Studies, 3(4), 7.
Légaré, F., Stacey, D., Pouliot, S., Gauvin, F. P., Desroches, S., Kryworuchko, J., … & Harrison, M. B. (2011). Interprofessionalism and shared decision-making in primary care: a stepwise approach towards a new model. Journal of interprofessional care, 25(1), 18-25.
Mattila, E., Pitkänen, A., Alanen, S., Leino, K., Luojus, K., Rantanen, A., & Aalto, P. (2014).
The effects of the primary nursing care model: a systematic review. J Nurs Care. doi,
10, 2167-1168