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Nursing is a core practice of medicine that incorporates the vital role of taking care of patients with keen responsibilities selflessly dedicated to the protection, prevention of illness and injury, promotion and optimization of health and abilities as well as the amelioration of patient suffering through diagnosis and treatment (Finkelman, 2015). Nursing care models, depending on how they are used, aid greatly in the delivery of quality, safe and efficient care to patients. This essay will focus on the identification of nursing care models used in a given practice setting, providing the literature review discussing the scholarly publications concerning the models and recommendations on utilization of effective models for improvement of healthcare delivery.
Nursing Care Model in Specialty Hospitals
Primary Nursing Model of Care
In the medical world, there is a vast range of healthcare settings equipped for both general and specific treatment purposes. Some of the facilities that practice a primary nursing model of care include general hospitals, specialty hospitals and clinics, rehabilitation centers based on selective cases, home health care and physician offices. In regard to these particular health care settings and specifically concentrating on the observation based on Vasicek Cancer Center in Temple, Texas, the primary nursing care model identified was primary nursing.
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In the above-mentioned specialist facility in Texas, primary nursing is evidenced by the practice in which a primary nurse, who is usually a competent registered nurse (RN), is assigned with the duty of directly caring for a patient and their family. The named nurse is majorly responsible for planning and implementation of procedures during the period of the patient’s stay at hospital. All consultations should take place in the exam room between the patient and the assigned primary nurse and kept confidential by the latter (Finkelman, 2015). This model encourages nurse-patient relationship where the nurse is both responsible and answerable to the patient, their family, and colleagues (Finkelman, 2015). Despite being fully committed according to this nursing care model, the primary nurse may still resort to collaboration and collective efforts if she needs assistance. This collaboration between the primary nurse, colleagues and other professional groups, should, however be also allowed by the client, in a form of a written content.
Delegation in this setting involves the assignment of duties to the staff. in particular associate nurses by the primary nurse during their off duties and in offering assistance when on duty (Finkelman, 2015). It is key to note that delegation does not mean the shift in responsibility and does not give associate nurses any autonomous power in regards to the patient. In this setting, autonomy is assumed through the fact that the associate nurses simply follow guidance, instructions, and the developed care plan put in place by the primary nurse (Finkelman, 2015).
The effects of adaptation of this model in the current healthcare are both positive and negative. Some of the positive impacts include the favorable nature of the model realized through individually and continually tailored care of the patient, presenting them with the rare opportunity of participating in the planning and implementation of care and fosters increased communication and relations between all parties involved in the treatment process including family and associate nurses.
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Primary nursing has also been observed to positively correlate with patient experiences where it has aided in the assertion of mental well-being of the patient as well as the overall satisfaction. Notable effects of the primary nursing model on the assigned primary nurse manifest through the increase in job autonomy and independent process of decision making. However, a primary nurse’s stress level may be negatively affected since they are burdened with all the responsibility as well as accountability. Being in charge of patients 24/7 could prove to have immense pressure on even a trained individual. The primary nursing model according to the research increases the retention levels of staff in a given work unit. The success of this model will require co-operation of staff with the primary nurse ensuring that the care plan developed is keenly observed and will lead to the effective treatment of the patient owing to the high quality of healthcare provision hence contributing to the satisfaction of all involved parties.
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The changes in the various healthcare models have been duly noted and led to many leadership and management roles in patient care to acknowledge that nursing care delivery models should advance the practice of professional nursing and maximize the ability of each member of the healthcare team (Marquis & Huston, 2012). For this reason the majority of the traditional nursing care models, including a total patient care model, a functional model, and case management are not viewed as efficient and effective in the current healthcare system. However, many of the supposedly newer models of nursing care delivery, according to Marquis and Huston (2012), are merely the retitled, modified, or recycled versions of the older models. These models include primary nursing as well as it is still effective in the current modern setting. Additionally, it has been modified to actively involve other medical practitioners and professionals for increasing success and effectiveness (Marquis & Huston, 2012).
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Marie Manthey states that the major challenge of primary nursing is that the implementation and sustenance of such a serious level of sophistication of practice requires highly skilled managers and leaders at every level of the organization (Marquis & Huston, 2012). The main difference between the team nursing and primary nursing is that in team nursing a nurse-leader coordinates team members of different educational preparation levels and skills in the care of a given group of patients, whereas in primary nursing, one nurse has the 24-hour duty and responsibility for care planning and coordination (Marquis & Huston, 2012). Originally, the primary nursing had been designed for use in hospitals, but over the years it has been extended to home health nursing as well as hospice nursing (Clinical Diabetes, 2015). Just like team nursing can succeed with an all registered nurse staff so can the primary nursing succeed with a diverse mix of staff unlike previous belief of using an all-RN staff that was costly?
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The primary nursing care model assumes that patients get better care and recover with ease when they can build a therapeutic relationship with the medical practitioner that is directly assigned to them (Clinical Diabetes, 2015) It is of vital necessity that any hospital or facility seeking to implement the primary care model needs to allow the primary nurses real authority to make decisions related to the patients under their care. Some of the noted issues arising as a result of primary care nursing include potential failure of implementation if the primary nurse is unable to focus effectively on patients due to a shortage in resources and staffing (Clinical Diabetes, 2015). Scheduling issues may also prove to be a challenge in the effective implementation of this model.
It is undeniably true that the primary care model is advancing from the traditional setting to suit modern times with the encouragement of using mixed staff and continued reliance of the primary nurse on the adequacy of staff. It is also true that the model is resource intensive thus could prove to be relatively expensive. The primary nursing model involves a holistic approach to patient care that includes not only the patient but the patient’s family and other associate nurses as well. The intensive investment and focus on the patient-nurse relationship are evident through the primary nursing model where the patient actively participates in the planning and implementation of the care modes. The main evidence that supports the use of primary models is the massive advantage accrued from its use which is accountability as there is the absence of ambiguity in regards to who is responsible for the patient’s care plan. The main disadvantage is the lack of enough credited nurses available to appoint as primary nurses.
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Despite the effectiveness of primary care nursing model, the advantages arising from the use of newer models should be acknowledged. The Inter-professional practice model seeks to improve quality and identify the importance of all health practitioners. It runs by cooperation, communication, collaboration, and reliability (Finkelman, 2015). The specialty hospitals using primary care nurse models should consider the incorporation of some aspects used in inter-professional practice model to enhance effectiveness by utilizing professional skills contributed by all involved practitioners. The Vasicek Cancer Center specializing in oncology should consider borrowing aspects from patient navigation which is a newer method of nursing care. The patient navigation model majorly aims to aid patients with cancer and especially those at risk for poor cancer results (Finkelman, 2015). It can, however, be adapted for use in other patient populations. Through adaptation of this model, the specialist facility will be able to decrease the barriers thus ensuring that patients get the care needed. Adaptation of team nursing could also prove to be useful as teamwork will relieve the primary nurse of burdensome responsibilities and exhaustion. It could also prove to be more resourceful regarding the skills contributed by other professionals and the benefits of teamwork. Since teamwork embraces the mix in staff, it could save the organization a massive amount of expenses compared to using an all registered nurse staff.
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This assignment has led to massive research regarding nursing care models and has been vital in paving the way for the acquisition of knowledge of both traditional and newer models as well as their uses, importance and implementation methods. The wide range of materials provided for this research paired with the observation of Vasicek Cancer center has proved that each model has its pros and cons but whichever is chosen for use should match the patient needs in their diverse uniqueness. It is also evident that these models are continually evolving to adopt better and more comprehensive care techniques. The common aspect shared by these models, new and traditional alike, is the respect of autonomy, quality, safety, and delegation.