Nursing our unit is a team nursing

Nursing Care Models
Hyunhye Lee
Chamberlain College of Nursing
NR447 Collaborative healthcare
November 2018

Nursing care models
Nursing profession has been developed from a task-oriented occupation to a holistic professional practice. Heath care around the world is under mounting pressure to improve efficiency and to manage costs. Patients are better informed about their care, disease process and medication than before, and they expect to receive the high quality and effective care. Nursing care models were developed to define what nursing is and could be. They describe the beliefs, values, and goals of nursing and the knowledge and skills needed to practice nursing. Nursing practice models have been used to implement resource-intensive strategies with the goal of decreasing expenses and using staff more effectively (Finkelman, 2016, p. 111). The purpose of this paper is to identify nursing care models utilized in my workplace and enhance my knowledge of how models impact the management of care. I will evaluate the efficiency of the nursing care models that I observed at work and determine how I would improve my nursing practice by collaborating with other staffs.
Team Nursing Model
I work in a very busy medical-surgical unit and our nursing ratio is 1:5. I think the first nursing care model associated with our unit is a team nursing model. The team nursing model involves pairing nurses who work as a team to deliver patient care. This model consists of a registered nurse, licensed practical nurse, and unlicensed assisted personnel (Finkelman, p.111, 2016). This model utilizes the different qualification level and activities of the staff members. Nurses working in team nursing situations described team nursing as patient-oriented, facilitating accountability, encouraging collaboration, enabling better coverage of patients and providing better access to more experienced nurses as a reference point for their decision making (Cioffi, Jane & Ferguson, Lorraine, 2009). At my workplace, RN is the team leader who is responsible for 5 patients’ assessments, documentation, all the IV medications, patient education, and the admission/discharge process. The LPN is responsible for administrating the oral medications, blood glucose monitoring, and dressing change. The last member of the team is CNA, we also call them PCT (patient care techs). They are responsible for obtaining vital signs, blood draw, and assisting patients with meals and personal care. This team nursing has been working out well and providing a supportive environment for the staffs. When the environment is collaborative and staff communication improves, nurse’s satisfaction increases, and they feel more supported. “When teamed with the nursing process, a model could give shape and a structure to the nursing assessment, enabling a focus on the patient and allowing clear identification of the nursing problems and hence the nursing care the patient required” (Murphy, 2010). From nurses’ experiences the effectiveness of
team performance was dependent on working together and communicating effectively.

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Interprofessional Practice Model
I also observed the interprofessional practice model in our unit. Interprofessional teamwork refers to the cooperation, coordination, and collaboration expected among members of different professions in delivering patient-centered care collectively (Finkelman, p.113, 2016). Interprofessional practice starts with the patient and includes all healthcare providers working together to deliver patient-centered care. There is an interdisciplinary team meeting every morning in our unit. Case manager, social worker, physician, physical therapy, charge nurse, and all the floor nurses need to participate in the meeting to discuss patient progress, plan for the day and discharge plan. This coordinates an efficient patient care and makes the team members working together for the improvement of the quality in patient care and to avoid delaying of progress. At the meeting, we also assess the patient’s home situation, if the patient needs any home health or DMEs before discharge, and if the patient needs any follow up outpatient referrals. We also have a white binder placed at the nursing station named “It takes two.” nursing management always encourages nurses to make rounds with physicians and write the physician name in the binder if the rounding was done together. The result of the suggestions was that patient satisfaction was increased when the nurse and physician made patient rounds together.

Functional Nursing Model
Functional nursing is a task-oriented model of nursing care that became popular during World War II associated with nursing shortage in United States and in battlefields (Shirey, 2008). This model is focusing on achieving effectiveness in patient care through division of tasks to provide care for a large number of patients. Tasks are assigned based on an individual’s skills, knowledge, and abilities. In functional nursing, RN performs the complex patient care while other support personnel are assisting the patient’s routine care. A disadvantage of functional nursing model is no individual is accountable for total patient care, because many individuals performing pieces of total care (Shirey, 2008).

Primary Nursing Model
Primary nursing is a nursing care model that developed in the late 1960s to address the limitations of functional and team nursing model with emphasis on the professional aspects of nursing practice (Shirey, 2008). The primary nursing model is widely implemented since it has been an ideal way of organizing nursing care delivery. In primary nursing, RN is a responsible person to coordinate and deliver patient care during the patient’s hospital stay.
This model supports increased communication between the people involved in patient care as well as patient satisfaction. The benefits that patient can expect from the primary nursing model would be receiving enhanced continuity of care and quality of care. The primary nursing model also reduces nurses’ experience of stress and increases levels of staff retention in the work unit.
The team nursing model and interprofessional practice model are the ones that I observed and utilized in my workplace. I believe that these two models are beneficial in today’s nursing care for our patient since the teamwork in nursing and quality in health care delivery has been strongly emphasized. “Accountable care organizations are groups of health care providers that work as a team to coordinate care for a group of patients, with the goals of providing high-quality, patient-centered care and reducing costs” (National Alliance for Quality Care, 2013).
Team nursing can make patient care more smoothly by minimizing interruptions, collaborating with team members and helping patients efficiently. It can also help with the emotional and physical burdens on the job assignments. It is important to carefully consider the types of teams required to provide patient care with optimal outcomes that are professionally satisfying to all health professionals. In the interprofessional practice model, all the team members work together to provide good quality of patient care. Maintaining a mutual respect for each discipline and effective communication skill are essential to improve the interprofessional collaboration.
Cioffi, Jane ; Ferguson, Lorraine. (2009). Team nursing in acute care settings: Nurses’ experiences. Contemporary nurse. 33. 2-12. 10.5172/conu.33.1.2.

Finkelman, A. (2016). Leadership and management for nurses: Core competencies for quality care (3rd ed.). Boston, MA: Pearson.

Murphy, F. (2010). Nursing models and contemporary nursing 1: their development, uses and limitations retrieved from Alliance for Quality Care. (2013). The role of nurses in accountable care organizations. Retrieved from National Alliance for Quality Care.
Shirey MR. Overview: Nursing Practice Models for Acute and Critical Care: Overview of Care Delivery Models. Critical Care Nursing Clinics of North America. 2008;20:365-373. doi:10.1016/j.ccell.2008.08.014.

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