Patient Care Delivery Model
1 Discuss the distinguishing characteristics of, as well as the pros and cons of the earlier models for organizing of nursing services that were in use (during the 1970s onwards), namely:
Answer: A The ‘Team Nursing’ model:
“Team Nursing” model emerged from the British model of a single Head Nurse after the Second World War. It had the following distinguishing characteristics:
Characteristics:
1 A Head Nurse oversaw two or three teams of registered nurses RNs and non-licensed personnel 2 Each team consisted of a RN who directed orderlies, licensed practical nurses, and nurse assistants 3 The team was held responsible for the care of the patient. 4 The Head Nurse help the most powerful position on the unit and was responsible for scheduling, staff performance appraisals, and making rounds, but did not have budget responsibilities
Negatives:
1 Nurses wanted more responsibility for patient care 2 The Head Nurse, (not the attending RNs), spoke to the physicians about all patients’ medical conditions
Positives:
1 A physician decided on a plan of care and it was the nursing staff’s responsibility to carry it out. This avoided any unintended negative consequence B The ‘Primary Nursing’ model:
Characteristics:
1 A specific RN (the primary nurse) was responsible about a patient’s condition from admission to discharge. 2 Physician spoke directly to the primary nurse about a patient’s condition instead of conferring only with the Head Nurse 3 The primary nurse then developed a plan of care for each patient which was implemented by RNs or nurse assistants on each shift
Positives:
1 The primary nursing model allowed the RNs to develop a relationship with patients similar to that of the physician-patient relationship
Negatives:
1 In extreme cases, the primary nurse would be on call for that patient 24 hours a day 2 This model required a high level of
Answer: A The ‘Team Nursing’ model:
“Team Nursing” model emerged from the British model of a single Head Nurse after the Second World War. It had the following distinguishing characteristics:
Characteristics:
1 A Head Nurse oversaw two or three teams of registered nurses RNs and non-licensed personnel 2 Each team consisted of a RN who directed orderlies, licensed practical nurses, and nurse assistants 3 The team was held responsible for the care of the patient. 4 The Head Nurse help the most powerful position on the unit and was responsible for scheduling, staff performance appraisals, and making rounds, but did not have budget responsibilities
Negatives:
1 Nurses wanted more responsibility for patient care 2 The Head Nurse, (not the attending RNs), spoke to the physicians about all patients’ medical conditions
Positives:
1 A physician decided on a plan of care and it was the nursing staff’s responsibility to carry it out. This avoided any unintended negative consequence B The ‘Primary Nursing’ model:
Characteristics:
1 A specific RN (the primary nurse) was responsible about a patient’s condition from admission to discharge. 2 Physician spoke directly to the primary nurse about a patient’s condition instead of conferring only with the Head Nurse 3 The primary nurse then developed a plan of care for each patient which was implemented by RNs or nurse assistants on each shift
Positives:
1 The primary nursing model allowed the RNs to develop a relationship with patients similar to that of the physician-patient relationship
Negatives:
1 In extreme cases, the primary nurse would be on call for that patient 24 hours a day 2 This model required a high level of