Observe staff in delivery of nursing care provided. Practice settings may vary depending on availability.
Identify the model of nursing care that you observed. Be specific about what you observed, who was doing what, when, how and what led you to identify the particular model.
Write a 5-7 page paper that includes the following:
Review and summarize two scholarly resources (not including your text) related to the nursing care model you observed in the practice setting.
Review and summarize two scholarly resources (not including your text) related to a nursing care model that is different from the one you observed in the practice setting.
Discuss your observations about how the current nursing care model is being implemented. Be specific.
Recommend a different nursing care model that could be implemented to improve quality of nursing care, safety and staff satisfaction. Be specific.
Provide a summary/conclusion about this experience/assignment and what you learned about nursing care models.
Nursing care Models to be used in the paper
The model of functional nursing is a task-oriented approach, focusing on jobs to be done. When it was more commonly used, it was thought to be more efficient. The nurse in charge assigned the tasks (e.g., one nurse may administer medications for all or some of the patients on a unit; an aide may take vital signs for all patients). A disadvantage of this model is the risk of fragmented care. In addition, this type of model also leads to greater staff dissatisfaction with staff feeling they are just grinding out tasks. When different staff members provide care without awareness of other needs and the care provided by others, individualized care may also be compromised. This model is not used much now. It can be found in some long-term care facilities and in some behavioral/psychiatric inpatient services, although in a modified form. In the latter situation, a registered nurse may be assigned the task of medication administration for the unit, and psychiatric support staff may be assigned such tasks as vital signs and safety checks of all patients. In this situation, RNs would still be assigned to individual patients to coordinate their care.
This model was developed after World War II during a severe nursing shortage and other major changes in medical technology occurred. It replaced functional nursing. A nursing team consists of a registered nurse, licensed practical/vocational nurses, and UAP. This team of two or three staff provides total care for a group of patients during an 8- or 12-hour shift. The RN team leader coordinates this care. In this model the RN has a high level of autonomy and assumes the centralized decision-making authority. Although the past approach to team nursing was thought to use decentralized decision making with decisions made closer to the patient, there actually was limited team member collaboration. In addition, these teams tended to communicate only among themselves and not as well with physicians and other healthcare providers. The team concept or model also focused on tasks rather than patient care as a whole. More current versions of the team model are different from this earlier type. Currently the team model has been changed to meet shifts in organizations and leadership corresponding to the needs for better consistency and continuity of care as well as collaboration and coordination and patient-centered care.