Introduction
Professional care models in nursing are numerous, but they all have a common goal: providing the best services for the patients and keeping a positive attitude of nurse professionals by organizing a satisfactory working environment (Finkelman and Kenner, 2013). Some of the traditional models are rarely employed in current practice, but they are valuable as they form a basis for new approaches. The observed nursing care model is the health care team, model. The paper presents summaries of the articles related to the observed care model and a different care model, analysis of observations, recommendations of a different approach, and a conclusion of the experience.
Review and Summary of Articles Related to the Nursing Care Model Observed
In their article “The emerging primary care workforce: preliminary observations from the primary care team: learning from effective ambulatory practices project,” Ladden et al. (2013) emphasize the need for delineating the responsibilities of the primary health care team members. Ladden et al. (2013) mention primary care teams frequently do not have a rigid division of the functions performed by each team member. The new roles, as observed by the authors, involve inspecting patient records to find care gaps, contact the customers by phone, and instructing patients on performing self-care. The responsibilities of a registered nurse have been broadened to chronic care control and hospital-to-home transitions. Behavioral health providers are now accumulated within the practice and provide consultations and interventions. Physicians have changed their focus from single to shared accountability since the other members of a team are authorized to perform essential care operations (Ladden et al., 2013).
Taking into consideration such significant shifts in primary care team members’ duties, the scholars suggest that the primary care team model needs further examination and suggestions on the ways of improving it.
Another article related to the primary care team model is “Job satisfaction of primary care team members and quality of care” by Mohr, Young, Meterko, Stolzmann, and White (2011). The research is dedicated to the job satisfaction of the participants of a primary care team model. The authors argue that cumulative job satisfaction levels are connected with the values of quality standards. Mohr et al. (2011) remark that the quality of care is usually considered to be impacted by such aspects as financial encouragement, practice settings, and experience. However, the scholars emphasize the significance of qualitative primary care in job satisfaction of team members.
Mohr et al. (2011) determine two models to illustrate their findings: the job characteristic model and the job demands/resources models. The first model establishes the features which impact the medical workers’ motivation and job satisfaction: the importance of the task, variety, feedback, autonomy, and identity. The second model analyzes the impact of working conditions on the employees. Job demands (time pressure, workload tension, emotional requirements) do not produce a significant adverse impact at low levels but tend to become more serious when the number of demands grows. Job resources (supervisor encouragement, a system of rewards, participation in the decision-making process) are connected with employee engagement, and other positive factors (Morh et al., 2011).
Review and Summary of Articles Related to a Different Nursing Care Model
In their study “The importance of transitional care in achieving health reform,” Naylor, Aiken, Kurtzman, Olds, and Hirschman (2011) delineate the benefits of a transitional nursing care model. This model, according to the authors, is invaluable for people hospitalized with complex chronic states, as such patients are among the most vulnerable populations. Appropriate transfer from one care level to another is a crucial element in the system of health care services. Naylor et al. (2011) have investigated that the transitional nursing care model significantly decreases the frequency of readmission cases. The benefits of such a model become possible due to delineating the responsibilities of medical workers dealing with a particular patient. For instance, introducing of in-person home calls of nurse workers to discharged patients or appointing a nurse as a leader of care or a clinical manager are some of the advantageous outcomes of this nursing care model.
The article by Naylor and Sochalski “Scaling up: bringing the transitional care model into the mainstream” (2010) emphasizes the need for implementing the transitional care model in mainstream practice. The authors remark that such care model is crucial for patients with chronic diseases, and it incorporates a variety of time-limited services making primary care efforts complete. Naylor and Sochalski (2010) distinguish the following elements of the transitional care model:
- an exhaustive evaluation of the patients’ health preferences and aims;
- the care which starts with admission to a hospital and continues after being discharged;
- the introduction of an evidence-based plan for the care model;
- methods of compiling and sharing data across care institutions;
- integrated services during the hospital stay and later at home by a specially trained professional (Naylor & Sochalski, 2010).
Observations of the Implementation of the Nursing Care Model and Their Discussion
The observed care model was the health care team, model. I was able to make such a conclusion because of the number of people taking care of the patient and their roles. A patient with chronic hypertension (a male, 52 years old) was brought to an intensive care unit, and a team of health care practitioners was performing various operations. As soon as the patient was admitted to the unit, a registered nurse (RN) gave instructions to two nurse workers to find the patient record and check the person’s blood pressure. Upon finding out that the pressure was critically high, the RN prescribed an injection of hydralazine to lower the patient’s pressure. Meanwhile, another team member was contacting the patient’s family and making sure that they knew about their relative’s situation. When the patient’s blood pressure was stabilized, the RN said that she would monitor the man for several hours and then he could be taken home.
All actions of the team members were correct and timely. However, there seemed to be too many people with unclear roles. Also, I was worried about such a fast discharge of the patient.
Recommendation of a Different Nursing Care Model that Could Be Implemented to Improve Quality of Nursing Care, Safety, and Staff Satisfaction
In this particular case, I would recommend employing a transitional nursing care model. The patient has a chronic illness, and his age makes him vulnerable to such conditions. Thus, it would be a good idea if a specialist contacted the patient after being discharged and helped him cope with his condition. The man could benefit greatly from the phone or in-person visits and recommendations. The nursing care professionals would have better job satisfaction if they had clear roles and knew their duties.
Conclusion
The assignment allowed me to get acquainted with the traditional and modern nursing care models. I was able to identify the advantages and limitations of various models. The model I observed was quite helpful, but it lacked the team members’ coordination and clear role division. The model I suggested presupposes caring about the patient even after he is discharged. It has been proved that the application of such a model may prevent repetitive hospitalizations. The assignment was rather informative and beneficial for my professional growth.
References
Finkelman, A., & Kenner, C. (2013). Professional nursing concepts: Competencies for quality leadership (2nd ed.). Burlington, MA: Jones and Bartlett Learning.
Ladden, M. D., Bodenheimer, T., Fishman, N. W., Flinter, M., Hsu, C., Parchman, M., & Wagner, E. H. (2013). The emerging primary care workforce: preliminary observations from the primary care team: learning from effective ambulatory practices project. Academic Medicine, 88(12), 1830-1834.
Mohr, D. C., Young, G. J., Meterko, M., Stolzmann, K. L., & White, B. (2011). Job satisfaction of primary care team members and quality of care. American Journal of Medical Quality, 26(1), 18-25.
Naylor, M. D., Aiken, L. H., Kurtzman, E. T., Olds, D. M., & Hirschman, K. B. (2011). The importance of transitional care in achieving health reform. Health Affairs, 30(4), 746-754.
Naylor, M. D., & Sochalski, J. A. (2010). Scaling up: bringing the transitional care model into the mainstream. The Commonwealth Fund, 103, 1-12.