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Nursing Care Models: Healthcare Settings and Research


Nowadays, nursing plays one of the key roles in the medical sphere, as these specialists tend to be discovered as mediators between the management of the hospital and patients. The quality of the provided care and patient satisfaction are vehemently dependent on their actions while implying that their job is more complicated than simply offering medical assistance to the individuals in need (Kieft, Brouwer, Francke, & Delnoij, 2014).

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Thus, to ensure safety and high quality of the services, different nursing care models are used, and in the context of this paper, two of them will be described while one of them will be discovered in healthcare settings while another model will only be supported by the scholarly research. After that, the implementation and recommendations for the observed model will be proposed. In the end, conclusions are drawn to summarize the findings of the paper and identify the learning outcomes.

Observed Nursing Care Model: Description

In the first place, it is essential to observe one of the nursing care models in the hospital settings, as it will help understand the overall flow of the processes. In this case, the concepts of team nursing or collaborative healthcare were reflected in the nursing practice. In his instance, it can be concluded from the title of this model that it implies working together as a team to deliver high-quality services to the patients in need. During the observation, it was possible to identify that nurses worked under the supervision of a team leader. The leading nurse (James) organized a meeting at 7:30 in the morning and presented the tasks that have to be completed during the day.

After highlighting information about patients and procedures that had to be completed, every nurse was assigned different tasks that complied with his/her level of competences. For example, Jane was obliged to give medications to the patients, as she had a profound knowledge of pharmacology and was very attentive to their needs and conditions. Other procedures such as bed bath, back care, and measuring blood pressure were performed by other specialists. In this case, this example showed the delegation of responsibilities.

At 8 am, nurses started completing their tasks across the wards of the community hospital in the surgical department. The whole process was under the control of a supervisor, and the nurses were obliged to follow the instructions and recommendations while another meeting was organized during the day (2 pm) for a check-up. After the tasks had been completed, it was necessary to report the results to the supervisor while some of the nurses consulted him during the process. For example, Jane was not sure whether the prescribed medication was appropriate due to the changes in the condition of the patient and contacted James to adjust the treatment.

Observed Nursing Care Model: Scholarly Sources

To discover the topic profoundly, it is necessary to review academic publications that provide additional information about team-based nursing. For example, the article Collaborative Practice Models and Team-Based Care in Oncology by Coniglio emphasizes that it is essential to train nurses and educate them since working in interdisciplinary teams is of paramount importance not only due to the effective decision-making, high-quality services, and safety but also the ability to balance supply and demand in healthcare market (Coniglio, 2013). With the help of the literature review, the author points out that creating teams with PAs and NPs will contribute to the optimization of resource allocation and help fill the gaps due to the lack of physicians (Coniglio, 2013). Nonetheless, differences in education may be a potential issue, and designing a well-developed communication plan, defining goals, and providing training can be viewed as critical attributes of this nursing model.

In turn, the article Team Nursing Experiences of Nurse Managers in Acute Care Settings by Fergusson and Cioffi discovers the same framework but from the managerial perspective (Fergusson & Cioffi, 2012). With the help of interviews, it was possible to understand that this model was highly appropriate in acute care and surgical settings, as nurses stated that it not only ensured high quality of care and safety but also contributed to collaborative learning and professional development (Fergusson & Cioffi, 2012). Nonetheless, the effectiveness of the nursing practice was dependent on the ability of the leader to motivate the rest of the team, as disregarding this matter might lead to adverse consequences. Both of the publications were effective since they provided a profound analysis of the model and highlighted the ways to enhance it.

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Different Nursing Care Model

Apart from the vast popularity of team-based nursing, another model is primary nursing care (Finkelman, 2012). For example, the article The Effects of Primary Nursing Care Model: A Systematic Review states that this model organizes the overall framework for providing services to the patients while one nurse is responsible for caring for a patient in the long-term (Mattila et al., 2014). Thus, the paper wants to expand the knowledge of the topic, and with the assistance of a systematic literature review, discovers the impact of this model on patients, their relatives, and healthcare providers (Mattila et al., 2014). According to the study, it has an advantageous impact on patients in maternity care, while more research is needed to determine other effects. It is the main drawback of this publication.

In turn, the article Perceptions of a Primary Nursing Care Model in a Pediatric Hematology/Oncology Unit discovers patients and nurses attitudes towards the primary nursing model, and these results are acquired with the help of quantitative surveys and descriptive statistics (Nadeau, Pinner, Murphey, & Belderson, 2016). Apart from the assumed drawbacks such as ineffective structure, it was revealed that both groups tended to discover only a beneficial side of this approach. For example, they stated that building trusting relationships with patients was of high significance due to increased levels of safety and satisfaction (Nadeau et al., 2016). Both publications present a clear connection of this model with the patient-centered care that is currently gaining popularity in the society.

Implementation and Recommendations

As it was mentioned earlier, the team-based nursing model had to be implemented in surgical and acute care settings (Fergusson & Cioffi, 2012). In this case, the described example complied with the aspects emphasized in the review of the articles. It was implemented successfully while taking into account the identified recommendations. In the first place, James, the supervisor, was perceived as a leader and authority, as the tasks were distributed effectively between the team members based on their skills. Simultaneously, the nurses were motivated and sought his advice when needed. For example, Jane asked James whether it was necessary to adjust medication due to the changes in medical condition. Overall, James was able to organize the working process effectively (timely meetings) while uniting the medical personnel by the shared values.

Nonetheless, this approach implies that the offered service is highly fragmented, and it may create difficulties for ensuring safety. In this case, to increase employee satisfaction, safety, and quality, it will be reasonable to take advantage of the primary nursing model. In this case, patients will be highly satisfied since they will know their nurses by names while the services will become more personalized and patient-centered (Nadeau et al., 2016). To make a successful transition from team to primary nursing model, it is possible to organize the working process in a similar way, but James will assign patients for the nurses instead of delegating responsibilities. In this instance, the nurses will have to complete different tasks during the day and improve their professional skills. Nonetheless, if the hospital does not have the required resources to implement it, it may be necessary to design a schedule, and nurses will take turns in taking care.


To summarize, team-based nursing is well-structured and cost-effective, and these matters are the main reasons for implementing it in hospitals. It is often employed in acute care and surgical settings since these units require a high level of efficiency and safety. Along with that, other approaches tend to exist, and the primary nursing model is associated with personalized and patient-centered care, as only one nurse is responsible for caring for a patient in long-term. In the context of the presented case, it will be reasonable to transit from team to primary method, as it will have a positive impact on the satisfaction and professional growth of the employees and quality and safety of the provided care.

Thus, this paper helped me understand that selecting a particular model was dependent on hospital’s goals, financial resources, number of staff, and units, as for one medical entity the primary care would be appropriate while for another one it would not. Overall, the management of the hospital has to evaluate all market possibilities, as these is no universal model to organize nursing activities, and it may be necessary to integrate several frameworks to reach the desired outcomes.


Coniglio, D. (2013). Collaborative practice models and team-based care in oncology. Health Care Delivery: Perspectives, 9(2), 99-100.

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Fergusson, L., & Cioffi, J. (2012). Team nursing experiences of nurse managers in acute care settings. Australian Journal of Advanced Nursing, 28(4), 5-11.

Finkelman, A. (2012). Leadership and management for nurses: Core competences for quality care. London, UK: Pearson Education.

Kieft, R., Brouwer, B., Francke, A., & Delnoij, D. (2014). How nurses and their work environment affect patient experiences of the quality of care: A qualitative study. BMC Health Services Research, 14(1), 249-259.

Mattila, E., Pitkanen, A., Alanen, S., Leino, K., Luojus, K., Rantanen, A., & Aalto, P. (2014). The effects of the primary nursing care model: A systematic review. Journal of Nursing & Care, 3(6), 205-217.

Nadeau, K., Pinner, K., Murphey, K., & Belderson, K. (2016). Perceptions of a primary nursing care model in a pediatric hematology/oncology unit. Journal of Pediatric Oncology Nursing, 34(1), 28-34.

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