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The Nursing Care Models Implementation


Currently, multiple models of care can be implemented in hospital settings. Some of these approaches are no longer used by the majority of establishments due to a number of reasons. According to Finkelman (2017), the functional model of nursing care, for instance, is utilized considerably less today. However, the models adapt and change with time which means that they may become widespread again. Overall, current trends show the popularity of patient-centered models that focus on the specific needs of an individual and try to match these requirements with the qualifications of a nurse. This type of model is vastly different from older approaches. The approach to care that is observed by the author in this essay can be defined as the primary care model. This paper aims to assess the implementation of the nursing care model in observed settings and recommend a different approach that could be utilized by the hospital to improve the quality of nursing care on the basis of scholarly resources.

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Review of the Observed Nursing Care Model

Primary care nursing (PCN) is an approach that focuses on patient participation. According to Riva, Schulz, Staffoni, and Schoeb (2014), a high level of interaction between a patient and a primary nurse positively affects the level of quality of care and impacts the way people view their treatment. The authors state that this model of care gives patients more freedom of choice, which affects their sense of personal control and encourages them to comply with the proposed treatment. As a result, persons report to being more satisfied with the provided care. Nurses, on the other hand, may feel that the burden of decisions is not as significant as in some other models of care.

This article investigates the process of patient discharge planning in the settings of PCN. The scholars note that discharge planning is an issue for many professionals as it reveals the need for communication between patients and the staff. The model of PCN is defined by this particular feature as it provides individuals with a primary nurse who monitors patients during their time at the hospital. Moreover, the decisions about one’s health are also discussed between a nurse and a client. While describing the communication between patients and primary nurses regarding discharge planning, Riva et al. (2014) state that the implementation of the PCN approach may benefit establishments that heavily rely on client participation. For example, rehabilitation centers that value a high level of compliance from their patients can use PCN as a way to make people more comfortable during their recovery process. However, it remains unclear whether patients and nurses may benefit from using this model in a different care delivery setting.

Another article that examines the benefits and drawbacks of the PCN model is written by Johansson, Lundström, and Heiwe (2015), who review the adapted type of this model in a setting that was not considered in the design of the approach initially. In this case, patients receiving hemodialysis treatment were asked to participate to see whether this model of nursing could bring any positive results. The authors state that the implementation of PCN for hemodialysis patients yielded mixed results. On the one hand, nurses who possessed the necessary qualifications were able to care for the persons and provide them with the needed support. On the other hand, many nurses reported a high level of stress which was caused by the frustration and negativity of the patients. The need for education is outlined by the authors as nurses often lacked communicational skills and specific knowledge about the treatment. The article concludes that this model of care can be used only after the excessive alteration.

Review of a Different Nursing Care Model

The role of patients and their relationship with nurses is also highlighted in another approach to nursing care, called the synergy model. For example, Spross (2014) states that the structure of this model focuses on the connection between nursing practice and patient outcomes. There are a number of elements that can be defined in this approach, including the patient and his or her features, the nurse and his or her competencies, and the system of healthcare itself. The characteristics of an individual and the competencies of a nurse become the central aspects of this strategy as it argues that these factors play a significant role in a patient’s path to recovery.

Nurses make decisions and act to help the patient go through the system of healthcare safely and successfully (Spross, 2014). The model highlights that some of the determinants of health are not under the nurse’s control, because an illness may appear as a result of a complex combination of socioeconomic, genetic, biological, and psychological factors. Thus, nurses should do everything they can to accommodate their patients and ensure that the system, the nurse, and the client are working together to reach the best outcome for the latter.

An example of an implementation of the synergy model is presented in the study of Swickard, Swickard, Reimer, Lindell, and Winkelman (2014), who examine the adaptation of this approach to the interhospital transfer of patients. The authors note that this type of care delivery would fit well with the process of transportation as it focuses on the needs of the patient. The model is centered on the synergy of the client and nurse’s characteristics and abilities. Furthermore, the researchers point out that this particular approach can be used in a wide variety of settings as it can be easily adapted to the needs of the establishment.

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In fact, the study presents multiple cases where the synergy model is used to determine the need to transfer the patient to a different facility to provide the best care possible. The authors show that the synergy model is based on the evaluation of the client and the available services of the hospital. Thus, this approach heavily relies on communication between the individuals and nurses, which is similar to the PCN setting. However, this particular model does not place the responsibility for the patient’s health on one nurse but distributes the weight of every decision among the qualified specialists.


Currently, the PCN model is being implemented in observed settings. A number of nurses care for patients during their stay at the hospital. While the clients seem to be satisfied with the fact that they are able to establish a connection with their care providers, they sometimes become frustrated because of the nurse’s limited scope of knowledge. Moreover, workers experience higher levels of stress as they need to perform many activities that may not correspond with their best capabilities. For instance, nurses who deal with patients that have multiple health-related problems note that their range of operations may be rather extensive. Here, the issue of nursing competencies should be addressed as highly complex patients need sufficient care.


To accommodate patients with complex conditions and increase the level of job satisfaction for nurses, the hospital can implement the synergy model into its practice. According to Spross (2014), this change may help nurses to adequately assess their qualifications and compare them with the patient’s needs. Thus, the problem of nurses being frustrated about their duties should be eliminated. The implementation of the new model may reduce workers’ burnout from dealing with complicated cases. The overall level of satisfaction among patients may also increase as they will remain the focus of attention while being treated by the most appropriately qualified staff. Furthermore, the issue of certain resources being unavailable is also addressed in this model. In this case, if the hospital does not possess the necessary equipment or specialists, the model’s system of evaluation allows nurses to make an appropriate decision. The current model does not have an established practice for discussing this problem in an efficient way.


The paper examines two different models of nursing care. Although both approaches can be considered patient-oriented, their structures are vastly different. The discussed scholarship shows that specialists often implement both strategies in various healthcare delivery settings. However, while the range of opportunities for adaptation for the PCN method is somewhat limited, the synergy model of care is shown to be much more flexible. All in all, this experience allows one to see that some establishments can continue to use older models of nursing care and change them to their particular situation. However, it is always possible to improve the current state of care and add some principles and concepts from newer approaches to provide the best care to the patients.


Finkelman, A. (2017). Professional nursing concepts: Competencies for quality leadership (4th ed.). Burlington, MA: Jones & Bartlett Learning.

Johansson, P., Lundström, K., & Heiwe, S. (2015). The primary nursing care delivery system within a haemodialysis context – Experiences of haemodialysis primary nurses in Sweden. Clinical Nursing Studies, 3(4), 7-14.

Riva, S., Schulz, P., Staffoni, L., & Schoeb, V. (2014). Patient participation in discharge planning decisions in the frame of primary nursing approach: A conversation analytic study. Studies in Communication Sciences, 14(1), 61-67.

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Spross, J. A. (2014). Conceptualizations of advanced practice nursing. In A. B. Hamric, C. M. Hanson, M. F. Tracy, & E. T. O’Grady (Eds.), Advanced practice nursing: An integrative approach (5th ed.) (pp. 27-66). Amsterdam, Netherlands: Elsevier.

Swickard, S., Swickard, W., Reimer, A., Lindell, D., & Winkelman, C. (2014). Adaptation of the AACN synergy model for patient care to critical care transport. Critical Care Nurse, 34(1), 16-28.

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