Nursing Management and Leadership

Post your response and respond to at least three (3) other students’ responses regarding one of the following Team nursing
Primary nursing
Total patient care
Functional nursing
Partnership model

Each response is 100 words and must have one scholarly article referenced in the last 5 years APA 7 format

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Total Patient Care Model

The total patient care model has an emphasis on the patients rather than the tasks that must be completed. Nurses in this model will be responsible for all the patient care for the patients that they are assigned. This is also the kind of experience that we as student nurses experience in the hospital when we are assigned to a patient to take care of all their needs. In comparison to the other methods that are more task oriented when assigning patients, I think that total patient care provides more consistency for the patient. I think that this will be helpful for them because they will have less providers coming in and out at different times disturbing them. They will also be able to develop a deeper therapeutic relationship with the nurse taking care of them, since the nurse will be providing all care. Another benefit of total patient care is the fact that one nurse will be able to follow the patient for the whole shift. This allows for changes from the patient’s baseline to be identified easier, because the nurse has spent so much time getting to know the patient already. There are some negatives to total patient care. By requiring nurses to provide all the care for a patient, resources may begin to become limited. If the nurse is assigned an appropriate number of patients, these tasks are possible. However, due to staff and budget shortages, many hospitals have increased the nurse-to-patient ratio. In models such as total patient care and with a high quantity of patients per nurse, the number of tasks that the nurse can complete within a shift decline (Havaei et al., 2019). Therefore, it may be necessary to have the assistance of patient care technicians to provide support for the nurses and patients. It has been found that in facilities that do not have supportive staff, like patient care technicians, emotional exhaustion increase (Havaei et al., 2019). Without assistance from sources like a patient care technician, in most settings total patient care may not be possible.

Team Nursing

The team nursing model was developed shortly after WW II due to the shortage of nursing staff (Yoder-Wise, 2018). It is thought of as a modification of the functional nursing model and is still applied today when shortages occur within facilities. This model is comprised of a team leader, a registered nurse (RN), who is in charge of supervising a group of employees with varying degrees of expertise, competencies and titles (being RNs, licensed practical nurse (LPN), licensed vocational nurse (LPV), and unlicensed nursing personnel (UAP)). With the common goal to care for a small group of patients. 

According to Khaw et al. (2019), some advantages of this model are improved patient satisfaction, improved quality of and safety of care, job satisfaction, and reduction in cost. This model is a cost-effective system because it utilizes more UAP’s than licensed personnel (Yoder-Wise, 2018). However, how does this impact patient outcomes? Is this truly beneficial?

Khaw et al. (2019) searched several electronic databases and determined there are some major barriers to the use of this patient care delivery method. That being insufficient training/preparation for the change in the model of patient care, deficient knowledge regarding RN team leadership roles and poor leadership skills. As well as the resistance to change and perceptions of unfair work distribution and that the decrease of RN’s would be detrimental to patient care. 

Moreover, research has shown no statistical difference with staff satisfaction after the application of the team nursing model (Havaei et al., 2019). Additionally, it was noted that RN’s working in a skill-mix model with LPNs reported a greater occurrence of poor patient outcomes. The same was witnessed in facilities with higher acuity. I have not witnessed a model such as this in use. With that being said I believe that this model if used correctly with clearly defined roles, strong leadership and appropriate communication amongst team members; when applied could greatly benefit patient care and staff satisfaction. 

how would compare Team nursing versus Partnership model? How are they alike or different?

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