Topic: The Caring Model / Great in Theory

But not practical in this day and age. 30 years ago with not as accute patients this “team approach” worked – but now with sicker patients, quicker turn around time between admission and discharge – numerous time consuming chores for the RN (patient assesments, iv starts, lab draws, and the never unending documentation process) it is just not feasible. In the old days one could actually have time with their patients and family’s but not in these days and times. Like I said nice in theory, and this is not a new concept just a revived concept, and it is not practical in this day and age.

Topic: The Caring Model / Team nursing...

I am an LPN working at a long term acute care hospital. We have recently been told that we are going to the “team nursing” approach to patient care. I have been a nurse for over 20 years, and have done this before. I know it can work as long as all members of the team work together in a collaborative effort to get things done; but I also know that if there is a situation in which one team member does exclusively one duty, and the other does another duty…then there are many other aspects of care that get ignored or delayed or just simply not done; because no one knows who should be responsible for it. For an example, on a team of say, 12 patients; one nurse does the meds for the whole team, another does the assessments for the whole team; but then the things like wound care and dressing changes, blood sugar checks, lab draws, and of course; turning and repositioning and cleaning patients….much of these things don’t get done in a timely manner; because the two licensed team members are so busy getting thier duties done for so many patients…they don’t have time to stop in between to tend to the other things. We are proposing that withing this “team effort”, there also be a collaborative effort to talk to each other and decide things like splitting up the meds and charting, so it gets done; leaving time then to approach the other things like wound care and dressing changes, lab draws, blood sugars…and so on; as a team together. We have until the 11th of September to come up with a plan and present to our manager. I am looking for input from others as far as how team nursing has worked, and what capacity or flexibility within that team has proven affective in getting patients properaly cared for.

Topic: Patient Centered Care / Patient Centered Care in Nursing

The innovative model is superb, outstanding and I wish I could work there!
However, I feel the role of the nurse in patient-centered care is to an extent, elusive.

As a RN at the bedside in medical/surgical units, I have come for focus my initiative on the patient. I was a critical care nurse, Cardiology nurse in the Catheterization and Electrophysiology labs, and a telemetry nurse. Although, I loved my roles, it is on the medical/surgical units that I can deliver patient/family-centered care. This is where my nursing skill and critical thinking are called upon with the greatest need.

As a nurse educator, I see the utmost value of role modeling and guiding the future nurses in an environment the both lacks and is in critical need of a patient focus. As technology advances, and the nurses’ population ages, there is a gap in patient-nurse interaction; not by the choices of any nurse, but by the nature of care delivery in response to the growing demands of acuity.

As a doctoral student of nursing science, my pursuit of information relating to patient-centered care in nursing, technology and in general has emerged from a primarily physician focus. This is outrageous. I completely respect the physician direction, but I am frustrated at the lack of emphasis on the role of the nurse-patient-centered care. Therefore, it is essential to implement strong initiatives toward patient-centered care, in promotion to become the norm, not the exception in the delivery of nursing quality and quantity care to and with patients and families.

Nurses are far past the role as handmaiden to the physicians. Today a patient-centered care model needs to include a strong role for both the physician and nurse as an invaluable team toward the delivery of patient-centered care with the patient as the third and most important member at the center and constant focus of care. Where one team member is in the primary role at one point, the others are in the supportive roles, of which continually interact and change in a fluent cohesiveness. This is patient-centered care.