Leadership and Management in Nursing Care Delivery Models

Leadership and Management in Nursing Care Delivery ModelsA caveat lecture mock up is an integral component for delivering uncomplaining care. Nursing care delivery model is a way of organizing at the unit level to facilitate the delivery of breast feeding care to the affected roles (Tiedeman Lookinland, 2004). formation of care is a key factor that determines quality of nursing care (Tiedeman Lookinland, 2004). Various types of care delivery models have been designed to meet the goals of efficient and effective nursing careWhile many varied care delivery models are implementd in the wards and departments of the acute care hospital that I invent in, it is beyond the scope of this paper to discuss them all. In the 20 bedded medical oncology ward that I work in, nursing care delivery is organised into police squad and particular nursing. Six beds are allocated to ingraft patients. One registered nursemaid is depute to be the pristine nurse of three trans envisiont patien ts each. The former(a) fourteen patients are split between ii teams of nurses. Each team has a registered nurse, an enrollight-emitting diode nurse and a patient care assistant. Thus, this paper is concerned with these two modes of organization of care. An overview of simple and team nursing models of care allow be presented. There later, the experiences of nurses involved in the delivery of care using these models of care will be discussed with regards to business organisation satisfaction and quality of care.Description of Care Delivery Model aboriginal squadEmerging in the United States in the1960s, the firsthand nursing model involves patients being allocated to individual nurses (Tiedman Lookinland, 2004). One registered nurse is allocated a number of patients for whose care this nurse is accountable during the patientshospital stay (OConnell, Duke, Bennett, Crawford, Korfiatis, 2006 Tiedman Lookinland, 2004).The nurse-patient relationship is the backbone of ancient n ursing. The capital nurse collaborates with other health team members, the patient and family to continually assess, plan, implement, and evaluate the patients nursing care (Reed, 1988 Sellick, Russell, Beckmann, 2003 Tiedman Lookinland, 2004). When the primary nurse is unavailable to provide care, associate nurses follow the plan of care developed by the primary nurse, unless a change in patients condition necessitates a modification of the care plan, so as to confirm the continuity of care for the patients (Tiedman Lookinland, 2004).Team NursingImplemented in the 1940s as a rejoinder to the nursing shortage contributeing from theWorld War II, team nursing is based on the premise of coaction and division of responsibilities for the nursing care of patients (Tiedman Lookinland, 2004).In team nursing, nurses and ancillary cater with different levels of education, skills and licensure are assigned to teams and each team provides total nursing care to the patients assigned to that team (OConnell et at., 2006 Tiedman Lookinland, 2004). Leadership for each team is provided by a team leader, who is an experienced registered nurse responsible for planning and supervising the provision of nursing care for patients cared for by team members. The team leader has overall account readiness for coordinating the nursing care provided, while the team members are accountable for completing their assigned tasks and for documenting the care delivered (OConnell et at., 2006).Nursing Staff trick SatisfactionPrimary TeamOne of the most important gains of primary nursing for the nurses interviewed was much encounter and enhanced relationships with patients. One nurse said, I know more about each of my patients and do not constantly have to get to know new ones. These views are consistent with Mccleod and Stellas (1992) learning where nursing faculty on medical and surgical wards were asked what they cared about primary nursing. Participants liked the enhanced rela tionships and collaboration with patients and other members of the healthcare team. To be able to take care of the same patients day after day was greatly appreciated by the nurses interviewed. This continuity of care led to the development of good relationships between the primary nurse and the patient as well as with relatives. This is an aspect that the nurses found increased their levels of rail line satisfaction (McCleod Stella, 1992).Primary nursing facilitated an in-depth knowledge of their patients and as a consequence, the nurses felt more able to act as a patients advocate. Nurses verbalised they had additional responsibility and accountability as all duties and responsibilities in taking care of a patient for his or her duration of stay is delegated entirely on a single nurse. The primary nurses interviewed sensed that they had the authority to make clinical judgments and decisions for the benefit of the patient. Their use of phrases such as freedom from control by oth ers, ability to plan and organize the workday, using knowledge to make decisions and advocating for the patient described autonomy. Autonomy refers to the ability to act according to ones knowledge and judgment, providing nursing care within the full scope of practice as defined by existing professional, regulatory, and organizational rules (Gagnon, Bakker, Montgomery, Palkovits, 2010). The nurses noted that through practicing primary nursing, their autonomy was increased.There is a substantial body of evidence indicating that nurses perceived autonomy is linked to job satisfaction. A study by Melchior, Halfens, Abu-Saad, Philipsen, van den Berg Grassman (1999) investigated the effects of a primary nursing care delivery dust on the work environment among nurses working in long-stay psychiatric care settings. Results showed that as a result of primary nursing, the nurses found more autonomy in their work and thus experienced increased job satisfaction. Similarly, Macguire and Bott ing (1990) analysed the perceptions of nursing staff, following the introduction of primary nursing into an acute medical ward for elderly people. Nurses report better communication, improved relationships and increased responsibility after implementing primary nursing. It appeared that both increased autonomy of practice and increased knowledge of specific patients, coupled with a greater continuity of care, gave nurses a high level of satisfaction than did previous methods of care delivery (Macguire Botting, 1990).On the downside, almost nurses commented that working in a primary care system tends to be isolating and this proved to be particularly difficult when they were looking after a critically ill patient. These experiences mirrored those reported by nurses in the study by Manley, Hamill, and Hanlon (1997).Team NursingNurses practicing team nursing commented that working as a team was a lot better, because past they can have somebody else backing them up. According to OCon nell et at. (2006), working collaboratively with team members serves to enhance job satisfaction, as many find this to be a learning experience that utilizes the expertise of each team member. This was back up by Rafferty, Ball, and Aiken (2001) who demonstrated that nurses who report a higher level of teamwork are more satisfied with their jobs, plan to stay in them, and are likely to experience less stress.However, enrolled nurses and the patient care assistants interviewed added that they felt the staff nurses were spending too much time with medications and writing reports while they were left to do the heavy manual work. A similar finding was demonstrated by OConnell et al. (2006). In this study, both registered nurses and enrolled nurses felt that the team-nursing model sometimes involved an uneven and unfair division of tasks that overburdened some nurses. The medication responsibilities of registered nurses within the team-nursing model obligate excessive demands on enrol led nurses as they were left with meeting the hygiene needs for the patients in their group without assistance. These tensions led to a decrease in job satisfaction.Quality of CarePrimary TeamThe nurses interviewed felt patients were more satisfied when primary nursing was in place because they received individualized care as a result of continuity and coordination of care. Primary nursing has led to the nurses having a better knowledge of the patient. Nurses pointed out that primary nursing enabled them to know each patient more closely. One nurse remarked, I know my patients like the back of my hand. Therefore, it was easier to find out what each patient needed and to meet those needs appropriately. Jenny and Logan (1992) intimate that greater knowledge of the patient is linked to the increased likelihood of picking up subtle changes in the patients condition. In addition, Perala and Hentinen (1989) found that through primary nursing, doctors received information about patients t hat was more exact and pertinent because nurses knew their patients better. This enabled nurses to provide more applicable and effective patient centred nursing care. In response to this therapeutic relationship, the patient feels more secure about and satisfied with nursing care (Jenny Logan, 2000). The nurses views were supported by the findings of Radwin (2000). In this study conducted over a 3-year period, oncology patients were asked to identify qualities of nursing care that were important to them. Professional knowledge, joint decision reservation between the patient and the nurse, individualized treatment plans, promptness to addressing individualized needs and continuity of care were some aspects of care delivery that were identified.Team NursingNurses interviewed said that since staff was administer more closely, the likelihood of missing things out was low. This, they felt, resulted in patients receiving better care. This sentiment was echoed by the nurses in OConnel l et al.s (2006) study. Moreover, nurses added that the patients benefitted from the combined skills of the team. According to the study by Cioffi and Ferguson (2009), team nursing made a difference to patient care as it was patient-oriented, all the nurses in the team were familiar with the patients receiving care, care was more complete as things were missed less often and staffs were supervised more closely. This resulted in patients receiving better care.In conclusion, providing care to a group of patients require nurses to be more efficient and use their time more effectively. Nursing care delivery models facilitate this. This paper has provided an overview of primary and team nursing care delivery models. The experiences of nurses were discussed with regards to job satisfaction and quality of care in the two models. Literature supporting the nurses experiences was then explored.