Successful nursing care delivery is one of the main goals of any nurse or other medical worker. It is not enough to focus on autonomy, accountability, and responsibility as the individual abilities that have to be developed. Nurses, as well as health care organizations, should also recognize and comprehend the nature of the chosen nursing care model to promote change and make improvements. According to Finkelman (2016), there are many approaches and models modern nurses like to work with. In my nurse practice setting, attention is paid to the development of a team nursing model because the leaders believe that traditional nursing and attention to communication is the key to successful healthcare delivery.
Nursing Care Model in Practice
Not many hospitals and medical centers practice team nursing because of the intentions to use new nursing models and rely on the recent technological achievements. In my practice setting, team nursing was offered as the main model of the work several years ago. Because of the evident problems with nurse shortage and the necessity to work with many patients and doctors at the same time, the teams of three or five nurses provide patients with total care during their 8-hour shifts (Finkelman, 2016).
Peculiarities of Team Nursing: Who and What
Today, the team nursing model that was introduced after WWII undergoes considerable changes in regards to the needs of patients, collaboration, and the necessity to offer patient-centered care (Finkelman, 2016). Our nursing teams demonstrate several benefits and positive outcomes. It is necessary to admit that each team has a leader or a registered nurse, who may usually be supported by a charge nurse, two staff nurses, and one licensed nurse. Each nurse has several duties and responsibilities to be fulfilled. For example, a registered nurse should follow the schedules of other team members and provide patients with direct care by observing and monitoring them. In some teams, these functions are divided between a registered nurse and a charge nurse. However, it is hard to find the required number of nurses for all groups. Staff nurses work directly with patients at their bedsides and report to their leaders. A licensed nurse performs basic duties, observes patients, and report on vital signs that may occur after taking medications. As a rule, licensed nurses should also follow the notes that are given in their patients’ charts.
The success of our team nursing may be explained by the possibility to get used to each other and know what to expect from every team member. Each shift has to be introduced in all cases and make conclusions in time. Sometimes, nurses ask to replace them because of illness or personal problems. In such situations, nursing teams should not ask for a new nurse. Each member tries to offer an idea so that the team could think about the alternatives of how to work without one player. Awareness of team members, the abilities to divide duties respectfully, and the possibility to replace each other in case of emergency are the main benefits of such a model.
Team Nursing Aspects: Where and When
Sometimes, according to team nursing models, nurses have to work not eight, but twelve hours per day. Such cases happen when another group cannot start working in time, or the current state of affairs makes people change their plans and increase the number of working hours. As a rule, these details are discussed with the registered nurse, who has to talk to another leader in a hospital. In other words, mutual discussions, cooperation, and consistency remain to be the main factors in team nursing.
If there is a day shift, all details are discussed as soon as all members are gathered. The leader provides other members with a brief introduction of all hospital cases at the moment and clarifies the tasks that should be performed. As a rule, our registered nurse comes one hour earlier than other members to get prepared for briefing and not to waste other members’ time. In other teams, some registered nurses find it normal to make the team wait and communicate with other nurses to gather more information. At this moment, we have five teams of nurses that work 8 hours per day at three different shifts and two weekends.
Scholarly Support of Team Nursing
Though Finkelman (2016) does not believe that team nursing is an effective nursing model for modern nursing and focuses on such models as interprofessional practice or patient navigation, there are many scholars, who support the chosen model and promote its usage in different settings. For example, Deravin, Francis, Nielsen, and Anderson (2017) introduce team nursing as a model that may address several safety issues and patient care at the same time and help to reduce nursing stress and increase job satisfaction.
The investigations of Zimbudzi (2013) on the quality of care offered to the patients with acute hemodialysis also prove the effectiveness of the team nursing model. Team nursing is successful for patients and nurses because it promotes the development of communication and collaboration between small groups of people and the possibility to learn less to achieve more. In other words, in both projects, as well as in my practice setting, team building is defined as a positive model that helps nurses to provide their patients with high-quality care and support in time.
However, not all researchers and scholars are ready to support team nursing. As well as Finkelman (2016), Malcolm, Shellman, Elwell, and Rees (2017) find interprofessional nursing models rather attractive because of the possibility to address several issues at once. The work of the teams does not become as crucial as it is in the model under analysis in this paper because interprofessional models make nurses focus on their knowledge and abilities but not on cooperation.
Payne and Steakley (2015) do not find it necessary to set the priorities and support the idea of a primary nursing model of care as the possibility to improve team nursing, promote autonomy, and use various educative tools. Primary nursing is the model that replaced team nursing in the late 1970s (Finkelman, 2016). Nowadays, modern researchers want to prove the strengths of professionalism and knowledge in nursing and underline the weaknesses of communication and collaboration that are usually inherent to the work of nurses, who choose team nursing models. The discussions and debates on the effectiveness of nursing models occur regularly in many hospitals, and it is the responsibility of their leaders to evaluate patients’ needs and nurses’ abilities and to make the final decision.
Implementation and Recommendations
Taking into consideration the evaluation and the analysis of different models and the possibility to observe how one particular model, team nursing, could be implemented in the practice setting, it is possible to say that this model has its strengths and weaknesses. On the one hand, the team nursing model helps nurses investigate their needs, develop responsibilities, and collaborate in the most appropriate for their ways. On the other hand, team nursing does not presuppose the necessity of education and engagement. However, knowledge is a crucial aspect of any kind of work.
Therefore, one of the possible ways to improve the quality of nursing care and safety and increase the level of nurse satisfaction is to pay attention to another nursing care model. For example, our hospital may use the synergy model for patient care where nurses’ competence has to be matched with patients’ needs, characteristics, and clinical units (Finkelman, 2016). Nowadays, there are many patients with severe diseases when the critical care setting is required. Still, not all acute care is usually offered within the hospital setting. To provide patients with any kind of help at any place, nurses have to investigate their competencies and learn how to combine them in regards to the needs of their patients. As a rule, nurses have to think about the needs and expectations of their patients before providing them with care. In such cases, the offered synergy model may be effective.
Conclusion and Summary
In general, the recent experience helps to make several important conclusions about the quality of nursing care and the necessity to choose an appropriate nursing care model. The discussions developed by Finkelman help to recognize several models and approaches nurses could choose in their work. The evaluation of several scholarly articles proves that each model may have its pros and cons in particular practice settings. Still, each time nurses come to a hospital, they have to realize that it is not enough to work according to a model or to take care of patients only. Nursing is a complicated process, and knowledge, practice, and personal engagement should matter in any step taken and every decision made.
Deravin, L., Francis, K., Nielsen, S., & Anderson, J. (2017). Nursing stress and satisfaction outcomes resulting from implementing a team nursing model of care in a rural setting. Journal of Hospital Administration, 6(1), 60-66.
Finkelman, A. (2016). Leadership and management for nurses: Core competencies for quality care (3rd ed.). Boston, MA: Pearson.
Malcolm, M., Shellman, J., Elwell, J., & Rees, C. (2017). GOT! Care: Preparing the emerging healthcare workforce for interprofessional collaborative practice: A pilot study. Health and Interprofessional Practice, 3(2), 2-12.
Payne, R., & Steakley, B. (2015). Establishing a primary nursing model of care. Nursing Management, 46(12), 11-13.
Zimbudzi, E. (2013). Discovering the untapped benefits of team nursing in an acute haemodialysis unit of a major teaching hospital. Journal of Nursing Education and Practice, 3(8), 149-153.